Orthopedic care

Arthroscopy is a minimally invasive procedure. It uses a small camera system and instruments to visualize and repair a joint, such as the knee. It is usually performed on an outpatient basis.

Our bone and joint specialists commonly use arthroscopy for:

• Improving instability
• Removing cartilage
• Removing the joint lining
• Repairing soft tissue tears
• Treating early-stage arthritis

One of the most common arthroscopic procedures is hip arthroscopy to repair a labral (cartilage) tear. Most patients can walk with crutches one to two weeks after the procedure while undergoing six weeks of physical therapy.

Ligament and tendon injuries are often associated with sports activities. However, ligament tears can also occur during more "routine" activities, such as reaching overhead for something on a high shelf.

Using a thorough exam and medical imaging, we diagnose your injury and work with you to decide on the appropriate treatment plan. If surgery is necessary, our surgeons are board certified in orthopedics with advanced training in arthroscopic repairs of ligament injuries.

Traumatic injuries to the extremities often result in severe fractures of one or more bones.

There can be a single fracture (break) in the bone, or the bone may be shattered into numerous pieces (comminuted). Additionally, the fracture may be closed or open. An open fracture means there is an injury to the surrounding soft tissues, and the bones are visible.

Our orthopedic doctors may use one of the following options to stabilize a fracture:

• External fixation — This involves placing pins in the bone on each side of the fracture from the outside of the injured extremity. (The pin is exposed through the skin.) The pins are then connected with a rod that is also outside of the extremity.
• Internal fixation — This technique is used when the fracture can be realigned, and a plate with screws or an interlocking rod hold the bones in alignment.
• Ring fixator — This device may be used to keep fractured bones in alignment. It is often used if there is a deformity to correct or if there is bone loss that is not addressed with allograft bone or vascularized bone flaps.

The hand is a complex structure, allowing you to execute very fine movements and feel a variety of sensations at any given moment. Our hand specialists understand this complexity and offer highly specialized hand and upper extremity care, including hand rehabilitation.

Some of our hand and arm treatments include:

• Reimplantation following a traumatic upper extremity amputation
• Skin and nerve grafting for a hand injury
• Ulnar nerve decompression

Hip replacement surgery replaces a damaged or arthritic hip joint with a prosthesis (implant).

Our orthopedic surgeons use the anterior approach for hip replacement whenever possible. This technique allows the doctor to access the hip socket from the front of the hip, moving around the muscle instead of cutting through it. This reduces postoperative pain and the chance of hip dislocation. It also allows for a quicker recovery.

We know ongoing pain in your knee has limited your ability to enjoy the things you love. We want to help you get back to the activities you enjoy and live a life without knee pain.

The surgical team at HCA HealthONE Presbyterian St. Luke's (P/SL) uses a state-of-the-art robotic system to make your surgery less invasive and more precise and get you back to an active life faster.

What is robotic knee surgery?

Dr. Kareem Sobky, a renowned orthopedic surgeon, is specially trained in robotic knee surgery. He and the HCA HealthONE P/SL surgical team use a very effective robotic system as a high-tech assistant during surgery.

Your surgery is not performed by the robot alone. Instead, the robot helps your team create an individualized, detailed plan for your surgery. It then aids your doctor during surgery by providing real-time images of the inside of your knee. The robot also holds tools in place and helps navigate delicate areas. This allows your surgeon to precisely place and size your knee replacement to match your anatomy and restore your knee as close as possible to the state it was before arthritis or injury.

Who can have robotic knee surgery?

This kind of surgery might be right for you if:

• You have severe knee pain, swelling or stiffness and exhausted other treatments
• Your doctor has diagnosed either a degenerative joint disease such as osteoarthritis, traumatic arthritis, avascular necrosis, rheumatoid arthritis or knee deformity and instability
• You have not found enough pain relief with treatments such as bracing, medication, physical therapy, and injections

Only your doctor can determine if you are eligible to have robotic knee surgery. Your doctor will consider your health history and current needs to help decide if this surgery would be right for you.

How does robotic knee surgery work?

In the operating room, small state-of-the-art cameras are attached to your leg. The robot tracks the motion of the cameras, making thousands of data points to assess motion, rotation and stability of the knee relative to your hip and ankle.

Throughout your surgery, the robot’s camera and trackers continuously assess the exact position of your leg, adjusting as necessary to ensure the very best fit as well as alignment to within 1 degree, and enhanced stability. This also allows for less exposure to the bone marrow and less bleeding during surgery.

What are the benefits of robotic knee surgery?

The robot allows Dr. Sobky and the team to take the least invasive approach. Additionally, the high-level planning and assistance during your procedure help make the surgery more accurate. The more accurate the procedure, the more normal the knee should feel. This often means reduced blood loss, less pain, shorter stay, faster recovery, and potentially longer-lasting knee replacement.

For more than 30 years, the Institute for Limb Preservation at HCA HealthONE Presbyterian St. Luke's has been the Rocky Mountain region's premier facility for treating diseases and traumatic injuries of the extremities. Here, we provide a highly specialized limb preservation program for people at risk of losing limbs.

Our goal is to salvage the limb and avoid amputation. As such, we have a multidisciplinary team, which includes vascular surgeons, orthopedists, plastic surgeons, neurologists and infectious disease specialists. This highly esteemed limb preservation team works collaboratively on complex cases, such as treating bone tumors with intra-arterial chemotherapy and a growing prosthesis.

The Spine Center at HCA HealthONE Presbyterian St. Luke's is a 36-bed unit dedicated to spine health. Here, our spine specialists diagnose and treat a range of conditions, from infantile scoliosis to cervical stenosis. We also offer pain management techniques, minimally invasive treatments and spine surgery to restore your health.

Physical therapy may be prescribed to help you recover from an injury or to help you make a full, healthy recovery after surgery. To help with that, we provide inpatient and outpatient physical therapy and rehabilitation services at our hospital.