Adult Reconstructive Surgery

Orthopedic Surgeons Offering Minimally Invasive Surgical Procedures:

Total Shoulder/Reverse Total Shoulder Replacement

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This is a popular procedure for restoring comfort and function to the arthritic shoulder. In this procedure, the arthritic ball is replaced by a smooth metal ball fixed to the arm bone (humerus) by a stem that fits within it. Reverse total shoulder replacement is where the socket and metal ball are switched. A reverse total shoulder replacement works better for people with cuff tear arthropathy because it relies on different muscles to move the arm. In a healthy shoulder, the rotator cuff muscles help position and power the arm during a range of motion. A conventional replacement device also uses the rotator cuff muscles to function correctly. The FDA approved the use of this surgery in 2003.

Candidates For Surgery:

  • A completely torn rotator cuff
  • Cuff tear arthropathy
  • A previous shoulder replacement that was unsuccessful
  • Severe shoulder pain and difficulty lifting your arm away from your side or above your head
  • A complex fracture of the shoulder joint
  • A chronic shoulder dislocation
  • A tumor in the shoulder joint
  • Tried other treatments (i.e., rest, medications, cortisone injections, and physical therapy) that have not relieved shoulder pain.

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​Direct Anterior Hip Replacement And Resurfacing

When a patient has arthritis of the hip, the underlying bone develops spurs and irregularities which can cause pain and loss of motion. A total hip replacement can relieve pain and restore normal function in patients whose hip joint has been damaged. During this surgery, the damaged hip socket and ball of the femur are replaced by human-made implants.


There are several benefits of the Direct Anterior Approach in hip resurfacing including; avoidance of detaching major muscle groups from bone, a higher likelihood of maintaining the blood supply to the remaining femoral neck, less risk of discoloration as the dynamic hip stabilizer is entirely unaffected, and less possibility for patients to experience a limp since the abductor is not released from the greater trochanter.


This approach is more tedious for the surgeon, and not all patients are candidates for it.

“MAKO” Robotic Hip Surgery + Unicompartmental Knee Surgery

Mako can be used for hip surgery. This technology provides your surgeon with a specific 3D model to pre-plan your hip replacement. During operation, based on your patient-specific plan, the surgeon guides the robotic-arm. This technology helps the surgeon focus on the removal of diseased bone, and preserve the healthy tissue.

Mako can also be used for knee surgery. This is a procedure designed to relieve the pain caused by joint degeneration due to osteoarthritis in the knee. It targets the part of your knee damaged by osteoarthritis so that your surgeon can replace the diseased portion of your knee while helping to spare the healthy bone and ligaments.

How It Works

1. Have A Plan Personalized For You

This process begins with a CT scan of your joint that is used to make a 3D virtual model of your anatomy. Then, this virtual model is loaded into the mako system software and is used to create your personalized pre-operative plan.

2. In The Operating Room

In the operating room, your surgeon will use mako to assist in performing your surgery based on your personalized preoperative plan. With the mako system, your surgeon can make changes to your program during operation as needed. When the surgeon prepares the bone for the implant, the mako system guides the surgeon within the predefined area and helps prevent the surgeon from moving outside the planned boundaries.

3. After Surgery

Your surgeon, nurses and physical therapists will help you set goals to get you back on the move. Additionally, they will closely monitor your condition and progress.

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Total Knee Arthroplasty

Total knee arthroplasty (replacement) may be required if arthritis or injury severely damage your knee. If all other nonsurgical treatments such as medications and using supports are no longer relieving your pain, you should probably consider total knee replacement surgery. This surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.

Viscosupplementation (Synthetic Joint Fluid)

Viscosupplementation is a procedure where a lubricating fluid is injected into a joint. Also called hyaluronic acid injections or hyaluronan injections, viscosupplementation is most commonly used to treat symptoms of knee osteoarthritis.

What Is It?

Hyaluronic acid is needed in healthy joints but is found in lower concentrations in osteoarthritic joints. By adding hyaluronic acid to the existing bone of an osteoarthritic knee, the goal is to:

  • Facilitate better knee movement
  • Reduce pain and
  • Perhaps slow osteoarthritis progression.


Typical candidates of viscosupplementation are people with knee osteoarthritis who have failed to improve with other non-surgical treatments.

Platelet Rich Plasma (PRP) And Stem Cell Injections

The use of platelet-rich plasma, a portion of the patient’s blood, which promotes healing of injured ligaments, muscles, and joints. This can be applied to various musculoskeletal problems. Additionally, stem cell injections support the reparative response of diseased, dysfunctional or injured tissue using stem cells or their derivatives.

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About Charles J. DePaolo, M.D.

Dr. DePaolo has practiced medicine in Asheville for over 20 years and specializes in Sports Medicine, Joint Reconstructive Surgery, and Shoulder, Hip, and Knee Surgery. He is speciality certified in Sports Medicine “Certificate of Added Qualifications in Sports Medicine”.