At Lake Regional Orthopedics, board-certified orthopedic specialists help prevent and correct problems that affect your bones and muscles. Our specialists provide surgical and nonsurgical repair of broken bones, torn ligaments and cartilage. They also treat joint problems from osteoarthritis and repetitive use injuries in the hand. Common procedures include arthroscopic (minimally invasive) surgery to repair joints and total joint replacement surgery. Lake Regional also has a foot and ankle specialist, who provides trauma care and limb salvage and reconstruction. In addition, we provide a Sports Medicine program and spine care from a University of Missouri Health Care neurosurgeon.
Common Joint and Bone Diagnoses
- Fracture and dislocation
Hip and Knee
- Knee ligament tear (ACL, MCL, PCL)
- Patellofemoral knee syndromes
- Meniscal (cartilage) tears
- Femoral acetabular impingement (FAI)
- Total hip replacement
- Total knee replacement
Shoulder and Elbow
- Rotator cuff tear
- Labrum tears, instability
- Frozen shoulder
- Golfer elbow (medial epicondylitis)
- Tennis elbow (lateral epicondylitis)
- Total shoulder replacement
Wrist and Hand
- Carpal tunnel
Foot and Ankle
- High-arch feet
- Ligament rupture and instability
- Bone infection
- Congenital deformities
- Total ankle replacement
Total Joint Replacement
Total joint replacement is a surgical procedure in which the diseased parts of the joint are replaced with new, artificial parts. Major advances in total joint replacement offer patients dealing with severe joint pain the ability to lead full, active lives. The most commonly replaced joints are the hip, knee and shoulder.
Total Joint Camp
Lake Regional's Total Joint Camp educates patients and their families about what to expect before, during and after joint replacement surgery. The two-hour class includes tips from the orthopedic surgeons, as well as from physical and occupational therapists, home health nurses, dietitians and social workers. Patients leave feeling better prepared and much more confident.
Hip to Hana®
In a traditional hip replacement surgery, surgeons access the hip from its posterior, or backside. This approach requires cutting muscles and tendons that have to be repaired at the surgery's end. At Lake Regional, our orthopedic surgeons access the hip joint from the anterior, or front. This positioning enables the surgeons to work through the natural gap between the muscles, which means they do not have to cut any muscles or tendons.
Our orthopedic surgeons are able to take the anterior approach because they use a Hana® table, a high-tech table with moving parts that enable precise patient positioning. Because no cutting and repair is necessary with the anterior approach, patients recover much more quickly and with less pain.
Your Nurse Navigator
If you have total joint replacement at Lake Regional Health System, you will meet Mary Overman, R.N. As your nurse navigator, she will lead you through the entire joint replacement experience, from preparing for surgery to recovering at home. Learn more about her role in this Q&A.
How do you support patients receiving total joint replacement?
I am their one point of contact for everything related to their surgeries. A big part of my job is educating patients about steps they can take to avoid setbacks and achieve good results. But I also help with things like scheduling appointments. That support makes the whole process a lot easier for patients.
How do you help patients achieve better outcomes?
Education is essential. One way we educate patients is through Total Joint Camp. This two-hour class covers what to expect before, during and after total joint replacement surgery. It also introduces patients to physical and occupational therapists, home health nurses, dietitians and social workers. Patients leave feeling better prepared and much more confident.
What is one simple piece of advice you give patients?
I always encourage patients to set a goal. They need to look forward to doing something with their improved mobility. It might be playing with grandchildren or maybe it’s going on a cruise. There is a lot of work to do with home exercises and outpatient therapy. Sometimes the process is slow. But that’s OK. Recovery is not a race. Steady progress is best.
Arthroscopic (Minimally Invasive) Surgery
Orthopedic surgeons use arthroscopy to repair joint problems without open surgery. Using a thin instrument with a video camera and lighting tool—the arthroscope—the doctor can see inside the joint to examine the bone, cartilage and ligaments. In many cases, the surgeon can make repairs during the same procedure. Compared to traditional, open surgery, arthroscopy usually costs less, is less painful and leads to a faster recovery.
1 Surgery, 2 New Knees: Kristi McGrew
Local teacher has both knees replaced at Lake Regional
Kristi McGrew, a reading teacher at School of the Osage Heritage Elementary School, had an unusual summer project.
“While school was out, my summer project was to get new knees so I can keep up with all of the kids,” says McGrew, who has served School of the Osage for 20 years. “Anytime I was on my legs for an extended period, they would get so sore and achy.”
Early Signs of Knee Trouble
McGrew’s knee troubles began with a torn ACL when she was 25. She had surgery, but as often happens with ACL tears, the knee eventually developed osteoarthritis. As the cartilage in her knee wore away, McGrew experienced increasing pain and loss of movement.
Then last December, her left knee began to have similar problems. That’s when she began to wonder if a woman in her 50s could be a candidate for knee replacement surgery.
There are pros and cons to replacing joints in mid-life, says Jeff Jones, D.O., a board-certified orthopedic surgeon at Lake Regional Orthopedics.
“In the past, hip and knee replacements were performed only on patients ages 65 and older,” he says. “That’s because the new joint won’t last forever — in general, 20 years is a good expectation. But many people don’t want to wait until they are 65. Many decide, ‘I want good quality years now, and if needed, I’ll deal with a second surgery later.’”
That made sense to McGrew.
“For quality of life, I decided to go ahead,” she says.
2 Replacements, 1 Summer
Hoping to use up just one summer, McGrew was happy to learn she could have both knees replaced at once. And “at once” meant exactly that — Dr. Jones asked his fellow Lake Regional board-certified orthopedic surgeon Rick Walker, D.O., to operate alongside him, with each of them replacing a knee. The main benefit of this approach, Dr. Jones says, is a shorter anesthesia time.
“That’s a little safer for the patient,” Dr. Jones says.
To get ready for her surgery, McGrew attended Lake Regional’s Total Joint Camp. This two-hour class helps patients know what to expect before, during and after total hip or total knee replacement surgery. The camp includes tips from the orthopedic surgeons, as well as from physical and occupational therapists, dietitians and social workers.
“It took away a lot of the worry and fear because I knew what to expect,” McGrew says.
After surgery, McGrew spent four days at Lake Regional Hospital. The care, she says, was a perfect balance of professional and personal.
“Professional because everybody really knew how to do their job, and I felt safe,” she says. “And then also personal because I never felt like anybody was just doing their job. I felt like they really, genuinely cared about me. People were always asking, ‘Can I do anything for you?’ Not only the medical professionals — the techs, nurses, physicians — but also the housekeeping personnel and volunteers. I felt really thankful.”
After being discharged, McGrew decided to spend seven days at the Lake Regional Skilled Nursing Facility, located within the hospital. She received physical therapy twice a day and occupational therapy as needed.
“The best thing about the Skilled Nursing Facility was that I had an extra week to focus — just focus — on getting better and getting stronger,” she says.
At first, McGrew needed help to walk short distances. A couple of days later, she just let staff know when she’d be walking.
“Then the last couple of days, I could get up and walk around as I pleased because I was safe to do that,” she says.
Expert Care Close to Home
For the rest of her summer, McGrew went to the hospital three times a week for physical therapy. She switched to twice a week when school started.
“My physical therapists are wonderful about helping me with practical aspects of life,” she says. “They ask me what is challenging me and then show me exercises and other tips to help make these tasks easier and to help me get stronger and more flexible. There is some stiffness, but I have no pain in my joints. I am able to go up and down stairs and am getting faster when walking. I was still using a cane for the first week back to work but abandoned it the second week.
“I know a lot of people think they have to go to a bigger city to get good hospital care, like somehow, right here at home, it’s not going to be good enough,” she adds. “I didn’t experience that at all. My surgeons used the latest methods, and along with that professionalism, I had the personal aspect because I had nurses who were parents of kids I’ve had in school. I had people from the community I know, and that means a lot to me, to be in my community, where I know the people who are taking care of me.”
Moving Again: A New Hip for Whitney Nepote
Kansas woman chooses "wonderful" Lake Regional team for hip replacement
Whitney Nepote of Paola, Kan., could have had her hip replaced closer to home, but she chose to make the three-hour drive to Lake Regional Orthopedics.
“My son lives in Sunrise Beach, and he said, ‘You need to come down here,’” Nepote says. “His wife had two hip replacements with Dr. Jones, and my son said: ‘He’s wonderful. He does the surgery a new way that has a faster recovery time. Come down here, and we’ll take care of you.’”
A Better Approach
Jeff Jones, D.O., is a board-certified orthopedic surgeon at Lake Regional Orthopedics. He and his fellow Lake Regional board-certified orthopedic surgeon Rick Walker, D.O., perform total hip replacement surgeries, like Nepote’s, using a hana ® table. This high-tech surgical table has moving parts that enable surgeons to access the hip joint from the front of the hip. The traditional, back approach requires cutting muscles and tendons, but with the front, anterior approach, surgeons can work through the natural gap between the muscles.
“Using the traditional, posterior approach, after we finished replacing the hip, we had to surgically repair the muscles and tendons we had cut,” Dr. Jones says. “Because no cutting and repair is necessary with the anterior approach, patients recover much more quickly and with less pain.”
The hana ® table also allows for X-ray imaging during the surgery, which improves outcomes “because we can see precisely what we’re doing during surgery, instead of taking an X-ray after we’re done,” Dr. Jones says.
Nepote was glad to go to the surgeon who had taken excellent care of her daughter-in-law and found her own care to be excellent, as well.
“I spent two days in the hospital, and the staff was wonderful, always coming in to see if I needed anything,” Nepote says. “Even the cleaning staff was caring. It was outstanding. I’d recommend it to anybody.”
After leaving the hospital, Nepote spent two weeks at her son’s home. Lake Regional Home Health helped care for her, and Nepote reports the nurses and therapists were “wonderful.”
Nepote continued her therapy back home in Kansas and six weeks after her surgery is excited at the changes she sees.
“Before I had the surgery, I hurt terribly, and it got to where I couldn’t even walk,” she says. “Now I’m able to drive, go to the store, clean our house, do laundry — I do everything.”
Total Joint Camp
Lake Regional’s Total Joint Camp, offered the second and fourth Wednesday of each month, helps patients know what to expect before, during and after total hip or total knee replacement surgery. The camp includes tips from physical and occupational therapists, dietitians, and social workers. Plus, participants are welcome to ask questions.
To register, call Lake Regional Rehab Therapy at 573-302-2230.
Thumbs Up for Exceptional Care: Tyler Delaney
Hyperbaric treatment helps 13-year-old keep his thumb.
At a reunion with Lake Regional Wound Healing Center staff members, 13-year-old Tyler Delaney was happy to give his former caregivers two thumbs up. After all, if not for the effort of orthopedic surgeon Scott Hofer, D.O., and the wound care team at Lake Regional, Tyler would likely be missing one of those thumbs today.
What was supposed to be a fun-filled vacation for Tyler's Wisconsin family nearly turned into a tragedy when Tyler's hand became entangled in a tow rope after a day of wakeboarding on the Lake of the Ozarks.
"As he was picking up the rope, the jet ski was still running," Tyler's father, Shawn Delaney, explains. "The rope got caught in the prop and got pulled in, which then wrapped around his thumb and dislocated it and almost pulled it off."
"When it immediately happened I thought I had lost my thumb," Tyler recalls. "As soon as I was told that I still had my thumb, I wasn't as worried, but I was still worried I could lose it."
Tyler's father rushed him to Lake Regional Hospital, where Emergency Department staff took immediate action to stabilize the wound and called in Dr. Hofer to determine if the thumb was salvageable.
"He sustained a circumferential laceration going around the finger with a fracture through the growth plate to the thumb," Hofer says. "He essentially nearly amputated the finger."
Initially, Dr. Hofer felt there was a 50-50 chance that Tyler might lose his finger. Half of the thumb had good circulation, but the nerve and blood vessel on the other half looked as though they were damaged beyond repair.
Fortunately for Tyler, youth was on his side.
"Kids heal a lot better than adults do," Dr. Hofer says. "Oftentimes, things that don't look salvageable are."
After cleansing and assessing the wound, Dr. Hofer realigned and stabilized the fracture by inserting a pin through the growth plate. He then repaired the skin lacerations with absorbable sutures.
With his thumb intact, Tyler was discharged into the care of his father. The pair hoped to salvage what was left of their time at the lake. But a follow-up visit to Dr. Hofer once again changed their vacation plans.
The tip of Tyler's thumb began to look dusky, and Dr. Hofer was worried the tip might die. He hoped the oxygen-rich environment of Lake Regional Wound Healing Center's hyperbaric chambers would improve oxygenation to the tissue and promote the healing process. Since opening in April 2009, the Wound Healing Center has used hyperbaric oxygen therapy to treat a variety of ailments, including diabetic wounds, bone and skin infections, and acute trauma arterial insufficiency.
"By increasing the oxygen in the atmosphere, we're improving the oxygenation of the tissues [even though there is not a good blood supply]," Dr. Hofer says.
Tyler ultimately spent the remainder of his vacation doing 10 two-hour stints in the clear, comfortable confines of a pressurized hyperbaric chamber—making him the youngest patient to receive hyperbaric treatment at Lake Regional. He passed the time watching movies and enjoying plenty of father-son bonding time with his dad sitting on the outside of the chamber.
"I had a different picture in my head from what the chamber was," Shawn says. "To see that...I could see him and he could see out was great."
After Tyler finished his treatments at Lake Regional, the family returned home to Wisconsin. However, Lake Regional made sure he would have the appropriate follow-up medical care. After an exhaustive search, Wound Healing Center Program Director Laurie Lowther was relieved to locate a center close to Tyler's home that had a pediatric surgeon on staff.
A year later, Tyler has full use of his thumb and is brushing up on his favorite musical pastime—drumming. For the Delaneys, it's a return to normalcy that would not have happened without the efforts of Lake Regional's doctors, nurses, technicians and support staff.
"They helped me out so much that we just had to come back and say thank you," Tyler says. "I'm sure we will be coming back for years to come."