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Did You Know?

Palmetto Bone & Joint is home to two physical medicine and rehabilitation specialists, Dr. Giridhar Gundu and Dr. Jacquelyn Van Dam, who diagnose and treat a broad range of orthopedic issues without surgery. This includes back pain, one of the biggest complaints of patients. Back pain is caused by age, arthritis, traumatic injury, and even work! Dr. Gundu and Dr. Van Dam use ultrasound to determine the source of pain and the best way to eliminate it.

Innovative procedures offered at Palmetto Bone & Joint

Minimally invasive knee replacements
The most innovative approach to knee replacement spares the vital quadriceps tendon.  The surgeons, with the aid of cutting edge surgical devices, no longer need to incise this muscle, which results in less pain and quicker recovery.  Less scar tissue also lends to less post operative stiffness.



Partial or unicompartmental knee replacements
Partial knee replacements resurface only on the side of the knee.  If only the medial side is damaged by arthritis, we may choose to replace this component.  All ligaments and muscles are left intact.  This can be an attractive option for the younger arthritic patient that is active in recreation and work.



Minimally invasive hip replacements
A wide range of options is available.  Approaches to the hip include the anterior approach as well as the Anterior-lateral and Posterior.  Although the posterior approach has not been the most widely used across the country, we have maintained the anterior and anterior-lateral have distinct advantages. Fewer complications like hip dislocations can be avoided with these newer approaches.  Hospital stays are frequently two days due to the limited pain post-operatively.


Also available and routinely used is the “Big Femoral Head” hip replacement.  This is the "all metal" hip replacement.  This large ball hip component virtually eliminates hip dislocations.  In addition to this advantage, is the fact that the plastic components are eliminated.  The plastic components are the culprit in most hip failure and cause the hip to “wear out.”  It is believed that the elimination of plastic will provide very good long-term results.


Resurfacing hip replacements such as the Birmingham Hip system is also available.  In this procedure, we mill the femoral head and then provide a cap on the ball and replace the socket with a metal liner.  This procedure is not minimally invasive though.  We often prefer the “all metal” hip since the results are exceptionally reproducible and it can be minimally invasive.



Cartilage transplantation
The doctors at Palmetto Bone & Joint have been performing cartilage transplantations for the past twelve years with classic results.  A variety of options are used.  This may be taken from one part of the knee and moved to the damaged side or from a cadaver donor.  We also use Carticel grafting where cartilage is removed and grown in a lab for several months then transplanted into a defect.  This has the advantage of using one’s own cartilage, but the obvious disadvantage of two surgeries.  Large defects are filled with the carticel technology or cadaver grafting.



Arthroscopic carpal tunnel surgery
Dr. Owens has performed approximately one thousand arthroscopic carpal tunnel repairs.  This eliminates all, but a small puncture incision to the wrist to remove the pressure on the median nerve and resolve the painful situation.  The incision on the palm can be essentially eliminated.



Arthroscopic shoulder surgery
Arthroscopic shoulder surgery has been widely used by Palmetto Bone & Joint for many years.  Rotator cuff surgery is one of the most common problems we face.  With the technology now available, we can improve the visualization of the cuff damage and repair the problem.  Many options are available and each has its own pros and cons.  The surgeons can help direct you in that decision using their years of experience.



Arthroscopic knee reconstruction
The expertise in sports medicine at Palmetto Bone & Joint is extensive.  We are the team doctors for Presbyterian College as well as all the local high schools in Laurens and Newberry counties.  Ligament reconstructions using arthroscopic repairs and performed commonly on high performance athletes, but may be necessary for the “weekend warrior” and the young laborer who works in a physically demanding job.  We may use tissue from the patient or cadaver depending on the patient’s request.  This now can be preformed as an outpatient.



Innovative spine fusions and decompressions
Palmetto Bone & Joint has many different options for difficult spine conditions such as arthritis and compression fractures.  This may involve fusing two segments into one with the use of a small metal plate or simply decompressing the “pinched nerve” through microscopic disc removal.  A large microscope is used to aid in the visualization of the spinal cord to remove or repair damaged segments through a very small incision.  With this device, the recovery can be measured in days rather than months.



MRI Compatible Spinal Cord Stimulators
Chronic back pain is a common complaint among adults. Palmetto Bone & Joint offers a new solution called MRI compatible spinal cord stimulation in which a small device similar to a pacemaker is implanted under the skin of the patient. The neurostimulator delivers mild electrical pulses to the spine, causing a tingling sensation in the area of the chronic pain. This medical advancement is helping chronic pain sufferers to conquer pain and return to normal activities.



SI (Sacroiliac) Joint Fusion
The sacroiliac joint is the joint that joins the sacrum (tailbone) to the pelvis. It can be the source of lower back pain, buttocks pain, sciatic leg pain, groin pain, hip pain, urinary frequency, and transient numbness, prickling, or tingling. Patients with severe and disabling sacroiliac joint dysfunction can suffer from insomnia and depression.


Palmetto Bone & Joint is among the first in South Carolina to perform SI joint fusion surgery using the iFuse Implant System, a minimally invasive procedure to treat sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruptions and degenerative sacroiliitis. This innovative procedure helps to relieve pain and help patient return to active lives.



Ultrasound Guided Interventional Procedures
Palmetto Bone & Joint is using ultrasound to more accurately diagnose and treat the sources of chronic pain. With this approach, injections can be delivered directly to the source of pain, providing highly effective relief.