Orthopedic Services



Specializing Institutions

Orthopedics is the study of the musculoskeletal system. Orthopedists specialize in the diagnosis and treatment of problems with bones, joints, ligaments, tendons, muscles and nerves. There are a lot of professions that offer non-surgical treatment alternatives for many orthopedic conditions, such as chiropractic, podiatry and occupational therapy. The most common conditions in orthopedics are musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumors and congenital disorders. Currently, more than one in four Americans suffer from a musculoskeletal impairment, with back and knee being the most prevalent.

Patients looking for excellence and innovation in orthopedic procedures will find it at the South Texas Medical Center. Some of our institutions have nationally recognized orthopedic care services, Joint Replacement Clubs and support groups, pediatric and geriatric orthopedics, and rehabilitation. Procedures available to patients at the South Texas Medical Center include total knee and hip replacement, shoulder care, spine surgery, orthopedic trauma care and orthopedic rehabilitation.

Some of the best orthopedic physicians and specialists in south central Texas work and research at the South Texas Medical Center to bring patients the best and latest in sports medicine, cartilage restoration, orthopedic reconstruction, joint replacement and advanced spine procedures. Specialists are also available to help patients recover after surgery through a friendly rehabilitation process. The South Texas Medical Center is also home to the Acute Rehabilitation Center, which is accredited by The Joint Commission and The Commission on Accreditation of Rehabilitation Facilities, to assist patients during every step of the rehabilitation process.

Orthopedic Articles

  • REFILE-Needy patients to get new hips or knees for free next week

    (In first sentence, changes "two years" to "three years")

    By Randi Belisomo

    (Reuters Health) - Excruciating hip pain forced 50-year-old Army veteran David Chalker to leave his machinist job three years ago, a decision that led to mounting debt, inability to afford health insurance and even a move into his in-laws' home with his wife and three daughters. But his family is counting on one operation next week - entirely free of charge - to change the course of both his health and finances.

    The Long Island, New York resident is one of 120 patients scheduled for hip or knee replacement during the first week of December, provided by Operation Walk USA. The nonprofit organization is a coalition of 85 orthopedic surgeons in 23 states volunteering to operate on patients who do not qualify for government assistance but cannot afford surgery on their own.

    "I would have been in miserable pain for the next who knows how many years until I got enough money to get insurance," said Chalker, who gave up his family's health coverage last year when his rate spiked to more than $1800 monthly.

    Chalker's wife, Lisa, said she felt like she won the lottery when they learned he met requirements for surgery. "We have a chance at a new start, he has a chance to be pain-free, and we can get back on our feet," she said.

    Orthopedic surgeon Matthew Hepinstall will implant Chalker's two new hips next Friday at Franklin Hospital in Valley Stream, New York. On Wednesday, Hepinstall will provide two other free surgeries at Manhattan's Lenox Hill Hospital.

    "The patients involved have severe difficulty walking, severe difficulty with daily activities and severe daily pain," Hepinstall said. "The operation will improve their ability to walk and ability to work and provide for their family."

    Since 2010, Operation Walk USA has provided more than $13 million in services for nearly 500 patients. To qualify, patients must be U.S. citizens or permanent residents, fall within 100 to 200 percent of federal poverty guidelines and have no access to Medicaid, the government program that helps with medical costs for some people with limited income.

    Pre- and post-operation services, like physical therapy, are free of charge. Implants are donated by device manufacturers, and doctors, nurses and technicians volunteer their time and skill.

    The biggest barrier to growth of the program, according to founder Dr. Adolph Lombardi, is finding hospitals willing to donate space. This year, 36 hospitals are participating.

    "Many think doctors are financially incentivized, but at the heart of it, we really want to help people," said Lombardi, an orthopedic surgeon in New Albany, Ohio. "When you work every day and work very hard, there's something about the person that comes up and gives you a big smile and says 'you changed my life.' There's not a dollar bill that can buy that."

    Janet Sitzmann has difficulty measuring the impact of a double knee replacement from Operation Walk USA in 2012. The now 57-year-old Kansas City, Missouri resident said her life before surgery was "pretty small," defined by trips to work, the grocery store and her laundry duties at home.

    The massage therapist was eventually laid off, as her rheumatoid arthritis made it hard to perform her duties. Sitzmann could not imagine her future, as it was difficult enough to envision her day. "I had a limited number of steps I could take in one day, and I really guarded them," she said.

    After the operation, she returned to work and to volunteering. She joined a choir and lost 35 pounds as a result of her increased activity. Sitzmann traveled to Europe for the birth of a grandchild three months after surgery, a trip she said would have been impossible without new knees.

    "Whatever I want to do now, I go do it."

    More information about Operation Walk USA is at opwalkusa.com. A separate organization, called simply Operation Walk (operationwalk.org/), provides similar free surgeries in developing countries.

  • REFILE-Needy patients to get new hips or knees for free next week

    (In first sentence, changes "two years" to "three years")

    By Randi Belisomo

    (Reuters Health) - Excruciating hip pain forced 50-year-old Army veteran David Chalker to leave his machinist job three years ago, a decision that led to mounting debt, inability to afford health insurance and even a move into his in-laws' home with his wife and three daughters. But his family is counting on one operation next week - entirely free of charge - to change the course of both his health and finances.

    The Long Island, New York resident is one of 120 patients scheduled for hip or knee replacement during the first week of December, provided by Operation Walk USA. The nonprofit organization is a coalition of 85 orthopedic surgeons in 23 states volunteering to operate on patients who do not qualify for government assistance but cannot afford surgery on their own.

    "I would have been in miserable pain for the next who knows how many years until I got enough money to get insurance," said Chalker, who gave up his family's health coverage last year when his rate spiked to more than $1800 monthly.

    Chalker's wife, Lisa, said she felt like she won the lottery when they learned he met requirements for surgery. "We have a chance at a new start, he has a chance to be pain-free, and we can get back on our feet," she said.

    Orthopedic surgeon Matthew Hepinstall will implant Chalker's two new hips next Friday at Franklin Hospital in Valley Stream, New York. On Wednesday, Hepinstall will provide two other free surgeries at Manhattan's Lenox Hill Hospital.

    "The patients involved have severe difficulty walking, severe difficulty with daily activities and severe daily pain," Hepinstall said. "The operation will improve their ability to walk and ability to work and provide for their family."

    Since 2010, Operation Walk USA has provided more than $13 million in services for nearly 500 patients. To qualify, patients must be U.S. citizens or permanent residents, fall within 100 to 200 percent of federal poverty guidelines and have no access to Medicaid, the government program that helps with medical costs for some people with limited income.

    Pre- and post-operation services, like physical therapy, are free of charge. Implants are donated by device manufacturers, and doctors, nurses and technicians volunteer their time and skill.

    The biggest barrier to growth of the program, according to founder Dr. Adolph Lombardi, is finding hospitals willing to donate space. This year, 36 hospitals are participating.

    "Many think doctors are financially incentivized, but at the heart of it, we really want to help people," said Lombardi, an orthopedic surgeon in New Albany, Ohio. "When you work every day and work very hard, there's something about the person that comes up and gives you a big smile and says 'you changed my life.' There's not a dollar bill that can buy that."

    Janet Sitzmann has difficulty measuring the impact of a double knee replacement from Operation Walk USA in 2012. The now 57-year-old Kansas City, Missouri resident said her life before surgery was "pretty small," defined by trips to work, the grocery store and her laundry duties at home.

    The massage therapist was eventually laid off, as her rheumatoid arthritis made it hard to perform her duties. Sitzmann could not imagine her future, as it was difficult enough to envision her day. "I had a limited number of steps I could take in one day, and I really guarded them," she said.

    After the operation, she returned to work and to volunteering. She joined a choir and lost 35 pounds as a result of her increased activity. Sitzmann traveled to Europe for the birth of a grandchild three months after surgery, a trip she said would have been impossible without new knees.

    "Whatever I want to do now, I go do it."

    More information about Operation Walk USA is at opwalkusa.com. A separate organization, called simply Operation Walk (operationwalk.org/), provides similar free surgeries in developing countries.

  • REFILE-Mindfulness program may improve some rheumatoid arthritis symptoms

    (Corrects spelling of Dr. Kreitzer's name in paragraphs 20 and 21)

    By Shereen Lehman

    (Reuters Health) - A two-month program combining gentle yoga with meditation techniques, known as Mindfulness Based Stress Reduction, seemed to ease tenderness, pain and stiffness among patients with rheumatoid arthritis in a new study.

    "I think these findings are pretty consistent with other studies of mindfulness and chronic conditions," said Mary Jo Kreitzer, who was not involved in the research.

    Although it was small, and relatively brief, the study's findings were impressive, said Kreitzer, the founder and director of the University of Minnesota Center for Spirituality and Healing.

    "I would say more research is needed to really understand how the mechanisms work," Kreitzer told Reuters Health, "so this trial is incredibly encouraging, but it's not definitive."

    Mindfulness Based Stress Reduction (MBSR) is a program developed decades ago at the University of Massachusetts to help seriously ill patients cope with pain, such as from advanced cancer or AIDS. But in recent years that program has been adapted and offered more widely to people seeking relief from pain and stress of many kinds.

    "Mindfulness training involves the cultivation of nonjudgemental attention to unwanted thoughts, feelings and bodily experiences via meditation and may help ameliorate both psychological and physical symptoms of chronic disease," write the study authors in Annals of the Rheumatic Diseases.

    Previous research has found mixed success when MBSR is used by sufferers of various conditions. For instance, in one trial among patients with fibromyalgia - a widespread pain syndrome of unknown cause - MBSR had little effect (see Reuters Health story of December 28, 2010 here: http://reut.rs/1HG0Sja).

    But Francesca Fogarty at the University of Auckland in New Zealand, who led the new study, and her coauthors note that past research has found MBSR improves the psychological wellbeing of rheumatoid arthritis patients.

    They wanted to see if mindfulness techniques had any impact on the disease process itself.

    Rheumatoid arthritis is a chronic disease caused by the immune system attacking tissue in the joints, especially in the hands and feet, and sometimes causes problems in other parts of the body, such as the eyes, skin, lungs and blood vessels.

    For their study, Fogarty's team enrolled 42 patients with rheumatoid arthritis who had no previous experience with meditation. Twenty one participants were put into a treatment group, and the other 21 served as a comparison group who were told they could go through the MBSR program after the study.

    The treatment group participated in an eight-week program of meditation, gentle stretching and light yoga. Right after the program ended, and again at two, four and six months later, the study team assessed participants' disease symptoms.

    These included the number of tender and swollen joints, levels of C-reactive protein (a marker of inflammation) and the patients' own assessments of their stiffness and pain based on a scale of 1 to 100.

    On average, and throughout the follow-up period, morning stiffness, tenderness and pain scores were lowered among those who had gone through MBSR, but not in the comparison group.

    There were no differences, however, in objective measures of disease activity like C-reactive protein levels and number of swollen joints between the MBSR and comparison groups.

    The authors conclude that MBSR likely helped participants by changing their "experience" of the disease.

    "This pattern of effects is also consistent with evidence linking mindfulness training to improved pain regulation and well-established links between reduced pain and greater wellbeing among people with rheumatoid arthritis," the authors write.

    "I think it follows the line of so many studies that have been coming out about mindfulness-based stress reduction over the last 15 years. Literally hundreds of studies have come out," Kreitzer said.

    "Mindfulness is a way to slow down and be in the present moment and that's what mindfulness training is, so in a mindfulness class people focus on breathing and relaxation and that's sort of how they ease into a practice of meditation," she said.

    Kreitzer said she thinks the study also demonstrates how important self-care and self-management approaches are. There's so much that people can do on their own," she said, adding that for many a sense of empowerment comes from being able to do something about their symptoms.

    MBSR classes are widely available at hospitals and privately, as well as through online programs (http://bit.ly/1vjU4kG), Kreitzer said.

    "People can just check with local healthcare facilities or even use Google to see if there are any mindfulness programs in their communities," she said.

    SOURCE: http://bmj.co/1HEG0J5 Annals of the Rheumatic Diseases, online November 18, 2104.

  • Celiac disease showing up in many forms and at all ages

    By Janice Neumann

    (Reuters Health) - A classical set of celiac disease symptoms no longer reflects the profile of most newly-diagnosed patients, according to a new study from Italy.

    Instead, doctors need to take other symptoms into account and consider the possibility of celiac disease, even when patients don't fit the old image of the condition, researchers say.

    "It's been a gradual phenomenon since the 1970s that fewer people are presenting with the classical diarrhea and more with non-classical or silent presentation, both in adults and children," said Dr. Peter Green, who wasn't involved in the study.

    "We don't actually know why one person has diarrhea and another presents with abdominal pain or osteoporosis," said Green, director of the Celiac Disease Center at Columbia University in New York.

    Dr. Umberto Volta and his coauthors write in the journal BMC Gastroenterology that just 15 years ago, celiac disease was still thought of mainly as a rare pediatric food intolerance, whose most common signs were diarrhea and intestinal damage that was diagnosed through a biopsy.

    The disease is now known to be an autoimmune disorder, caused by an inability to tolerate the gluten protein in wheat, barley and rye.

    Eating gluten typically causes inflammation of the intestinal lining in people with celiac disease and makes it hard to absorb nutrients.

    Research shows that more than 1 percent of people worldwide have the disease, but most may not know it, the authors of the study note. The diagnosis is based on a blood test for signs of the abnormal immune response, such as antibodies, as well as biopsy in some cases.

    With his colleagues, Volta, a professor of medicine at the University of Bologna in Italy and vice president of the Ethical Committee at St. Orsola-Malpighi University Hospital, looked at the celiac patients diagnosed over the course of 15 years at that hospital.

    The study involved 770 patients, 599 of them female, diagnosed between 1998 and 2007. Nearly half were diagnosed during the first 10 years of the study period and the rest in the last five years, indicating a steep rise in rates of diagnosis.

    Among all the patients, 610 people, or 79 percent, had symptoms when they were diagnosed. But most of their problems were not the typical diarrhea and weight loss, but rather "non-classical" issues like bloating, osteoporosis and anemia. Diarrhea was a symptom in just 27 percent of patients.

    Indeed, classical symptoms became less common over the years, decreasing from 47 percent of patients during the first 10 years to 13 percent in the last five. Meanwhile, other problems, as well as a lack of any significant related illness, increased by more than 86 percent.

    "The most striking change in clinical presentation of celiac disease over time has been the decrease of diarrhea as the leading symptom and the progressive increase of other non-classical gastrointestinal symptoms (such as constipation, bloating and alternate bowel habits as well as gastro-esophageal reflux, nausea, vomiting and dyspepsia)," Volta said in an e-mail to Reuters Health.

    "A high proportion of celiac disease patients did not show any gastrointestinal symptom, but they displayed extra-intestinal manifestations such as iron-deficiency anemia, unexplained osteoporosis, abnormalities of liver-function tests and recurrent miscarriages," he said.

    The most common illness associated with celiac was thyroid disease. Only half the patients had severe intestinal damage, and 25 percent had partial damage.

    In later years, more patients were diagnosed through blood tests. That may be one factor accounting for the changing pattern of typical symptoms, Volta said, because the patients were diagnosed earlier, before gluten had done its damage.

    "The effects of gluten weren't as severe yet," Volta said. "The story of celiac disease has been radically changed by the discovery celiac disease-related antibodies, which identify plenty of unsuspected cases."

    Green agreed that testing has vastly improved diagnosis of the disease. He said that in the United Kingdom, anyone with iron deficiency or migraine is tested for celiac disease.

    While most celiac specialists understand the varied symptoms, other physicians might not, he said. Green pointed out that in the United States, only 17 percent of people with the disease are actually diagnosed.

    "Anyone can have celiac disease, it's common and underdiagnosed," said Green. "The message we want to get out is if you think you've got celiac disease, don't just go on a gluten-free diet, test for it."

    Volta said he hoped the study reminded doctors about the many problems that can signal celiac disease.

    "I hope doctors keep in mind that celiac disease is a very frequent food intolerance, which should be investigated not only in patients with diarrhea and overt malabsorption, but also in people (with other symptoms)," Volta said.

    "The treatment by gluten-free diet improves the quality of life in symptomatic patients and prevents complications in all celiac disease patients including those without symptoms," he said.

    SOURCE: http://bit.ly/1ATNpT3 BMC Gastroenterology, Nov. 18, 2014.

  • REFILE-Mindfulness program may improve some rheumatoid arthritis symptoms

    (Corrects spelling of Dr. Kreitzer's name in paragraphs 20 and 21)

    By Shereen Lehman

    (Reuters Health) - A two-month program combining gentle yoga with meditation techniques, known as Mindfulness Based Stress Reduction, seemed to ease tenderness, pain and stiffness among patients with rheumatoid arthritis in a new study.

    "I think these findings are pretty consistent with other studies of mindfulness and chronic conditions," said Mary Jo Kreitzer, who was not involved in the research.

    Although it was small, and relatively brief, the study's findings were impressive, said Kreitzer, the founder and director of the University of Minnesota Center for Spirituality and Healing.

    "I would say more research is needed to really understand how the mechanisms work," Kreitzer told Reuters Health, "so this trial is incredibly encouraging, but it's not definitive."

    Mindfulness Based Stress Reduction (MBSR) is a program developed decades ago at the University of Massachusetts to help seriously ill patients cope with pain, such as from advanced cancer or AIDS. But in recent years that program has been adapted and offered more widely to people seeking relief from pain and stress of many kinds.

    "Mindfulness training involves the cultivation of nonjudgemental attention to unwanted thoughts, feelings and bodily experiences via meditation and may help ameliorate both psychological and physical symptoms of chronic disease," write the study authors in Annals of the Rheumatic Diseases.

    Previous research has found mixed success when MBSR is used by sufferers of various conditions. For instance, in one trial among patients with fibromyalgia - a widespread pain syndrome of unknown cause - MBSR had little effect (see Reuters Health story of December 28, 2010 here: http://reut.rs/1HG0Sja).

    But Francesca Fogarty at the University of Auckland in New Zealand, who led the new study, and her coauthors note that past research has found MBSR improves the psychological wellbeing of rheumatoid arthritis patients.

    They wanted to see if mindfulness techniques had any impact on the disease process itself.

    Rheumatoid arthritis is a chronic disease caused by the immune system attacking tissue in the joints, especially in the hands and feet, and sometimes causes problems in other parts of the body, such as the eyes, skin, lungs and blood vessels.

    For their study, Fogarty's team enrolled 42 patients with rheumatoid arthritis who had no previous experience with meditation. Twenty one participants were put into a treatment group, and the other 21 served as a comparison group who were told they could go through the MBSR program after the study.

    The treatment group participated in an eight-week program of meditation, gentle stretching and light yoga. Right after the program ended, and again at two, four and six months later, the study team assessed participants' disease symptoms.

    These included the number of tender and swollen joints, levels of C-reactive protein (a marker of inflammation) and the patients' own assessments of their stiffness and pain based on a scale of 1 to 100.

    On average, and throughout the follow-up period, morning stiffness, tenderness and pain scores were lowered among those who had gone through MBSR, but not in the comparison group.

    There were no differences, however, in objective measures of disease activity like C-reactive protein levels and number of swollen joints between the MBSR and comparison groups.

    The authors conclude that MBSR likely helped participants by changing their "experience" of the disease.

    "This pattern of effects is also consistent with evidence linking mindfulness training to improved pain regulation and well-established links between reduced pain and greater wellbeing among people with rheumatoid arthritis," the authors write.

    "I think it follows the line of so many studies that have been coming out about mindfulness-based stress reduction over the last 15 years. Literally hundreds of studies have come out," Kreitzer said.

    "Mindfulness is a way to slow down and be in the present moment and that's what mindfulness training is, so in a mindfulness class people focus on breathing and relaxation and that's sort of how they ease into a practice of meditation," she said.

    Kreitzer said she thinks the study also demonstrates how important self-care and self-management approaches are. There's so much that people can do on their own," she said, adding that for many a sense of empowerment comes from being able to do something about their symptoms.

    MBSR classes are widely available at hospitals and privately, as well as through online programs (http://bit.ly/1vjU4kG), Kreitzer said.

    "People can just check with local healthcare facilities or even use Google to see if there are any mindfulness programs in their communities," she said.

    SOURCE: http://bmj.co/1HEG0J5 Annals of the Rheumatic Diseases, online November 18, 2104.