Orthopedic care at Presbyterian/St. Luke's Medical Center

Orthopedic doctors in Denver

When you have an injury or joint pain that limits your daily activities, you need to see one of the top orthopedic specialists in Denver. You can get that level of care at Presbyterian/St. Luke’s Medical Center, where you will be evaluated and treated by nationally recognized orthopedic doctors.

For example, our orthopedic specialists have been recognized as leading physicians by local and national sources, such as:

• Best orthopedic surgeons by U.S. News & World Report
• Top doctors by 5280
• Best doctors by Denver Business Journal

For more information about Presbyterian/St. Luke's Medical Center's orthopedic services, please call (800) 262-5462.

Bone, joint and muscle conditions we treat

Our orthopedic specialists diagnose and treat a variety of conditions, including:

Our orthopedic clinic's services

Presbyterian/St. Luke’s Medical Center features advanced technology and an experienced orthopedic care team. Whether you are seeking care for hip pain or a back injury, we provide comprehensive services to get you back on your feet.

Arthroscopy

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 tear. (The labrum is a ring of cartilage in your hip socket.) Most patients can walk with crutches one to two weeks after the procedure while undergoing six weeks of physical therapy.

Ligament and tendon injury care

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.

Fracture stabilization

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.

Hand and upper extremity care

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:

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

Hip replacement

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.

Knee replacement

During a total knee replacement, the entire knee joint is replaced with a prosthetic joint because all parts of the joint are damaged. In a partial knee replacement, only the damaged or diseased parts of the joint are replaced with prostheses.

Based on your age, medical history and the condition of your knee and ligaments, your knee doctor will determine if a partial or total knee replacement is right for you.

Orthopedic rehabilitation

Physical therapy may be prescribed to rehabilitate 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.

Institute for Limb Preservation

For more than 30 years, the Institute for Limb Preservation at Presbyterian/St. Luke's Medical Center 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 patients 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.

Targeted muscle reinnervation for people with amputations

Targeted muscle reinnervation (TMR) is an innovative procedure that can improve prosthetic use in patients with above elbow amputations and shoulder disarticulations. Additionally, up to 85% of amputees experience phantom limb, neuroma and residual limb pain. By rerouting nerves damaged during amputation and giving them a place to transmit their signals, TMR can help to reduce these types of pain.

At Presbyterian/St. Luke’s Medical Center our innovative team has provided this advanced, delicate procedure—one of the few centers in the nation—since 2015.

Pain prevention and improved prothesis control

Presbyterian/St. Luke’s offers both primary and secondary TMR as part of the Institute for Limb Preservation, a unique program specializing in the treatment of conditions and diseases that place patients at risk of losing a limb.

Primary or acute TMR (Above elbow amputation and shoulder disarticulation) is performed at the time of amputation. As part of the amputation, the nerves that control the hand, wrist and elbow are rerouted into residual muscles in order to control a prosthesis in an intuitive manner.

Primary TMR patients can control their prosthesis intuitively, simply by thinking about natural movements. Nerves that control the hand and wrist are rerouted to residual muscles and thus by thinking of the hand or wrist motion that is required for a task, the muscle will amplify that signal and send it to the prosthesis to be carried out naturally. In other words, think about closing the hand and the prosthesis will close the hand.

Secondary or delayed TMR is performed for amputees who have already had an amputation without TMR. This can be done for either patients experiencing phantom limb pain, painful neuromas or residual limb pain or for upper extremity amputees who wish to have better prosthetic control. For these patients, rather than learning to use a prosthetic, the prosthetic learns how to interpret the patients desire for movement. Additionally, when nerves are rerouted to specific muscles, patients have more targeted muscle function, allowing for more refined movements and a wider range of motion with a myoelectric prosthetic.

Who is a candidate for TMR?

Patients having significant phantom pain or residual limb and neuroma pain at all levels of amputation in upper and lower extremity should be evaluated to see if they are a candidate for TMR. Additionally, those interested in the procedure to better control their prosthetic can undergo a medical review to determine their eligibility.

The TMR team

As part of our Institute for Limb Preservation, the TMR team offers patients the benefit of working with a multidisciplinary group of professionals with years of specialized training and experience. The team members include:

• Plastic surgeon
• Physical therapist
• Orthopedic surgeons
• Prosthetists
• Certified hand therapist/occupational therapist
• Patient navigator

For a consultation to discuss if TMR is right for you, please call our patient navigator at (800) 262-5462.

The Spine Center

The Spine Center at Presbyterian/St. Luke's Medical Center 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.