In addition to specialized services, Iowa Ortho offers general orthopaedic service for all your orthopaedic needs. General orthopaedic surgeons care for bone, muscle, ligament, and tendon disorders.  These can be the result of injury, disease, infection, tumor, or congenital causes.  We offer a multidisciplinary approach providing a complete array of therapeutic, diagnostic, and state-of-the-art surgical orthopaedic technology to our patients. Iowa Ortho’s board certified general orthopaedic surgeons and experienced clinical staff provide the full range of general orthopaedic services, from basic to complex including

• Sprains and dislocations;
• Simple to complex fractures;
• Treatment and diagnosis of knee, hip, shoulder, hand, and back pain;
• Complex trauma-related bone and joint disorders;
• Carpal Tunnel and Ulnar Tunnel Syndromes;
• Total Joint Replacement of the hip, knee, and shoulder;
• Minimally invasive surgical techniques;
• Arthroscopic repair of ligament tears, and rotator cuff tears;
• Operative and nonoperative management
• Synvisc Injections (Joint Fluid Supplementation);
• Steroidal Injections;
• Work Related Injuries.

Orthopaedic Fractures
A fracture is the separation of a bone into two or more pieces caused by extreme stress to the bone during trauma. Fractures can be closed (the skin is not disrupted during the fracture), or open (the skin has been ruptured).  Fractures caused by trauma range from simple falls causing hairline fractures to more serious body-altering fractures causing life threatening physical injuries. Our physicians provide coverage for emergency trauma and fracture care for accidents involving motor vehicles, falls, and work-related incidents, among others.

Iowa Ortho is dedicated to providing state-of-the-art comprehensive clinical evaluation, treatment, and management for orthopaedic fractures for pediatric through adult patients.

Sprains  
Ligament sprains – A ligament sprain refers to a partial or complete tear of ligament substance. Ligaments are comprised of millions of fibers of collagen, intertwined and woven similar to strands that comprise a rope. When a ligament is sprained, portions of the fibers can be damaged or torn. In low-grade or minor sprains, only a few of the fibers are torn.  Pain may be associated with this type of sprain, but usually patients do not experience instability from the ligament being too loose. In higher grade or complete sprains, a large portion of the fibers are torn causing the ends of the ligament to be fully separated from each other.  When this occurs, pain is usually accompanied by instability of the joint as well.  The majority of minor sprains can be treated with activity modification, anti-inflammatory medications, and time. However, for more serious high-grade sprains/tears of ligaments, surgical treatment may be necessary.

Muscle Strains – Muscle strains are similar to ligament sprains, except that they occur in muscle tissue rather than in the collagenous ligament substance.  Muscle sprains are also rated based upon a few of the muscle fibers being torn to a complete tear.  Treatment necessary is based upon the type of strain and the degree of injury, similar to ligament tears.

Total Joint Replacement
Iowa Ortho is recognized as a leader in total joint replacement in achieving exceptional clinical results in the treatment, management, and replacement of diseased and injured joints.  The goal of joint replacement is to reduce or eliminate pain in the affected joint, increase the level of function, and restore motion to the hip, knee, shoulder, or other joint injured or damaged by trauma, disease, or conditions that occur through the natural process of aging.  Iowa Ortho offers the most advanced state-of-the-art minimally invasive joint replacement techniques available.

Joint Camp
Iowa Ortho recognized that state of the art joint replacement surgery of the hip and knee would be complemented by state of the art recovery and rehabilitation, and teamed with Mercy Medical Center, a leader in joint replacement rehabilitation, to develop a Joint Camp for patients undergoing hip and knee joint replacement procedures.  The purpose of Joint Camp is to integrate surgery, recovery and rehabilitation into one continuum for patients and their caregivers.   [For more information on Joint Camp go to the Orthoscope link on the homepage and select the Winter 2007 issue] 

Synvisc Injections (Joint Fluid Supplementation/Viscosupplement)

When knee joints develop osteoarthritis, normal joint fluid, called synovial fluid, becomes thinner, losing its ability to lubricate and cushion the knee joint. Without this cushioning, cartilage in the knee joint may wear down over time, causing pain, stiffness, and reduction of occupational or recreational activities. Joint fluid supplementation can improve the cushioning and lubricating effects of synovial fluid that has been damaged by osteoarthritis.

Synvisc is injected directly into the knee joint replacing damaged or absent synovial fluid with a substance similar to that found in healthy joints without disease.  Injections are given over the course of 3 visits to your orthopaedic surgeon, 1 week apart.  It’s necessary to achieve the maximum benefit by receiving all 3 injections. 

Many patients begin to experience relief of symptoms after the first injection, but typically most patients feel the most significant relief of knee pain 8 weeks after the first injection.

Synvisc is most effective for mild to moderate osteoarthritis.  Your orthopaedic surgeon will do a thorough examination and may recommend obtaining x-rays to determine the level of progression of osteoarthritis.  Although Synvisc is most widely utilized in the knee joint, it can be effectively used in other joints as well. 

Synvisc was approved by the FDA on 08/08/97.  Side effects are relatively minor and may include redness at the injection site. 

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a painful disorder of the wrist and hand.

Repetitive hand movements can lead to carpal tunnel syndrome. Carpal tunnel syndrome (CTS), is most commonly found in people whose occupations require pinching or gripping with the wrist held bent. People at an increased risk to develop CTS include those who use computers, carpenters, assembly-line workers, and meat packers. Recreational activities such as gardening, needlework, golfing and playing the piano can sometimes bring on the symptoms of CTS.

CTS can be brought on by other conditions or injuries.  It may be caused by an injury to the wrist, such as a fracture or dislocation.  It can also be caused by some diseases including diabetes, rheumatoid arthritis or certain thyroid diseases.  Carpal tunnel syndrome is also common in women during the last few months of pregnancy, usually resolving upon delivery without intervention.

Joint and Soft Tissue Injections
Your orthopaedic surgeon may recommend an injection into the painful affected joint or surrounding area of soft tissue.  Injection of anti-inflammatory medicines such as corticosteroids and pain relievers (lidocaine and xylocaine) are among the most commonly used medicines for joint and soft tissue injections.  Before injecting the joint or soft tissue, the physician may remove fluid around the joint. 

Joint and soft tissue injections are done by inserting a needle into a joint or soft tissue space between the muscle and bone.  These injections can be used diagnostically or therapeutically to reduce pain from many different conditions, including arthritis in the joints, tendonitis, carpal tunnel syndrome, and bursitis.

Shoulder Disorders
A common area of shoulder pain is soreness of the tendon (a cord that attaches a muscle to a bone) of the rotator cuff (the part of the shoulder that helps circular motion). Shoulder soreness and pain can also be caused by the subacromial bursa (a sac of fluid under the highest part of the shoulder). The shoulder is susceptible to acute traumatic injuries, wear-and-tear conditions caused by repetitive activities, athletic activity, heavy lifting, and arthritis.

The shoulder is a complex joint that allows for full rotation of the arm.  The shoulder joint itself is a shallow socket.  Due to its many uses for daily activities and the frequency with which arm movements are necessary, the shoulder is susceptible for injury.

Common shoulder conditions and injuries include:

• Shoulder Instability
• Shoulder Fractures
• Rotator Cuff Tears
• Tendon Tears and Ruptures

Rotator Cuff Tears

The rotator cuff is a sheet of tendon originating from four small muscles on the scapula, or shoulder blade.  They blend together to attach to the humeral head, or ball of the shoulder. When surgical repair is necessary, there are three commonly utilized surgical techniques for rotator cuff repairs:  open repair, mini-open repair, and arthroscopic repair.  Arthroscopic repair is a minimally invasive technique, utilizing multiple small incisions, called portals, and the use of arthroscopic technology to visualize and repair the rotator cuff through the small openings.  A repair performed using the arthroscopic technique is less invasive due to the smaller incisions, resulting in less tissue disruption, and decreased blood loss during surgery.  In most cases this usually means the patient has less pain post-operatively.  Additionally, arthroscopic repairs are often done as an outpatient procedure and do not require hospitalization.

When selecting Iowa Ortho for your orthopaedic needs, you can be confident of receiving excellent, comprehensive surgical and non-surgical services that meet patients’ diverse orthopaedic needs – from a sprain steroidal injection, to joint replacement.  In addition to our general orthopaedics, Iowa Ortho offers sub-specialty areas including sports medicine, spine, hand and upper extremity, shoulder, foot and ankle, pain management, physiatry, and pediatric and adolescent orthopedics.  From treating Drake University and Iowa Cub athletes to caring for the full range of orthopedic needs in the communities we serve, Iowa Ortho remains committed to providing the patients who select Iowa Ortho with the excellence in orthopedic care.  We consider it a privilege to be selected as your orthopaedic providers.  When you need orthopaedic care, call the experts at Iowa Ortho at 515-247-8400, or toll free 800-642-6381...you can place your trust in us.