SERVICES

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At Nolo Ortho, we provide a wide range of orthopaedic services, including orthopaedic surgery, sports & regenerative medicine, and onsite physical therapy. We also proudly offer a sports medicine walk-in clinic for those unexpected ailments and injuries. Learn more about the services we provide below.

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SPORTS MEDICINE WALK-IN CLINIC

We understand that orthopaedic injuries are never planned. Additionally, our goal is to be there for you when you need us. That's why we developed our Sports Medicine Walk-In Clinic, open Monday through Friday from 8 a.m. to 4:30 p.m. to provide easy access when an unexpected injury occurs.

SHOULDER + UPPER EXTREMITY

The shoulder is very complex and has a wide range of motion. Unfortunately, this also makes it more vulnerable to injury than many other parts of the body. At Nolo Ortho, we treat a range of shoulder and upper extremity conditions. This includes rotator cuff tears and injuries, dislocated and separated shoulders, and more.

ROTATOR CUFF TEAR/INJURY

The rotator cuff includes a set of muscles and tendons surrounding the shoulder joint, which help to keep it stable. Rotator cuff injuries are common, especially as you get older. Some causes of a rotator cuff tear include either an injury or degeneration over time. It is also possible to have a partial or full-thickness (complete) rotator cuff tear. Common symptoms of a rotator cuff tear include pain at rest and at night (mainly when lying on the affected shoulder), as well as pain or weakness with lowering or lifting your arm or during certain movements, and/or a popping sensation when moving the arm in particular positions. At Nolo Ortho, we provide a number of surgical and nonsurgical treatment options for rotator cuff tears and injuries, including shoulder arthroscopy.

DISLOCATED SHOULDER

Most often, a dislocated shoulder is caused by a fall or blow, triggering the arm bone to pop out of the shoulder socket. This injury often causes severe pain in the shoulder and upper arm, as well as a bump in the front or back of the shoulder, depending on how the bone is dislocated. Treatment options for shoulder dislocation include moving the bone back into place, splinting/immobilization, ice rest, medication, rehabilitation, and in very rare cases, surgery.

SEPARATED SHOULDER

A separated shoulder doesn’t directly affect the shoulder joint, contrary to what you might think by its name. Rather, one of the ligaments that connects the collarbone (clavicle) to the shoulder blade tears, Symptoms include immediate intense pain, shoulder and collarbone tenderness, bruising and/or swelling, and a distorted shoulder. Treatment for shoulder separation includes rest, ice, medication, rehabilitation/physical therapy. In rare care cases, surgery may be considered. Most patients regain full function within a few weeks of the injury.

SHOULDER BURSITIS

Shoulder bursitis is the inflammation of a bursa, which is a small fluid-filled sac that reduces friction between moving parts in your body’s joints, in the shoulder. Symptoms include an achy or stiff feeling, increased pain when you move or press on the inflamed area and swelling and redness. Consult a doctor if the pain becomes debilitating, or if you experience a sudden inability to move your arm, excessive swelling or redness at the affected area, a sharp or shooting pain (especially during exertion) or run a fever. Treatment of shoulder bursitis includes rest, ice, and medication. Bursitis pain typically goes away within a few weeks with proper treatment. However, recurrent flare-ups are common.

SHOULDER IMPINGEMENT ("SWIMMER'S SHOULDER")

Shoulder impingement syndrome, also known as ‘swimmer’s shoulder,' usually occurs when the top outer edge of the shoulder blade rubs up against the rotator cuff beneath it. Shoulder impingement often occurs due to a preexisting rotator cuff injury or irritation and is typically caused by inflammation from repetitive shoulder activities. Typical symptoms include pain when lifting the arm overhead, difficulty reaching behind the back, and weakness of the shoulder muscles. Treatment includes rest, medication, ice, and rehabilitation/physical therapy. If conservative treatments don’t work, surgery may be considered.

ADHESIVE CAPSULITIS ("FROZEN SHOULDER")

Frozen shoulder, also called adhesive capsulitis, is a condition described as stiffness and pain in the shoulder joint. Typically, the symptoms are gradual, worsening over time and then recovering, usually within one to three years. Patients recovering from a medical condition or procedure that prevents movement of the arm – such as a stroke or mastectomy – are at a higher risk of developing this condition. Treatment options involve physical therapy, including range-of-motion exercises, and sometimes, corticosteroids and numbing medications may be injected into the joint. In rare cases, surgery may be indicated.

JOINT REPLACEMENT

Joint replacement is used to improve function, mobility, and strength by replacing all or part of the joint. Joint arthritis can limit mobility and reduce one's quality of life and is the most common condition leading to joint replacement. At Nolo Ortho, we provide partial and total knee replacement and partial and total hip replacement. This includes minimally invasive, muscle-sparing joint replacement to help patients get back to their lives and daily activities.

TOTAL + PARTIAL KNEE REPLACEMENT

Knee arthritis is extremely common. In fact, more than 10 million Americans suffer from knee arthritis. Osteoarthritis is the most common cause of degeneration of the knee, which can be thought of as "wear and tear". This typically occurs as people age. Rheumatoid arthritis can also cause degeneration, though it is less common. Over time, arthritis can cause gradually increasing pain and swelling of the knee. Eventually, the cartilage wears out and the bones touch one another, causing pain, swelling, and difficulty bearing weight. X-rays or other imaging will be used to help diagnose the extent of a patient's condition and determine the best treatment plan. Non-surgical options such as physical therapy, anti-inflammatory medications, weight loss, activity modifications, bracing, and joint injections will be considered first. Surgery may be an alternative if those options don't work.

The most common surgery for knee arthritis is a knee replacement, also known as total joint arthroplasty. This is a common surgery, during which, the surgeon removes arthritic cartilage and bone and implants a prosthetic joint in the knee. It has a long-proven track record of being a successful treatment for patients with knee pain and arthritis when non-surgical options have failed. A partial joint replacement is an option if a full replacement isn't needed. During a partial replacement, the surgeon only removes the impacted surfaces instead of the entire joint. The decision between total and partial replacement depends upon factors like degeneration, age, and more.

TOTAL + PARTIAL HIP REPLACEMENT

Hip arthritis is thought to impact around 25% of Americans. Aging, genetics, previous injuries, hip dysplasia, and many other factors can cause hip arthritis. Over time, as the cartilage wears out, the bones in the hip begin to rub against one another, causing pain and discomfort in the groin, thigh, and/or buttocks. It can also cause reduced mobility and a limited and/or painful range of motion. This can make simple activities, like tying shoes, standing up and sitting down, and walking, difficult for many patients. Conservative, non-surgical treatments are always the first option. These include physical therapy, anti-inflammatory medications, weight loss, activity modifications, water therapy, and sometimes joint injections. However, there is no cure for hip arthritis. So, if conservative treatments fail, hip replacement surgery may be the best option.

During hip replacement surgery, a surgeon replaces the ball and socket in the hip. At Nolo Ortho, we provide both partial and total hip replacement. In a total anterior and posterior hip replacement, the entire hip joint is removed, and a prosthetic joint is implanted. In a partial replacement, only the affected surfaces are instead replaced. Hip replacement can relieve pain and improve range of motion.

SHOULDER REPLACEMENT

In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis. The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid). Several conditions can cause shoulder pain and disability that lead patients to consider shoulder joint replacement surgery, including a failed previous shoulder surgery degenerative joint disease, or osteoarthritis as well as several conditions attributed to rheumatoid arthritis.

TOTAL SHOULDER ARTHROPLASTY

Total shoulder arthroplasty, or total shoulder replacement, involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket. These components vary and may either be cemented, or press fit into the bone. If the bone is good quality, your surgeon may choose to use a non-cemented (press-fit) humeral component. If the bone is soft, the humeral component may be implanted with bone cement. In most cases, an all-plastic glenoid (socket) component is implanted with bone cement. Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.

REVERSE TOTAL SHOULDER ARTHROPLASTY

Another type of shoulder replacement is the reverse total shoulder arthroplasty procedure. The reverse total shoulder arthroplasty is used for those with completely torn rotator cuffs and severe arm weakness, and those patients with severe arthritis and rotator cuff tearing as well as patients with a previously failed shoulder replacement surgery. For these individuals, a conventional total shoulder replacement can still leave them with pain. They may also be unable to lift their arm up past a 90-degree angle. Not being able to lift your arm can be severely debilitating. In the reverse total shoulder arthroplasty, the socket and metal ball are switched: A metal ball is attached to the shoulder bone, and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.

SPORTS MEDICINE

Unfortunately, normal wear and tear and injuries are common for athletes. Get back to the game faster with our advanced sports medicine in Brentwood, TN and the surrounding areas. At Nolo Ortho, we provide minimally invasive shoulder, knee, and hip arthroscopic surgery and more, as well as return-to-sports programs through our onsite physical therapy center. When you're in need of quality sports medicine in Smyrna, TN or a surrounding area, turn to the team you can trust. Choose Nolo Ortho!

KNEE ARTHROSCOPY

Knee surgery is very common. In fact, it is one of the most common procedures in the United States. Many patients have knee arthroscopy to repair torn cartilage in the knee. This can have a variety of causes, including a fall, sports injury, and more. Arthroscopy is a conservative surgical technique used to treat torn knee cartilage.

During knee arthroscopy, a surgeon makes two small (about 1/4 of an inch) incisions in the front of the knee. Then, the surgeon uses a narrow tube with a camera to navigate the knee. After this, they can repair tears, “clean” the joint, and more. Most arthroscopic knee procedures are outpatient, meaning a hospital stay isn't required. Patients are under general anesthesia for the procedure, which usually lasts about an hour. Patients are generally allowed to walk on the surgical leg immediately. However, some post-procedure pain and swelling are expected, which ice and elevation help to minimize. In most cases, patients can go back to full activity 4 to 6 weeks after surgery. Knee arthroscopy is the preferred surgical option for patients and athletes who want to return to an active lifestyle safely and quickly. Post-surgery physical therapy is also critical to a full recovery. We are proud to offer onsite physical therapy at our center. When you choose Nolo Ortho for your knee procedure, you can feel confident in the care you're receiving. We provide the sports medicine Brentwood, TN trusts, so you can rest assured that we'll have you back playing the sports you love in no time!

SHOULDER ARTHROSCOPY

Shoulder arthroscopy is most used to treat rotator cuff issues. The rotator cuff is a complex series of small muscles that help your shoulder joint function. These muscles also keep the arm bones properly attached to the shoulder socket. In most cases, rotator cuff problems aren't associated with a specific injury, yet develop over time. Arthroscopy is a conservative technique to shoulder surgery.

During shoulder arthroscopy, a surgeon makes three or four small (around 1/4 inch) incisions. The incisions allow access to the joint to repair torn tissue and correct sources of pain. During the surgery, which lasts around 1-2 hours, patients are under general anesthesia. Most patients receive a nerve block after surgery to minimize post-surgical pain. A sling is usually worn for several weeks. Physical therapy is also vital to recovery. Most patients undergo a 6–8-week PT program, which ensures patients regain range of motion and rebuild strength. At Nolo Ortho, we are proud to provide onsite, expert physical therapy to help patients make a full recovery. Recovery after the procedure is typically about 3 months. While shoulder arthroscopy has a longer recovery period than knee arthroscopy, the long-term results are excellent for most patients. If you're considering shoulder arthroscopy, turn to the sports medicine Smyrna, TN depends on. Call Nolo Ortho today.

PHYSICAL + REGENERATIVE MEDICINE

PHYSICAL MEDICINE

Through our physical medicine program, we diagnose and treat a variety of medical conditions with procedures such as epidural steroid injections (ESIs), thoracic ESIs, lumbar ESIs, selective nerve blocks, medial branch blocks, facet joint Injections, radiofrequency neurotomy, sacroiliac joint injections, hip injections, and EMG/nerve conduction studies, and more.

REGENERATIVE MEDICINE

Regenerative medicine is the science and medical practice of harnessing your body’s own ability to heal and “regenerate” itself, and to essentially supercharge its own healing powers. These capabilities include repairing or replacing tissue that has been damaged due to disease or injury. In orthopaedics, these treatments have been shown to work well in repairing injuries to ligaments, tendons, muscles, and joints, often helping patients to avoid surgery altogether. These methods give the body a chance to heal on its own. By employing regenerative modalities like platelet-rich plasma (PRP) and stem cells, a doctor injects concentrated cells from the patient’s own body directly into the site of injury. The platelets have natural growth factors which are essential to healing. PRP therapy is especially heralded for its success in resolving or minimizing knee pain, but it also works in helping to heal other joints as well.

ON-SITE PHYSICAL THERAPY

Nolo Ortho's state-of-the-art on-site physical medicine and therapy center provides individualized treatments to help patients heal from injuries, restore function, and get back to life and sport faster. As an on-site program, we work as a team with Nolo Ortho's providers, to monitor and communicate patient progress. This helps to ensure excellent outcomes and healing. Our services include physical medicine, post-surgical care, sports injury rehabilitation, sports training, back and neck therapy, and more.

BOUTIQUE EXPERIENCE. ADVANCED EXPERTISE.

At Nolo Ortho, your experience matters. That's why we proudly provide a modern boutique practice experience combined with advanced orthopaedic expertise.

BOUTIQUE. bou· tique |/bo͞oˈtēk/ [noun]

: a small business that offers highly specialized, sophisticated services or products.

EXPERTISE. ex· per· tise | /ek-(ˌ)spər-ˈtēz/ [noun]

: skill of an expert.
: having, or displaying special skill or knowledge derived from training or experience.