Pacific Rim Orthopedic Surgeons

Our Services

Discover the Proliance Pacific Rim orthopedic services and the treatments our surgeons are able to provide at our surgical center.

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Shoulder injuries are frequently caused by athletic activities that involve excessive, repetitive, overhead motion, such as swimming, tennis, pitching, and weight lifting. Injuries can also occur during everyday activities such washing walls, hanging curtains, and gardening.

If you are experiencing pain in your shoulder, you should ask yourself:

1. Can I rotate my arm in all the normal positions?
2. Does it feel like my shoulder is sliding out of the socket?
3. Do I lack the strength in my shoulder for daily activities?

If you answered “yes” to any one of these questions, you should consult a doctor at Pacific Rim Orthopedic Surgeons for help in determining the severity of the problem.

Elbow Injuries

Your elbow joint is a joint made up of three bones: your upper arm bone and the two bones in your forearm. Muscles, ligaments, and tendons hold the elbow joint together. It is a combination hinge and pivot joint. The hinge part of the joint lets the arm bend like the hinge of a door; the pivot part lets the lower arm twist and rotate. Several muscles, nerves, and tendons cross at the elbow.

The repetitive sudden movements done in competitive sports can stress the elbow and cause tears to tendons.

> Learn about Elbow Replacement Surgery

> Learn about Shoulder Replacement Surgery

> Learn about Olecranon Bursitis: Elbow Bursitis

> Learn about Ulnar Nerve Entrapment: Cubital Tunnel Syndrome

> Learn about Golfer’s Elbow

> Learn about Tennis Elbow

> Learn about Elbow Osteoarthritis

Pacific Rim Orthopedic  Surgeons has a fellowship-trained specialist in hand and wrist procedures.

The hand is a very complex organ with multiple joints, and different types of ligaments, tendons and nerves. With constant use, it is no wonder that hand injuries are common. Hand injuries can result from excessive use, degenerative disorders or trauma. Some of the most common injuries to the wrist are wrist sprains and wrist breaks. (Learn about the differences between wrist sprains and wrist breaks.)

Arthritis, tendinitis, and carpal tunnel syndrome are caused by overuse or by repetitive actions like using a computer keyboard. Nerves damaged by injury can be disabling and result in loss of hand function. It is vital to seek medical help as soon as possible after any hand injury.

> Learn about Finger Joint Replacement Surgery

> Learn about Hand Surgery

> Learn about Tendinitis (Tendonitis)

> Learn about Dupuytren’s Contracture

> Learn about Radial Tunnel Syndrome

The foot and ankle system is composed of 26 bones, multiple joints, ligaments, and muscles to create a unique biomechanical complex.  Foot and ankle conditions can range from benign to devastating problems. Fortunately, Proliance Pacific Rim Orthoapedic Surgeons has the expertise to manage the gamut of foot and ankle problems.

Two types of doctors can help you care for your foot and ankle problems. Foot and ankle subspecialty trained orthopaedic surgeons and podiatrist. Ultimately, whoever you choose, you should feel comfortable with the health care professional providing the care for your foot. Foot and ankle orthopaedic surgeons train on the care of musculoskeletal problems involving the whole body. This wide area of training helps a foot and ankle subspecialty trained orthopaedic surgeon provide more wholistic care for your foot.

Dr. Udawatta, a foot and ankle subspecialty trained orthopaedic surgeon, who joined us in Sep 2021, can take care of your hip all the way down to your foot. Recognizing that the lower extremity is not composed of single anatomic areas that are treated in isolation, you can be confident that our team will help you get back on your feet by caring for your whole body!

Despite being a surgeon, Dr. Udawatta often times tries to find non-operative solutions for your problem. Sometimes, your foot and ankle problem can be helped with a few modifications to your shoes or starting a stretching program. When these options do not work, surgery is occasionally warranted. Rest assured, our team will help you feel safe and confident in the care you are receiving.

Learn more about our foot and ankle specialists here!

Or call to make an appointment today so we can help you get back on your feet!

Learn about specific types of Foot & Ankle Conditions here:

> Learn about Ankle Sprains

> Learn about Toe Joint Replacement

A normal cartilage layer in joints allows nearly frictionless and pain-free movement. When it is damaged or diseased by arthritis, joints become stiff and painful. Every joint is enclosed by a fibrous tissue envelope or capsule with a smooth tissue lining, called the synovium. The synovium produces fluid that reduces friction and wear in a joint. After examination, joint replacement is considered if other treatment options will not relieve the pain and disability.

Although hip replacement surgery and knee replacement surgery are the most common, this procedure can be performed on other joints, including the ankle, foot, shoulder, elbow, and fingers. The materials used in a joint replacement are designed to enable it to move just like a natural joint.

Healthier patients may have the option of having their hip or knee replacement done at an outpatient center, instead of in the hospital. Outpatient centers are less costly and maintain quality and personalized care.

Recovery Process

In general, your surgeon will encourage you to use your “new” joint shortly after your operation.

For hip and knee replacements, you will often stand and begin walking the day after the procedure. Initially, you will walk with a walker, crutches, or a cane. Most patients have some temporary pain in the replaced joint because the surrounding muscles are weak from inactivity and the tissues are healing.

Exercise is an important part of the recovery process. Your surgeon will discuss an exercise program for you after surgery. This varies for different joint replacements and for the differing needs of each patient.

After your procedure, you may be permitted to play golf, walk, and dance. More strenuous sports, such as tennis or running, may be discouraged. The motion of your joint will generally improve after the procedure.

Pacific Rim Orthopedic Surgeons has a fellowship-trained specialist in sports medicine. Sports injuries occur due to overuse or acute trauma of a part of the body when participating in a certain activity. For example, runner’s knee is a painful condition generally associated with running, while tennis elbow is a form of repetitive stress injury at the elbow.

Other types of injuries can be caused by hard contact with something. This can often cause a broken bone or torn ligament or tendon.

Pacific Rim Orthopedic Surgeons will help you get the right treatment for your injury.

One of the most common sports injuries is to the anterior cruciate ligament, better known as the ACL, and is usually found in activities that involve a landing, jumping, sudden stops, or sudden changes in direction. The ACL is in the knee and crosses the posterior cruciate ligament to form an X shape, which places it in control of the front and back motion of the knee and provides rotational stability by running diagonally in the middle of the knee by preventing the tibia from sliding out in front of the femur.

An ACL injury can lead to higher risk in activities like sports and long-term damage if appropriate treatment isn’t sought out.

Anterior Cruciate Ligament Explained

An ACL injury is a sprain or tear of the anterior cruciate ligament and is one of the most common injuries in sports like basketball, downhill skiing, football, and soccer. Many patients report instant symptoms at the moment of an ACL tear, such as:

ACL Injury.

  • loss of range of motion in the knee
  • a popping sound heard at the moment of injury
  • a popping sensation felt at the moment it is torn
  • Unable to put weight on the knee
  • a feeling of instability in the knee
  • Severe pain in the knee
  • An inability to continue the activity in progress

As with other ligament injuries, doctors use a grading system to classify the severity of the injury:

  • Grade One: Mild damage to the ligament, slightly stretched but still able to keep the knee joint stable.
  • Grade Two: the ACL is stretched to the point it has become too loose, also referred to as a partially torn ACL
  • Grade Three: this grade of an anterior cruciate ligament tear is what people often mean when they refer to ACL injuries. The ligament has been torn in half or pulled directly off the bone, making the knee unstable.

Most ACL tears and injuries are complete or near complete tears that require immediate treatment for proper recovery.

ACL Tear Causes

An injured ACL can result from several activities, including:

  • Sudden stops
  • Slowing down while running
  • Landing from a jump incorrectly or awkwardly
  • Quick changes in direction
  • Direct contact, as from a tackle

The risk of an ACL injury increases when other factors are included:

  • Poor conditioning
  • Playing on artificial turf
  • Using poorly maintained sports equipment, such as ski bindings
  • Using faulty movement patterns, such as knees moving inward during a squat. 
  • Participating in sports such as basketball, gymnastics, soccer, and football.

ACL Injury Prevention & Complications

ACL injuries, especially if left untreated, can cause a person to be at higher risk for osteoarthritis in their knee, even if having surgery to fix the tear. To better prevent an anterior cruciate ligament tear, there are several steps you can take:

  • Core strengthening exercises that help to avoid moving the knee inward during a squat
  • Exercise that emphasizes proper technique and knee position when jumping or landing from a jump.
  • Strengthening leg muscles that ensure balanced leg muscle strength, especially in the hamstrings
  • Improve techniques for pivoting and cutting movement.

Surgery and Treatments for Injured ACL

ACL treatments depend on the grade of the ligament injury and the patient’s needs, such as considering their athletic goals and sports activities. An athlete who is younger may require surgery to safely return to playing sports or training while a less active or older athlete can forgo surgery if they no longer participate in activities that will further injure the ligament. 

There are several nonsurgical treatment options for ACL injuries for patients that don’t want to seek an operation to restore the ligament, such as progressive physical therapy and rehabilitation to help the knee return to a pre-injured state. These nonsurgical avenues also include prevention education to avoid future ACL injuries.

For surgery, a patient has several options that depend on both their medical history and the grade of the tear to their ACL:

  • Patellar tendon autograft
  • Hamstring tendon autograft
  • Quadriceps tendon autograft
  • Allografts

Your musculoskeletal system gives you the ability to move. It provides form, support, stability, and movement to the body. This complex system includes your bones, joints, ligaments, tendons, muscles, and nerves, and allows you to move, work, and be active.

Treatment for many musculoskeletal conditions can be done without a surgical procedure by using medication, exercise, and other rehabilitative or alternative therapies.

Pacific Rim Orthopedic Surgeons will discuss your diagnosis and available treatment options with you to help you select the best plan to enable you to live a more active and functional life.

Learn about specific types of Musculoskeletal Trauma here:

> Learn about Septic Arthritis

> Learn about Osteomyelitis

Need Urgent Care?

If you need medical care and cannot wait for a scheduled appointment, please visit Pacific Rim’s Same Day Medical Care page.

* If you are experiencing a medical emergency, please call 911

Quality of Life Care

Aging, disease, and injury can severely impede movement. The focus of Pacific Rim Orthopedic Surgeons is to enable you to return to the activities you enjoy in life.

We strive to help our patients achieve a return to normal activity through compassionate and exceptional care using evidence-based medicine in a patient-friendly environment. We are committed to bringing you a high standard of care that is patient-focused, with the goal of improving your quality of life.

Dad with daughter on his shoulders at the beach