Surgical Procedures Available Through Dr. Ward

•  Diagnostic shoulder arthroscopy: Evaluation of the joint to identify issues like tears, inflammation, or loose bodies when imaging is inconclusive.

•  Subacromial decompression (acromioplasty): Removal of bone spurs or inflamed tissue in the subacromial space to treat impingement syndrome.

•  Rotator cuff debridement or repair: Cleaning up damaged tissue or repairing (suturing/anchoring) partial or small full-thickness rotator cuff tears.

•  Labral debridement or repair: Trimming or repairing torn labrum (including certain SLAP lesions or Bankart lesions for instability).

•  Loose body removal: Extraction of cartilage fragments or other debris from the joint.

•  Synovectomy: Removal of inflamed synovial tissue.

•  Biceps tenotomy or tenodesis: Releasing or reattaching the long head of the biceps tendon for tendonitis, tears, or related pain.

•  Adhesive capsulitis release (for frozen shoulder): Releasing scar tissue and contractures to restore motion.

•  AC (acromioclavicular) joint procedures: Distal clavicle resection or debridement for arthritis or impingement.

•  Ligament repair or plication: Addressing minor instability or capsular laxity.

•  Bursectomy: Removal of inflamed bursa in the subacromial space.

Shoulder Arthroscopy Procedures

•  Open Reduction and Internal Fixation (ORIF): Realigning (reduction) and stabilizing fractures with plates, screws, or wires. Common sites: distal radius, ankle (bimalleolar/trimalleolar), tibial plateau, femoral shaft (with plating), olecranon, patella, proximal humerus.

•  Intramedullary (IM) nailing: Inserting a rod into the marrow canal for long bone fractures. Most common for femoral shaft, tibial shaft; also subtrochanteric or certain humeral fractures.

•  External fixation (temporary or definitive): Pins/screws connected to an external frame for unstable fractures, open fractures, or damage-control orthopedics (DCO) in polytrauma patients. Often used for tibial plateau, pilon, or pelvic stabilization initially.

•  Percutaneous pinning or screw fixation: Minimally invasive for certain fractures (e.g., hip/femoral neck in elderly, scaphoid, some pediatric fractures).

•  Hemiarthroplasty or total hip arthroplasty for hip fractures: For displaced femoral neck fractures in elderly patients (hemiarthroplasty common; total hip in select active patients).

•  Proximal femoral fixation: Sliding hip screw or cephalomedullary nail for intertrochanteric/subtrochanteric hip fractures.

•  Shoulder trauma: ORIF for proximal humerus fractures, clavicle fractures; arthroscopic or open management of acute dislocations or associated rotator cuff/labral tears.

•  Knee trauma: ORIF for tibial plateau fractures, patellar fractures; arthroscopic-assisted fixation or debridement for osteochondral fractures; ACL reconstruction if acute (though often staged).

•  Ankle/foot trauma: ORIF for ankle fractures; syndesmotic fixation.

•  Wrist/hand trauma: ORIF for distal radius (volar plating common), scaphoid, metacarpal/phalangeal fractures.

•  Soft tissue procedures: Irrigation and debridement (I&D) for open fractures or infections; fasciotomy for compartment syndrome; tendon/ligament repairs (e.g., Achilles, quadriceps/patellar tendon ruptures); nerve exploration/repair in select cases.

•  Dislocation reductions (open if needed): Shoulder, elbow, hip, knee dislocations (often closed initially; open for irreducible or with associated fractures).

•  Revision or conversion procedures: Hardware removal (symptomatic), nonunion repair (bone grafting), or conversion to joint replacement (e.g., failed hip fracture fixation to THA).

Trauma Injuries Performed

•  Diagnostic knee arthroscopy: Systematic evaluation of all compartments (suprapatellar pouch, gutters, medial/lateral compartments, intercondylar notch, patellofemoral joint) when imaging is inconclusive or to assess concurrent pathology.

•  Meniscal procedures:

•  Partial meniscectomy (trimming/debridement of irreparable torn meniscus, most common).

•  Meniscal repair (suturing, all-inside technique for repairable tears, especially in younger patients or red-red zone tears).

•  Anterior cruciate ligament (ACL) reconstruction: Graft placement (autograft patellar tendon or allograft) using arthroscopic portals; often combined with meniscal work. (PCL reconstruction is less common but similar.)

•  Loose body removal: Extraction of cartilage, bone fragments, or debris causing locking/pain.

•  Synovectomy or synovial biopsy: Removal of inflamed synovial tissue (e.g., in rheumatoid arthritis, pigmented villonodular synovitis) or sampling for infection/inflammation.

•  Chondroplasty / cartilage debridement: Smoothing of damaged articular cartilage surfaces.

•  Microfracture or other cartilage restoration: Drilling into subchondral bone to stimulate fibrocartilage repair for focal defects; or advanced techniques like osteochondral autograft transfer (OATS) or allograft.

•  Treatment of osteochondritis dissecans (OCD): Debridement, drilling, fragment fixation, or removal.

•  Patellofemoral procedures: Lateral retinacular release, medial patellofemoral ligament (MPFL) repair/reconstruction for instability, or debridement of chondromalacia patellae.

•  Plica resection: Excision of symptomatic synovial plicae causing pain/snapping.

•  Irrigation and debridement (I&D): For septic arthritis or infection.

•  Other: Removal of Baker’s cyst (if intra-articular component), notchplasty (for ACL), or adjuncts in multi-ligament injury.

Knee Arthroscopy Procedures

•  Carpal tunnel release: Transection of the transverse carpal ligament to decompress the median nerve. Most common hand surgery overall.

•  Trigger finger (stenosing tenosynovitis) release: A1 pulley release for locking fingers/thumb.

•  De Quervain’s release: First dorsal compartment release for thumb-side wrist tendinopathy.

•  Ganglion cyst excision: Removal of dorsal or volar wrist/hand cysts (open or arthroscopic-assisted).

•  Hand/wrist fracture fixation: Open reduction internal fixation (ORIF) with plates/screws/pins/K-wires for distal radius (volar plating common), metacarpal, phalangeal, scaphoid, or other carpal fractures. Percutaneous pinning for simpler cases.

•  Tendon repair or reconstruction: Primary repair of extensor tendon lacerations; tenolysis for adhesions; trigger finger-related work.

•  Nerve decompression: Ulnar nerve (cubital tunnel or Guyon’s canal). Median nerve (carpal tunnel)

•  Thumb basal joint (CMC) arthroplasty: For trapeziometacarpal arthritis (LRTI—ligament reconstruction tendon interposition—or suspensionplasty common; fusion for high-demand patients).

•  Soft tissue procedures: Irrigation and debridement (I&D) for infections/abscesses; foreign body removal; fasciotomy for compartment syndrome.

•  Other trauma-related: Reduction/fixation of dislocations (e.g., PIP, CMC); mallet finger repairs

Hand Procedures

Total Joint Replacement Procedures

•  Total Knee Arthroplasty (TKA / Total Knee Replacement): Replacement of all three compartments (medial, lateral, patellofemoral) of the knee. Most common total joint procedure overall (hundreds of thousands performed annually in the US). Indications: diffuse osteoarthritis or inflammatory arthritis with pain and functional limitation failing conservative care (PT, injections, etc.).

•  Partial (Unicompartmental) Knee Arthroplasty (UKA / Partial Knee Replacement): Replaces only one compartment (most often medial). Less invasive, preserves ligaments (e.g., ACL) and more native bone. Suitable for isolated unicompartmental arthritis with intact ligaments and minimal deformity. Faster recovery and more “natural” feel for many patients, but higher long-term revision risk if arthritis progresses to other compartments.

•  Total Hip Arthroplasty Anterior Approach (THA / Total Hip Replacement): Replacement of the femoral head and acetabulum. Highly successful for pain relief and function. Common indications: osteoarthritis, femoral neck fractures (in select elderly patients), avascular necrosis, dysplasia.

•  Hemiarthroplasty Anterior Approach (Partial Hip Replacement): Replaces only the femoral head (e.g., for displaced femoral neck fractures in lower-demand elderly patients). Less common in elective settings than total hip.

•  Anatomic Total Shoulder Arthroplasty (TSA): Replaces the humeral head and glenoid, preserving natural anatomy. Best for glenohumeral osteoarthritis with intact or reparable rotator cuff and adequate bone stock.

•  Reverse Total Shoulder Arthroplasty (RTSA / Reverse Shoulder Replacement): “Reverses” the ball-and-socket (glenosphere on scapula, humeral socket). Primarily for rotator cuff tear arthropathy, massive irreparable rotator cuff tears with pseudoparalysis, complex proximal humerus fractures (especially in elderly), revision cases, or severe glenoid bone loss. Has become increasingly common due to expanded indications and excellent pain relief/function in appropriate patients.

•  Revision total joint arthroplasty (hip, knee, shoulder) — for loosening, infection, instability, wear, or periprosthetic fracture.