CONDITIONS TREATED

Dr. Jelsma is happy to assist all patients with their general orthopedic needs. In particular, he specializes in sports medicine, minimally invasive arthroscopic surgery, and other practice areas outlined below such as knee and shoulder replacement. If Dr. Jelsma believes that your problem falls outside his area of expertise, he will assist you in finding a qualified specialist who can provide you with superb care.

Dr. Jelsma prides himself on seeing all of his patients personally. First, each patient is examined. Next, additional tests like MRIs or x-rays may be ordered to determine an accurate diagnosis. Dr. Jelsma then reviews a list of treatment options with the patient in order to make a decision while taking into account their personal goals and lifestyle considerations.

Because all surgery carries risk, our office emphasizes trying all non-surgical options first. Many non-operative treatments like medication, injections, and physical therapy can be highly effective in curing orthopedic injuries. Dr. Jelsma wants to solve your medical issue with as little risk and pain as possible.

Unfortunately, conservative options do not yield satisfactory results for all injuries. Surgery, in these cases, may be the appropriate option. Dr. Jelsma has been in practice since 1995 and has performed over 10,000 operations. In any surgical procedure, Dr. Jelsma will oversee all aspects of your care—both before and after surgery. In any case, you will be consulted in all aspects of the decision making process.

We let the patients know before deciding on surgery, the length and commitment involved in one’s rehabilitation program after the procedure. We want our patients to realize that rehabilitation after surgery is an important part of surgical success. Patients are informed what level of personal commitment is involved in their recovery. We discuss what follow-up therapy will be required, and assist you in getting it set up.

WHAT WE TREAT

We treat all musculoskeletal issues of the extremities. The following is a list of common conditions we treat:

Knee

  • ACL tears, as well as other ligament tears
  • Meniscus tears
  • Patellar instability
  • Osteochondral injury
  • Arthritis of the knee
  • Patellar or quadriceps tendon tears

Shoulder

  • Rotator cuff tears and biceps tears
  • Shoulder instability and labral tears
  • Shoulder impingement
  • Arthritis of the shoulder
  • AC joint separations
  • Adhesive capsulitis (frozen shoulder)

Elbow

  • Tennis elbow
  • Golfer’s elbow
  • Biceps or triceps tendon tears
  • Arthritis of the elbow
  • Ulnar collateral ligament tears in throwers
  • Loose bodies in the elbow
  • Bursitis of the elbow
  • Ulnar nerve entrapment

Foot and Ankle

  • Achilles tendinitis and Achilles tendon tears
  • Ankle instability
  • Loose bodies or osteochondral injuries of the ankle
  • Arthritis of the ankle

Hip

  • Hip impingement
  • Labral tears
  • Arthritis of the hip
  • Bursitis of the hip

Wrist and Hand

  • Carpal Tunnel Syndrome
  • Trigger fingers
  • Ganglion cysts
  • Tendinitis of the wrist or hand
  • Arthritis of the wrist or hand

General Conditions

  • Sprains or strains
  • Fractures
  • Contusions to muscle or bone
  • Tendinitis or bursitis
  • Arthritis
  • Torn tendons, ligaments, or cartilage

Below is a short explanation of some of the more common knee and shoulder injuries we treat in our office.

Knee Conditions

ACL Tears

The anterior cruciate ligament (ACL) is one of four ligaments that stabilize the knee joint.  ACL tears typically result from a sudden traumatic injury to the knee. Patients usually know when ACL tears occur, because they may feel or hear a pop in the knee, which may give out and cause a fall. The knee then swells and becomes painful and unstable. ACLs are most commonly torn during sports that involve sudden stops or changes in direction, like baseball, basketball, or football.

ACL tears generally require surgery to fix.  Reconnecting the torn pieces of the ligament does not repair the ACL.  Instead, the torn ligament is entirely replaced with a new one, utilizing a minimally invasive arthroscopic technique.  Part of another ligament from the knee or hamstring is used to create a graft for a new ACL.

Meniscal Tears

Two wedge-shaped pieces of cartilage sit between your thighbone (femur) and shinbone (tibia).  These are called meniscus cartilages. They act as shock absorbers to cushion and stabilize the joint.

Meniscus tears in the younger population commonly happen because of a traumatic injury.  Athletes who are moving fast with a lot of momentum can easily wrench or twist their knees by accident, causing a meniscal tear.  People who tear their meniscus will often hear a pop when it happens.  For middle-aged and older adults, meniscus tears can occur from less traumatic activities such as kneeling and squatting.

Knee Arthritis

Arthritis is a condition that causes pain, swelling, and stiffness in any joint in the body, particularly the knees. Arthritis appears almost exclusively in adults.  The two most common forms of arthritis are osteoarthritis and rheumatoid arthritis.  Osteoarthritis is the most common form of arthritis to affect the knee.  It results from prolonged wear and tear on the joint, so it mostly affects adults over fifty. The cartilage that protects the knee bones gradually wears away, causing pain and stiffness.  Rheumatoid arthritis is a chronic disease that attacks joints throughout the body, damaging cartilage and softening bone.

Knee Replacement

The knee is a hinge joint where the thigh bone (femur) and the shin bone (tibia) meet. When the knee moves, the knee cap (patella) moves over the femur. In a healthy joint, a layer of cartilage cushions the bone ends, allowing smooth, easy motion in the knee. But arthritis as well as certain knee injuries and diseases can damage the cartilage, causing the bones to rub together and leading to pain and stiffness.

A total knee replacement consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee. These artificial parts help the knee move smoothly so the patient can experience pain relief and a better quality of life.

Shoulder Conditions

Rotator Cuff Tears

The rotator cuff is a group of four muscles and their tendons that stabilize the shoulder and allow for complete freedom of movement of the arm. The tendons can be torn by an acute injury such as attempting to lift a heavy object. It can also tear from a long period of overuse, which is why this condition is most common in patients over 40. In both cases, rotator cuff tears cause severe pain and weakness in the shoulder.

Tears may be treated with nonsurgical procedures, including rest, anti-inflammatory medication, steroid injection, or physical therapy.

Those tears that do not improve may require surgery to fix. Dr. Jelsma performs rotator cuff surgery using modern all arthroscopic procedures. Arthroscopic surgery involves making several small quarter-inch incisions in the shoulder and then inserting a small camera lens. The camera displays the inside of the shoulder on a monitor, allowing Dr. Jelsma to perform the repair using tiny, specially designed tools. The arthroscopic repairs that Dr. Jelsma specializes in are the least invasive method of rotator cuff repair, leaving patients with less scarring and pain after surgery.

Shoulder Instability and Labral Tears

The shoulder is the most inherently unstable major joint in the body due to its unique anatomy. It is a ball and socket joint, like the hip. But whereas the hip has a round socket which stabilizes the ball in the socket, the shoulder has a very flat socket which offers less bony stability to the joint. The shoulder therefore relies on the soft tissues, which consists of the labral cartilage, capsule, and surrounding rotator cuff muscles, to stabilize the joint. The advantage of this unique anatomy is that it allows more range of motion than any other joint.
The disadvantage is that the shoulder can be dislocated more easily than other joints. Shoulder instability is more frequently seen in adolescents and young adults.

There are two basic types of instability: the first is due to a traumatic injury, and the second is due to genetic laxity of the soft tissues surrounding the joint. In a traumatic injury, the shoulder is forcefully dislocated, typically causing a tear of the labral cartilage and capsule. Most patients with a traumatic dislocation develop recurrent instability because the labrum and capsule do not heal properly when left alone. Many of these patients will benefit from minimally invasive arthroscopic surgery to repair the torn labrum and capsule, and restore normal anatomy. In contrast, a patient with genetic laxity is usually best treated by physical therapy to strengthen the muscles around the shoulder, which act as a dynamic stabilizer to the joint.

Shoulder Replacement

Arthritis in the shoulder means that the cartilage layer which covers both the ball and socket has worn away, resulting in chronic pain and stiffness. If nonsurgical treatment (including rest, physical therapy, anti-inflammatory medication, and injections) fails to relieve or adequately control pain, then a shoulder replacement can be performed to relieve the pain and improve function.