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Foot and Ankle

The ankle and foot work together to provide support, shock absorption, balance, and other functions essential for movement.  While most minor injuries heal on their own, severe injuries and chronic conditions should be evaluated by an orthopaedic specialist. Call WRMC Orthopaedic and Sports Medicine Clinic at (870) 793-2371 for an appointment.

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Ankle Injuries

  • Achilles Tendinitis – The Achilles Tendon connects the calf muscle to the heal bone.  It is used to climb, jump, run, stand on your tip toes, and walk.
  • Sprains/Instability - An ankle sprain is the stretching or tearing of ligaments that support the ankle joint.
  • Fractures – A fracture of one or more bones that make up the ankle joint.

Foot Injuries

  • Bone Spurs
  • Bunions/Bunionette
  • Diabetic Foot Care
  • Flat Feet
  • Ganglion Cysts
  • Hammertoe/ Mallet Toe
  • Heel Fracture
  • Heel Spurs
  • Lisfranc Fracture
  • Metatarsal Fracture
  • Stress Fractures
  • Toe Fracture

Hand and Wrist

The hand and wrist are a complex set of bones, joints, ligaments, muscles, and tendons.  Overuse injuries may cause pain and stiffness, limiting the ability to complete activities of daily living, enjoy hobbies and sports, and work. Pain and stiffness that limit function and last for more than two weeks should be evaluated by an Orthopaedic Specialist. To make an appointment with one of our providers call, (870) 793-2371.

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Hand and Wrist Conditions

Hand and Wrist Treatments

Hip and Knee

Hip and or knee pain that limits the ability to walk and limits your daily activity should be evaluated by an Orthopaedic specialist. Constant, debilitating joint pain is not a normal part of the aging process. Pain may be caused by arthritis, sport injuries, trauma, or work-related injuries, and may worsen over tie if the underlying cause of the pain is not addressed.

Our surgeons have extensive training and experience in the diagnosis and treatment of hip and knee conditions. We will diagnose the cause of your pain and work with you to develop an effective treatment plan.

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Hip Conditions and Treatments

Minimally Invasive Direct Anterior Approach Hip Replacement

Direct anterior approach is a minimally invasive surgical technique for total hip replacement. Patients undergoing and anterior approach hip replacement generally have a shorter hospital stay, lower pain, and quicker return to regular activities.

Direct anterior approach is a minimally invasive surgical technique for total hip replacement. Patients undergoing and anterior approach hip replacement generally have a shorter hospital stay, lower pain, and quicker return to regular activities.

Robotic Assisted Hip Replacement

Using Mako® robotic assisted surgical technology, surgeons provide hip replacement surgery personalized to each patient’s diagnosis and unique anatomy. Before surgery surgeons use a CT scan of the hip to create a 3D virtual model of the hip and the Mako software to develop a pre-operative plan. During surgery, the surgeon guides the Mako® robotic arm to remove the arthritic bone and insert the hip implant.

Knee Conditions and Treatments

Knee pain may be resolved with conservative therapies such as rest, bracing, and physical therapy. When conservative treatments are unsuccessful, an Orthopaedic specialist may recommend injections or surgical intervention.

Robotic-Assisted Partial and Total Knee Replacement

Using Mako® robotic assisted surgical technology, surgeons provide partial and total knee replacement personalized to each patient’s diagnosis and unique anatomy. Before surgery surgeons use a CT scan of the knee to create a 3D virtual model of the hip and the Mako software to develop a pre-operative plan. During surgery, the surgeon guides the Mako® robotic arm to remove the diseased joint and prepare the bone for placement of the knee implant. The Mako® system allows the surgeon to adjustments to the plan as needed during surgery to ensure an accurate placement of the implant.

Patient Instructions for Joint Replacement Surgery

Shoulder and Elbow

Shoulder and elbow pain may be caused by arthritis, injury, or repetitive motion during sports or work activities. The physicians of WRMC Orthopaedic and Sports Medicine Clinic are experienced in the diagnosis and treatment of upper extremity conditions. Our goal is to provide treatment that relieves pain, restores function, and allows patients to resume an active and healthy lifestyle.

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Shoulder Conditions and Treatments


Elbow pain is usually an overuse injury caused by repetitive motion and stress to the joint. These injuries are most common in golfers, pitchers, and athletes playing racket sports. Our orthopaedic specialists evaluate patients with elbow pain and may prescribe conservative treatments such as anti-inflammatory medication to relieve pain, rest, bracing, physical therapy, and at home exercise. Conditions that don’t respond to conservative treatment may require a surgical intervention.

Common Elbow Conditions and Treatments


What is Osteoarthritis?

Osteoarthritis is the most common form of arthritis. It is also called degenerative joint disease or wear and tear arthritis.  It occurs more frequently in the hands, hips, and knees. 

With osteoarthritis, the cartilage within a joint begins to break down and the underlying bones begins to change.  These changes usually develop slowly and get worse over time. Osteoarthritis can cause pain, stiffness, and swelling.  In come cases, it limits function and causes disability; some people are no longer able to do daily tasks or work. 

What are the Signs and Symptoms of Osteoarthritis

  • Pain or aching
  • Stiffness
  • Decreased range of motion or flexibility
  • Swelling

How Many People Have Osteoarthritis?

Osteoarthritis affects more than 30 million US adults. 

What Causes Osteoarthritis?

Osteoarthritis is caused by damage or breakdown of joint cartilage between bones. 

What are Risk Factors for Osteoarthritis

  • Joint injury or overuse - Injury or overuse, such as knee bending and repetitive stress on a joint, can damage a joint and increase the risk of osteoarthritis in that joint. 
  • Age - The risk of developing osteoarthritis increases with age.
  • Gender - Women are more likely to develop osteoarthritis than men, especially after age 50.
  • Obesity - Extra weight puts more stress on joints, particularly weight-bearing joint like hips and knees.  This stress increases the risk of osteoarthritis in these joints. Obesity may also have metabolic effects that increase the risk of osteoarthritis. 
  • Genetics - People who have family members with osteoarthritis are more likely to develop the disease.  
  • Race - Some Asian populations have a lower risk for osteoarthritis. 

How is Osteoarthritis Diagnosed

A doctor diagnoses osteoarthritis through a review of symptoms, physical examination, x-rays, and lab tests. 

How is Osteoarthritis Treated

There is no cure for osteoarthritis, doctors treat osteoarthritis symptoms with a combination of therapies, which may include the following:

  • Increasing physical activity
  • Physical therapy with muscle strengthening exercises
  • Weight loss
  • Medications, including over-the-counter pain relievers and prescription drugs
  • Supportive devices such as canes
  • Surgery, if other treatments options are not effective

In addition to these treatments, people can gain confidence in managing their osteoarthritis with self-management strategies.  These strategies help reduce pain and disability so people with osteoarthritis can purse the activities that are important to them. These five simple and effective arthritis management strategies can help. 

How Can I Manage Osteoarthritis and Improve My Quality of Life

The Centers for Disease Arthritis program recommends five self-management strategies for managing arthritis and its symptoms.

  • Learn self-management skills - Join a self-management education class, which helps people with arthritis and other chronic conditions-including osteoarthritis-understand how arthritis affects their lives and increases their confidence in controlling their symptoms and living well.  Learn more about the CDC-recommended self-management education programs. 
  • Get physically active -  Experts recommend that adults engage in 150 minutes per week of at least moderate physical activity. Every minute of activity counts, and any activity is better than none. Moderate, low impact activities recommended include walking, swimming, or biking.  Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease, stroke, and diabetes.  Learn more about physical activity for arthritis.
    • Go to effective physical activity programs - For people who worry that physical activity may make osteoarthritis worse or are unsure how to exercise safely, participation in activity programs can help reduce pain and disability related to arthritis and improve mood and and the ability to move. Classes take place at local Ys, parks, and community centers. These classes help people with osteoarthritis feel better.  Learn more about CDC recommended physical activity programs. 
  • Talk to your doctor - You can play an active role in controlling your arthritis by attending regular appointment with your healthcare provider and following your recommended treatment plan. This is especially important if you also have other chronic conditions, like diabetes or heart disease. 
  • Lose Weight - For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees.  Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of osteoarthritis. 
  • Protect your joints - Joint injuries can cause or worsen arthritis. Choose activities that are easy on the joints like walking, bicycling, and swimming.  These low-impact exercises have a low risk of injury and do not twist or put too much stress on the joints.  Learn more about exercise safely with arthritis. 

Learn More about Osteoarthritis

Learn More about Arthritis

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Fracture & Trauma

Accidental or sports injury, prolonged stress from overuse, and osteoporosis are the most common causes of orthopaedic fractures.  If you experience symptoms associated with a fracture, it is important to seek emergency medical treatment.  WRMC Orthopaedic and Sports Medicine Clinic Surgeons provide orthopaedic trauma care at White River Medical Center’s Emergency Department. If you experience a medical emergency call 911. 


  • Deformity – the limb is out of normal alignment
  • Inability to bear weight
  • Severe bruising and swelling
  • Sudden severe pain with numbness or tingling

X-rays or CT scans are usually used to confirm diagnosis and show the type and exact location of a fracture. Casts and splints may be used to treat simple or stress fractures.  Complex fractures may require surgery to reposition the broken bone for proper healing and may require plates and screws to stabilize the bone during healing.

Types of Fractures

The following general terms are used to describe most fractures

  • Complete – The bone is broken into two distinct pieces
  • Incomplete or Partial – A crack in the bone
  • Compound or Open Fracture – Bone fragments break through the skin
  • Simple or Closed Fracture – Bone fragments do not break through the skin
  • Stress Fractures – Hairline cracks in a bone caused by overuse
Mako Robotic Assisted Joint Replacement Surgery

Joint Replacement Surgery

Joint replacement surgery removes damaged or diseased parts of a joint and replaces them with a joint implant. Our surgeons offer Hip, Knee, and Shoulder replacement surgery.

Joint replacement surgery may be recommended after more conservative treatments, such as lifestyle changes, physical therapy, and medication, are unsuccessful. It may also be recommended if pain limits and restricts mobility, making routine activities difficult.

Our approach to joint replacement surgery recognizes that our patients and their support system are important members of the care team. The White River Medical Center Orthopaedic Liaison and our staff work with each patient to coordinate education, surgical pre-admission testing, and insurance pre-certification necessary to prepare for surgery. Our goal is to improve mobility, relieve pain, and restore function for every patient allowing them to return to a healthy, active life after surgery.

Joint Replacement Services Offered

  • Robotic Assisted Knee Replacement (total and partial)
  • Robotic Assisted Hip Replacement
  • Total Shoulder Replacement/Reverse Total Shoulder Replacement

Robotic Assisted Joint Replacement

Our surgeons use robotic assisted technology for partial knee, total knee, and total hip replacement surgery. Using the Mako® Robotic Assisted Surgical system, surgeons create a personalized surgical plan based on each patient’s unique anatomy. Clinical studies comparing Mako® Robotic Assisted Surgery to conventional joint replacement report the following:improvements in the fit and anatomical alignment of the prosthetic joint, reduced soft issue injury, lower pain scores, and higher satisfaction.

Risk Factors You Can't Change

Some risk factors for osteoporosis cannot be changed. These include

  • Gender. Women are at higher risk for osteoporosis than men. They have smaller bones and lose bone more rapidly than men do because of hormone changes that occur after menopause. Therefore, if you are a woman, you are at higher risk for osteoporosis.
  • Age. Because bones become thinner with age, the older you are, the greater your risk of osteoporosis.
  • Ethnicity. Caucasian and Asian women are at the highest risk for osteoporosis. This is mainly due to differences in bone mass and density compared with other ethnic groups. African-American and Hispanic women are also at risk, but less so.
  • Family History. Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too.
  • History of Previous Fracture. People who have had a fracture after the age of 50 are at high risk of having another.

Risk Factors You Can Change

There are other risk factors for osteoporosis that can be changed.

  • Poor diet. Getting too little calcium over your lifetime can increase your risk for osteoporosis. Not getting enough vitamin D -- either from your diet, supplements, or sunlight -- can also increase your risk for osteoporosis. Vitamin D is important because it helps the body absorb calcium. An overall diet adequate in protein and other vitamins and minerals is also essential for bone health.
  • Physical inactivity. Not exercising and being inactive or staying in bed for long periods can increase your risk of developing osteoporosis. Like muscles, bones become stronger with exercise.
  • Smoking. Cigarette smokers may absorb less calcium from their diets. In addition, women who smoke have lower levels of estrogen in their bodies. Learn more about smoking and bone health.
  • Medications. Some commonly used medicines can cause loss of bone mass. These include a type of steroid called glucocorticoids, which are used to control diseases such as arthritis and asthma; some antiseizure drugs; some medicines that treat endometriosis; and some cancer drugs. Using too much thyroid hormone for an underactive thyroid can also be a problem. Talk to your doctor about the medications you are taking and what you can do to protect your bones.
  • Low body weight. Women who are thin -- and small-boned -- are at greater risk for osteoporosis.

Use this checklist to find out if you are at risk for weak bones.

Many of these risk factors, both ones you can change and ones you cannot change, affect peak bone mass, which is when your bones achieve maximum strength and density. Because high peak bone density can reduce osteoporosis risk later in life, it makes sense to pay more attention to those factors that affect peak bone mass.

Learn more about peak bone mass.

Sports Medicine

The Orthopaedic Specialists at WRMC Orthopaedic and Sports Medicine Clinic provide diagnosis, treatment, rehabilitation, and injury prevention recommendations for athletes and fitness enthusiasts at every age and skill level. Physicians may also provide consultation to athletes for agility, endurance, and strength training. Our team includes an American Academy of Orthopaedic Surgeons certified Sports Medicine Specialist and fellowship trained Sports Medicine Specialist. Orthopaedic Surgeons are on call to ensure access to timely care in the event of an orthopaedic sports injury. Call our clinic at (870) 793-2371 to learn more about our Sports Medicine services.

Common Sports Injuries

Work Injuries

When an orthopaedic injury occurs at work it is important to seek prompt treatment.  Our clinic is dedicated to providing efficient patient centered care to treat many work-related injuries and help patients return to work as soon as safely possible.  We work closely with human resource departments to ensure proper documentation to satisfy worker’s compensation insurance requirements. If you are injured at work, call (870) 793-2371 to discuss an evaluation.

Common Orthopaedic Work Injuries

  • Overexertion Injuries – Carrying, Holding, Lifting, Pulling
  • Repetitive motion injuries - Carpal Tunnel Syndrome
  • Reaction Injuries – Crush injuries, Reaching, Slipping, Tripping

Note - WRMC Orthopaedic and Sports Medicine Clinic is a general Orthopaedic practice and we do not treat diseases or injuries of the back and spine. 

Arthroscopic Surgery

Arthroscopy is an outpatient surgical procedure used to visualize, diagnose, and treat conditions inside the joint.   During an arthroscopic procedure, the surgeon inserts an instrument with a camera and light into a small incision.  Images are transferred onto a screen to allow the surgeon to see inside the joint and confirm diagnoses. Instruments may be inserted through other small incisions to allow the surgeon to repair cartilage, ligament, or tendon damage.

Arthroscopy is minimally invasive and most patients report less pain and quicker return to daily activities when compared to open surgery.   Most patients return to work or school in a few days. It is important for patients to follow post-operative instructions carefully to prevent complications and allow healing.

Arthroscopic Procedures

  • Ankle
  • Elbow
  • Hip
  • Knee – Cartilage Tears, Chondromalacia, Anterior Cruciate Ligament Tears
  • Shoulder – Dislocations, Impingement Syndrome, Rotator Cuff Tears
  • Wrist – Carpal Tunnel Syndrome

Injection Therapy

The Orthopaedic Surgeon may recommend injections to relieve joint pain and inflammation as a part of an overall plan of care.  Injections may be recommended in conjunction with other treatments before surgical intervention is considered.  Relief is usually felt within a few days following the injection and may last up to six months.  Injections are effective in the temporary relief of pain and inflammation.  

  • Corticosteroids – Corticosteroid injections are used to treat osteoarthritis of the hips, knees, and shoulders. 
  • Enzymes – The enzyme collagenase clostridium histolyticum is injected into the palm of the hand to treat Dupuytren’s contracture, a thickening of the tissue under the skin in the palm of the hand. As the tissue thickens, knots and a thick cord develop causing the finger to bend inward.  The injection relaxes and weakens the cord allowing the cord to be broken so that fingers can be straightened and functional.
  • Hyaluronic Acid Injections – A solution of hyaluronic acid is injected into the knee to restore the normal properties of normal joint fluid.  This injection may be used for patients who are not good candidates for knee replacement surgery
  • Platelet Rich Plasma (PRP) – This injection uses the patient’s blood and platelets to promote healing.  It is used to treat osteoarthritis pain. Early research suggests PRP injections can alter the body’s immune response and help reduce inflammation.  Most insurance companies do not cover the cost of PRP injections.