Shoulder Injuries for Soccer Athletes

 

As participation in soccer continues to explode and physicality in the sport increases, we are seeing more and more injuries to the shoulder in young athletes.

Three of the more common upper extremity injuries we see from athletes participating in soccer are:  clavicle fractures, AC joint separations and shoulder dislocations.

A relatively common shoulder injury seen in soccer players is a clavicle (“collarbone”) fracture.  Symptoms of a clavicle fracture include pain and swelling at the site of injury.  Because there is little skin overlying the clavicle, a fracture is usually pretty easy to spot.  There can be a deformity or a bump at the middle of the clavicle.  This area is usually very tender to touch and movement of the arm becomes painful. Many clavicle fractures can be treated with a short period of sling immobilization, but If a player has a suspected clavicle fracture, it is important to talk with an orthopedic surgeon who routinely treats shoulder injuries so that they can evaluate the extent of the injury and whether surgery may be right for them.

Another relatively common shoulder injury is an acromioclavicular (“AC”) joint separation, also known as a shoulder separation.  This often occurs as the result of a fall directly onto the shoulder.  Apart from pain in the shoulder region, it can sometimes be more difficult to pick up on an AC joint injury.  In very severe cases there can be a deformity where the collarbone appears to be sticking above the rest of the shoulder, but this is rare.  Diagnosis of an AC joint injury usually involves an X-ray and exam by an orthopedic physician specializing in shoulder injuries. Fortunately, most injuries to the AC joint can be treated with a brief period of immobilization and rest followed by gradual return to activity.  In rare instances surgery is needed.

Lastly, the shoulder can also be at risk for dislocation if a player lands awkwardly on an outstretched hand.  This injury could occur in the instance when a goalie dives to make a save and lands with his or her arm outstretched above their head.  Typically there will be an obvious deformity of the shoulder and the player will be unable to move their arm.   Sometimes a shoulder dislocation will go back in place or “reduce” on its own, but most of the time it requires a medical professional to reduce the shoulder. This is usually best done in the emergency department where x-rays can be obtained afterwards to ensure that the shoulder is appropriately positioned in the joint.  After a shoulder dislocation has been reduced it is important that appropriate treatment is provided to prevent recurrent instability from developing in the injured shoulder.  This may include physical therapy or in extreme cases surgical intervention to reinforce the stability of the joint.

If you’re having shoulder troubles or think you may have sustained one of these injuries during a game or practice its best to be evaluated by an orthopedic surgeon who specializes in treatment of shoulder or sports injuries.

Kansas City Orthopaedic Institute Now Offering Mako SmartRobotics™

Kansas City Orthopaedic Institute Now Offering Innovative Technology in Total and Partial Knee Replacement with Stryker’s Mako SmartRobotics™

Released January 13, 2020

Kansas City Orthopaedic Institute, the region’s only orthopaedic hospital is excited to offer Mako SmartRobotics™. This advancement in joint replacement surgery transforms the way knee replacements are performed.

Robotic-arm assisted surgery is a new approach to joint replacement that offers the potential for a higher level of patient-specific implant alignment and positioning.1 The technology allows surgeons to create a patient-specific 3D plan and perform joint replacement surgery using a surgeon controlled robotic-arm that helps the surgeon execute the procedure with a high degree of accuracy.2

“I am excited that Kansas City Orthopaedic Institute has invested in the Mako SmartRobotics™ technology. My partners and I have performed over 500 surgeries with Mako and it is changing the way joint replacement surgeries are performed,” said Dr. Scott Wingerter, MD, PhD.  “Using a virtual 3D model, the Mako System allows surgeons to personalize each patient’s surgical plan pre-operatively, so there is a clear plan for how the surgeon will position the implant before entering the operating room. During surgery, the surgeon can validate that plan and make any necessary adjustments, while the robotic-arm then allows the surgeon to execute that plan with a high level of accuracy and predictability. The combination of these three features of the system has the potential to lead to better outcomes and higher patient satisfaction.”

“We are proud to be the only hospital that specializes solely on orthopaedics to offer this highly advanced robotic technology in our area,” said Paul Kerens, Senior Executive Officer at Kansas City Orthopaedic Institute. “This addition to our orthopaedic service line further demonstrates our commitment to provide the community with outstanding healthcare.”

For more information about the services offered at Kansas City Orthopaedic Institute, or to make an appointment, call (913) 319-7633 or visit www.kcoi.com.

About Kansas City Orthopaedic Institute

As the area’s first and only hospital dedicated exclusively to orthopedics, Kansas City Orthopaedic Institute provides comprehensive orthopedic care, from diagnostic imaging to inpatient and outpatient surgery, pain management services, urgent care, and outpatient physical and occupational therapy. Kansas City Orthopaedic Institute is a physician-owned orthopaedic hospital and a joint venture with Saint Luke’s Hospital. Located in Leawood near Overland Park, Kansas, the hospital and its Ortho Urgent Care center proudly serve the Greater Kansas City metropolitan area.

3651 College Boulevard ● Leawood, Kansas 66211

 

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References

  1. Anthony, Ian, Bell, Stuart W., Blyth, Mark, Jones, Bryn, MacLean, Angus, Rowe, Philip. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty. The Journal of Bone and Joint Surgery. Volume 98-A: Number 8. April 20, 2016. pp 627-35.
  2. Dunbar NJ, Roche MW, Park BH, Branch SH; et al. Accuracy of Dynamic Tactile-Guided Unicompartmental Knee Arthroplasty. Journal of Arthroplasty. May 2012. 27(5): 803-808.e1.

 

FOR IMMEDIATE RELEASE

Melissa J. Heck

Director of Marketing & Business Development

Kansas City Orthopaedic Institute

mheck@kcoi.com

913-253-8956

Kansas City Orthopaedic Institute Receives 2020 Best of Leawood Award

Kansas City Orthopaedic Institute Receives 2020 Best of Leawood Award

Leawood, KS, May 20, 2020 – Kansas City Orthopaedic Institute has been selected for the 2020 Best of Leawood Award in the Hospitals category by the Leawood Award Program. Each year, the Leawood Award Program identifies companies that we believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small business through service to their customers and our community. These exceptional companies help make the Leawood area a great place to live, work and play. Various sources of information were gathered and analyzed to choose the winners in each category.

“It is an honor to once again be recognized as one of the best companies in the City of Leawood,” said Dr. Charles E. Rhoades, CEO of Kansas City Orthopaedic Institute.  “Our relationship with the City of Leawood began over 20 years ago and have seen the partnership grow in many ways.  One of the reasons why we choose the City of Leawood as the home for our hospital is their commitment to working with businesses to help them achieve their goals and being a champion for local companies in the community.”

The 2020 Leawood Award Program focuses on quality, not quantity. Winners are determined based on the information gathered both internally by the Leawood Award Program and data provided by third parties.

 

About Kansas City Orthopaedic Institute

As the area’s first and only hospital dedicated exclusively to orthopedics, Kansas City Orthopaedic Institute provides comprehensive orthopedic care, from diagnostic imaging to inpatient and outpatient surgery, pain management services, and rehabilitation therapy. Kansas City Orthopaedic Institute is a physician-owned specialty hospital and a joint venture with Saint Luke’s Hospital. Located in Leawood on College Boulevard, east of Mission Road, the hospital and its Ortho Urgent Care center proudly serve the Greater Kansas City metropolitan area. Kansas City Orthopaedic Institute is accredited by the Accreditation Association for Hospitals/Health Systems (AAHHS).

 

About Leawood Award Program

The Leawood Award Program is an annual awards program honoring the achievements and accomplishments of local businesses throughout the Leawood area. Recognition is given to those companies that have shown the ability to use their best practices and implemented programs to generate competitive advantages and long-term value. The Leawood Award Program was established to recognize the best of local businesses in our community. Our organization works exclusively with local business owners, trade groups, professional associations and other business advertising and marketing groups. Our mission is to recognize the small business community’s contributions to the U.S. economy.

 

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Important Message From Kansas Orthopaedic Institute Regarding COVID-19

The Kansas City Orthopaedic Institute and our orthopaedic physician clinics are taking precautions to protect our patients, families, providers and visitors as we continue to deliver care during this health emergency.  As part of the Saint Luke’s Health System, we are modeling our precautions and procedures from Saint Luke’s.  The new knowledge and changes are being constantly reviewed, and our policies will be updated as needed.

All persons entering our facility will be required to wear a mask/face covering.  This is to protect all patients and employees at KCOI.  We appreciate your cooperation. 

All people entering the KCOI facility will have their temperature screened and will be asked questions regarding health symptoms and travel.

These questions will include:

  • Do you have the following symptoms
    • Fever of 100 degrees or higher
    • New loss of smell/taste
    • Cough (within the last 14 days)
    • Shortness of breath
    • Diarrhea
    • Repeated shaking with chills
    • Chills
    • Headache
    • Sore throat
    • Body aches
  • Within the last 14 days have you:
    • If you have traveled outside of the KC Metro you will not be permitted to enter if you have visited the quarantine states listed on the KDHE Website?
    • Traveled internationally, arrived home from a cruise ship on/after 3/15/2020?
    • Have visited or been a patient of a retirement facility, long term care facility, nursing home, assisted living facility (ALF), skilled nursing facility (SNF) or rehabilitation center in the past 14 days?
    • Are you an employee of a retirement facility, long term care facility, nursing home, or rehab center and visited them in the past 14 days?
    • Have you visited or live in a correctional/detention facility?
  • Within the last 14 days have you had contact with anyone who:
    • Has been quarantined
    • Has been placed on home or self-monitoring, or
    • Has become ill with a fever, cough or difficulty breathing?
    • Has a cough and a fever of 100 degrees or higher?

If you have answer ‘Yes’ to any of these questions, please call your primary care physician and your orthopedic surgeon’s office located at KCOI to get more detailed instructions 913-319-7633.

Effective Wednesday, 3/18, KCOI will be instituting a NO VISITORS policy across all entities.

Guidelines for Hospital and Clinic Visitors

  • No visitors or companions in all physician clinics (see exceptions below)
  • No visitors in hospital, includes all hospital services (see exceptions below)
  • Companions and visitors may wait in their cars or at home.
  • Registration will ask patient for a good phone number
  • Physicians and nurses will call with reports and when ready for discharge.
  • Exceptions may be made for legal or special need, using professional judgment, such as:
    • Minors (one parent/guardian)
    • Companion needed due to:
      • Cognitive needs
      • Communicative needs
      • Undergoing procedure with conscious sedation
      • Mobility issues
      • Adult guardianship

The Ortho Urgent Care at KCOI will remain open at this time as a community service to give patients an additional option to a traditional hospital emergency department.

Credible COVID-19 Information Sources

The Centers for Disease Control and Prevention

Kansas Department of Health and Environment 

Kansas City, Missouri Health Department 

Saint Luke’s Kansas City COVID-19 What You Need To Know

Dr. Theodore Koreckij, Spine Surgeon, Offers New Treatment for Chronic Low Back Pain

A new treatment is available at Dickson-Diveley Orthopaedics from Theodore Koreckij, M.D., orthopedic spine surgeon. The treatment, called the Intracept® Procedure, is an outpatient, minimally invasive procedure for relief of chronic low back pain. Intracept is indicated for patients who have experienced low back pain for more than six months and have not responded to nonsurgical treatments.


The Intracept Procedure uses radiofrequency ablation to relieve chronic low back pain.

The Intracept Procedure blocks transmission of pain signals from the basivertebral nerve, which is located in the bones of the spine (vertebrae). To perform the procedure, Dr. Koreckij advances a specialized probe into the vertebrae through a small incision in the lower back. Once the Intracept probe is positioned at the precise location of the pain-sensing basivertebral nerve, it uses radiofrequency energy (heat) to disable the nerve, rendering it unable to transmit pain signals.

Here is a short video about the Intracept Procedure and how it works.

Results: Decreased Low Back Pain

Dr. Koreckij has been performing the FDA-cleared procedure as part of a second Level I Clinical Study since September 2017. The study, which was designed to corroborate and confirm the results of the first clinical study, closed enrollment earlier this year with superior results. According to Relievant Medsystems, the company that developed the Intracept Procedure, study participants reported a greater than 50 percent decrease in pain at their three-month follow up.

As a result of the study’s successful completion, the Intracept Procedure is now available commercially. Dickson-Diveley Orthopaedics, located inside Kansas City Orthopaedic Institute, is currently one of only two facilities in a six-state region to offer the procedure.

“When it comes to back pain treatments, it’s rare to halt a study ahead of schedule, so the early completion speaks volumes about the positive outcomes we can achieve with the Intracept Procedure,” Dr. Koreckij said. “I am thrilled to offer this option to help improve quality of life for people with chronic low back pain.”

About Dr. Koreckij, Orthopedic Spine Surgeon

A board-certified and fellowship-trained spine surgeon, Dr. Koreckij specializes in a variety of surgical and non-surgical treatment options for adult degenerative disorders of the spine and conditions associated with metastatic disease. His commitment to evidence-based medicine and staying current in the latest treatments for spine diseases led to his involvement in the INTRACEPT study.

To consult with Dr. Koreckij about the Intracept Procedure or other treatment options for back and neck pain, call 913-319-7600. New patients may also request an appointment online.

Demystifying Wrist and Ligament Injuries

Ankle and knee injuries certainly top the list when it comes to the most common injuries in basketball and football players.  However, wrist injuries, such as the one plaguing the University of Kansas depth chart  should not be overlooked.

Frequently, wrist injuries such as fractures can be quickly diagnosed by an xray.  However, it is common for injuries not to be identified until an MRI of the wrist is obtained.  MRI imaging allows the orthopedic surgeon to identify injuries to the soft tissues as well as injuries to the bone that may not be apparent on the x-ray alone.

In the most recent publicized case, X-ray alone was not able to identify the injury of concern, and an MRI was needed.

I would argue that, in addition to a high quality x-ray reviewed by an orthopedic wrist specialist, a detailed examination is essential to pick up the necessity of higher resolution imaging such as an MRI.  It is the combination of X-ray imaging and high quality examination that provides for the best screen for the athlete with a wrist injury.

The anatomy of the wrist is complex, and its ligament names are not as famous as that of the “anterior cruciate ligament (ACL) or ulnar collateral ligament of the elbow (UCL).  The most frequently injured ligament requiring surgical management is called the scapholunate ligament.  An orthopedic wrist specialist is best suited to evaluate for this injury clinically, and provide appropriate management.  Treatment of these injuries could include casting, splinting, hand therapy or surgery.

Beware of self-diagnosing a wrist injury as a “sprain”. Even wrist fractures can behave like a “sprain”. Best to be safe and not sorry and get a high quality x-ray and thorough wrist evaluation by an orthopedic wrist specialist.

Dr. Kenneth P. Unruh

How Direct Access To Physical Therapy Benefits Your Life

Kiran Chandra

Physical Therapy Without A Doctor’s Referral
Back pain from yard work over the weekend? Sore ankle from your slow pitch softball game? Knee arthritis acting up again? You’ve had these symptoms before, right? Physical therapy helped take care of the problem and got you back to life. In the past, that meant taking time scheduling an appointment with your physician to receive a physical therapy referral. This process takes time plus an extra co-pay to your doctor. Meanwhile, you are in pain and you already know what the solution is. The need for waiting and an extra trip to the doctor are now in the past. In the state of Kansas, you now have direct access to physical therapy. Here is everything you need to know about direct access and how it can make your life, and your recovery, easier.
What Does Direct Access Mean For Physical Therapy?
In popular culture, the word “access” implies exclusivity – like a backstage pass to a rock concert or high level clearance to government files. When it comes to direct access to physical therapy, however, the opposite is true. Instead of physician referral, or MD approval, in the State of Kansas if you need physical therapy, “Come on in!” That’s right, direct access essentially cuts out the middleman. If you need physical therapy, call our office and schedule an appointment.
What Are The Benefits Of Direct Access PT?
Direct access saves times allowing quicker access for you to begin receiving treatment from one of our highly skilled and specially certified therapists.
How Does Physical Therapy Benefit You And Your Life?
Our physical therapists at Kansas City Orthopaedic Institute (KCOI) are able to provide highly attentive and personalized care. All of our Physical & Occupational Therapy rehab sessions are conducted one-on-one between you and the therapist. We are able to create a personalized treatment plan and home exercises both printed and electronic with videos. This will help you on your path to achieving your goals and returning to activity. If at the end of two weeks of care or sooner at KCOI, your therapist feels that you should see a physician, they can assist in scheduling you with an appropriate orthopedic specialist here at the KCOI. We have board certified and fellowship trained physicians on staff in every area of orthopedics.
Does Insurance Cover Direct Access Physical Therapy?
All processes are handled the same way they would be if you were referred by a physician. We will verify your insurance prior to your initial visit. However, if the insurance verification staff finds any issues regarding your being a Self-Referral, with no doctor prescription, then the staff will contact you to let you know that you would need to either become private pay or would need to obtain a prescription for physical therapy.

For more information or to schedule an appointment, call 913-253-8980

Ortho Urgent Care Extends Hours of Operations

 

 

Kansas City Orthopaedic Institute Announces Extended Hours for Urgent Care

 

(Leawood, KS) May 7, 2018– Effective today, Monday, May 7 the Ortho Urgent Care at Kansas City Orthopaedic Institute will expand the hours of operations to 8 a.m. to 8 p.m. Monday through Friday.  The weekend hours of operations for the Ortho Urgent Care will remain at 10 a.m. to 4 p.m.

“We are very excited to announce the expanded weekday hours for our Ortho Urgent Care,” said Kansas City Orthopaedic Institute CEO Dr. Charles Rhoades.  “This will allow us more opportunities to provide and fulfill the health care needs of our community.”

The Ortho Urgent Care clinic located at Kansas City Orthopaedic Institute provides access to highly specialist orthopedic care and sports medicine experts.  The urgent care staff at Kansas City Orthopedic Institute can provide rapid diagnosis and treatment as well as onsite services including diagnostic imaging, bracing, splinting, and casting.  The Ortho Urgent Care is available for patients ages 12 and older and to better serve the community no appointment is necessary.  Estimated wait times for Ortho Urgent Care can be found on our website at https://www.kcoi.com/orthopedic-care/urgent-care/

About Kansas City Orthopaedic Institute

As the area’s first and only hospital dedicated exclusively to orthopedics, Kansas City Orthopaedic Institute provides comprehensive orthopedic care, from diagnostic imaging to inpatient and outpatient surgery, pain management services, and rehabilitation therapy. Kansas City Orthopaedic Institute is a physician-owned specialty hospital and a joint venture with Saint Luke’s Hospital. Located in Leawood near Overland Park, Kansas the hospital and its Ortho Urgent Care center proudly serve the Greater Kansas City metropolitan area. Kansas City Orthopaedic Institute is accredited by the Accreditation Association for Hospitals/Health Systems (AAHHS).

 

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What is a Hip Labral Tear and how is it treated

With news of Kansas City Royals Outfielder, Alex Gordon going on the disabled list with a labral tear in his left hip we wanted to take a look at what exactly is a labral tear and what are some of the symptoms and causes for this injury.

What is it?

  • A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of the socket of your hip joint. In addition to cushioning the hip joint, the labrum acts like a rubber seal or gasket to help hold the ball at the top of your thighbone securely within your hip socket.

What are the symptoms?

Many hip labral tears cause no signs or symptoms. Occasionally, however, you may experience one or more of the following:

  • A locking, clicking or catching sensation in your hip joint
  • Pain in your hip or groin
  • Stiffness or limited range of motion in your hip joint

How can you prevent this injury?

  • Hip labral tears are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid loading your hip with your full body weight when your legs are in positions at the extreme ends of your hip’s normal range of motion.

How can physical therapy help with this injury?

  • A physical therapist can teach you exercises to maximize hip range of motion and hip strength and stability. Therapists can also analyze the movements you perform that put stress on your hip joint and help you avoid these forces.

Don’t forget that our Ortho Urgent Care Clinic is open evenings and on weekends.  Call 913-319-7633 for additional information on the Ortho Urgent Care Clinic.

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Kansas City Orthopaedic Institute Physicians Recognized Among 2017 Super Doctors

Twelve orthopedic surgeons and physicians at Kansas City Orthopaedic Institute have been recognized among Kansas City’s Super Doctors® in 2017. This recognition is determined by the results and findings of the latest study by MSP Communications.

The Super Doctors designation, which is typically awarded to approximately five percent of the region’s active physicians, identifies outstanding physicians from more than 40 different specialties, including orthopedic surgery and interventional physiatry. This year’s list includes the following physicians (those noted with an asterisk have consistently achieved the prestigious designation for at least a decade and are now members of the Kansas City Super Doctors Hall of Fame):

Timothy Badwey, M.D. *
Dr. Badwey specializes in treating foot and ankle conditions, and has received the Super Doctors designation 11 years in a row.
Cris Barnthouse, M.D., orthopedic surgeonCris Barnthouse, M.D. *
Dr. Barnthouse specializes in treating knee and shoulder conditions. 2017 marks the 10th consecutive year he has been named among Kansas City Super Doctors.
Jon Browne, M.D., orthopedic surgeonJon Browne, M.D.
Dr. Browne specializes in treating knee conditions. This is the third consecutive year he has received the Super Doctors designation.
Scott Cook, M.D., orthopedic surgeonScott Cook, M.D. *
Dr. Cook specializes in treating knee and hip conditions, including joint replacement surgery. He has been named among Kansas City Super Doctors for the past 11 consecutive years.
Brian Divelbiss, M.D.
Dr. Divelbiss specializes in treating hand, wrist, shoulder and elbow conditions. This is the ninth consecutive year he has received the Super Doctors designation.
C. Lan Fotopoulos, M.D.
Dr. Fotopoulos specializes in interventional physiatry for hip, neck, back, shoulder and knee conditions. This is the ninth time he has been named one of Kansas City’s Super Doctors.
Robert Gardiner, M.D. *
Dr. Gardiner specializes in treating knee and hip conditions, including joint replacement. He has now received the Super Doctors designation 11 years in a row.
Lowry Jones, Jr., M.D. *
Dr. Jones specializes in treating shoulder, elbow, knee, hip, foot and ankle conditions. 2017 marks the 11th consecutive year he has been named among Kansas City Super Doctors.
Mark Rasmussen, MD, orthopedic surgeonMark Rasmussen, M.D. *
Dr. Mark Rasmussen specializes in treating knee and shoulder conditions. This is the eleventh consecutive year he has received the Super Doctors designation.
TJ Rasmussen, MD, orthopedic surgeonT.J. Rasmussen, M.D. *
Dr. T.J. Rasmussen specializes in treating knee and shoulder conditions, and has received the Super Doctors designation 11 years in a row.
Charles Rhoades, M.D., orthopedic surgeonCharles Rhoades, M.D. *
Dr. Rhoades specializes in treating knee, shoulder, elbow, hand and wrist conditions. This is the eleventh consecutive year he has been named one of Kansas City’s Super Doctors.
Daniel Stechschulte, Jr., M.D., Ph.D., orthopedic surgeonDaniel Stechschulte, Jr., M.D. *
Dr. Stechschulte specializes in treating shoulder, elbow and knee conditions. He has now received the Super Doctors designation 11 years in a row.

Each year, MSP Communications undertakes a detailed multi-phase selection process to identify physicians who have attained exceptional peer recognition and professional achievement. The assessment includes a survey of doctors, an independent evaluation of candidates by research staff and a peer review of candidates by practice area. The selection process also checks each physician for good professional standing and disciplinary action. In particular, Super Doctor candidates are evaluated on the following criteria:

  • Years of experience
  • Hospital appointments
  • Fellowships
  • Professional activities
  • Leadership positions
  • Academic achievements/positions
  • Board certifications
  • Publications, lectures and presentations
  • Honors and awards
  • Other outstanding achievements

MSP Communication publishes its Super Doctors lists in newspapers, inserts and magazine sections across the country. Honorees can also be found online at superdoctors.com, where users can search by physician name, specialty and location. To request an appointment with one of the physicians above, please contact Kansas City Orthopaedic Institute.

About Kansas City Orthopaedic Institute

As the area’s first and only hospital dedicated exclusively to orthopedics, Kansas City Orthopaedic Institute provides comprehensive orthopedic care, from diagnostic imaging to inpatient and outpatient surgery, interventional physiatry, and rehabilitation therapy. Kansas City Orthopaedic Institute is a physician-owned specialty hospital and a joint venture with Saint Luke’s Hospital. Located in Leawood near Overland Park, Kan., the hospital and its Ortho Urgent Care center proudly serve the Greater Kansas City metropolitan area. Kansas City Orthopaedic Institute is accredited by the Accreditation Association for Hospitals/Health Systems (AAHHS).