Submitted by aedraper on Wed, 07/08/2020 - 14:29
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The Best Orthopaedic Care
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To earn national recognition demonstrates our ongoing commitment to clinical excellence.
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Certified
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We are the largest academic practice in VA with 50 board-certified physicians, 22 Advanced Care Practitioners and 26 Athletic Trainers.
Specialized
Specialized
With fellowship trained surgeons in 8 orthopaedic subspecialties, we offer an evidence-based practice progressive in knowledge and skill.
Collaborative
Scholarly
We actively participate in the exchange of knowledge to advance the field of orthopaedic surgery through research and education.
Experienced
Experienced
Our commitment in providing specialized orthopaedic care to SWVA began in the 1950s. Today, we continue the legacy of excellence.
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High Performing at CRMH for Hip and Knee
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Region's Only
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for Virginia Tech
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Foot and Ankle
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Foot and Ankle

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Foot and Ankle Surgery
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Offering advanced treatments and relief for your next step forward.
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Foot and Ankle
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Meet Our Team
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Foot and Ankle Surgery
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We're here to diagnose and treat your foot and ankle care needs.
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Foot and Ankle
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View Our Locations
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Orthopaedics and Bone Health
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From head to toe, our team collaborates on simple and complex orthopaedic problems.
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Becker's Hospital Review
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Top 100 Hospitals with Great Orthopaedic Programs
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VT Health Care Provider
Official health care provider for Virginia Tech
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US News & World Report
Best Regional Hospital Southwestern Virginia
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Top Orthopaedic Team
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We're here to help.
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Are you ready to schedule an appointment with one of our providers? Do you need more information?
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Leadership and Practice
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Proud of our
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Seeing You Safely
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Don't put your health on hold—see us safely. Dr. Clements shares an inside look at the safety measures we've put in place to keep you and our staff safe.
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Ankle Replacement
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Ankle Replacement
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If other treatment methods have failed, an ankle replacement may be your best treatment option to relieve foot or ankle pain. During joint reconstruction, a total ankle implant system is used to reconstruct the ankle joint for patients suffering from arthritis. At Carilion Clinic, we have four experienced surgeons you can trust to perform this procedure with successful outcomes. Talk to your provider to see if it's the right choice for you.
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Limb Preservation
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Limb Preservation
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At Carilion Clinic, our foot and ankle surgeons team up with experts in wound care to treat non-healing wounds. We use advances in limb-sparing treatments to optimize your independence and mobility.
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Deformity Correction
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Deformity Correction
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Our expert team is trained on many types of foot deformities. Whether born with a deformity, inherited over time or the result of another condition, we can provide treatments for the foot, ankle, heel, tendon or toes. Our doctors specialize in both podiatric and orthopaedic surgery to offer the most comprehensive care.
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Arthritis
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Arthritis
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Arthritis causes pain and stiffness in any joint in the body and is common in the small joints of the foot and ankle. We partner with you to manage and treat your pain and offer treatments that may include bracing, steroid injections, physical therapy or anti-inflammatory medications. If non-surgical options are not providing relief, we will discuss surgical options as a last resort.
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LAB Sports
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Rehabilitation
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LAB Sports Performance is a premier training facility for total body and functional movement with customized rehabilitation plans.
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Institute for Orthopaedics and Neurosciences (ION)
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The Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients. ION serves as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

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Research & Education
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Elevating care through innovative
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Research and Education
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Education
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Residency Program
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Residency Program
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Based out of Carilion Roanoke Memorial Hospital, our residency program is fully integrated with the Carilion Clinic Department of Orthopaedics, ranked as one of the nation's top orthopaedic groups by U.S. News & World Report.
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VTCSOM
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We are proud to have nationally and internationally recognized faculty committed to educating the next generation of students at VTCSOM.
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Graduate Medical Education
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When it comes to residencies and fellowships, finding the right fit is very important. Our GME program offers amazing support and training.
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Research
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Active Research Studies
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Active Research Studies
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At Carilion Clinic Orthopaedics, we are actively involved in finding innovative ways to improve the care we give to our patients. Here is a list of select research studies for Foot and Ankle.

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  • A Multicenter, Open Label Phase 2 Pilot Trail of Subjects with Non-healing Venous Leg Ulcers Treated with Standard Care Plus Cryopreserved Human Umbilical Cord (TTAX01)
  • Measurement Discrepancies in Posterior Malleolar Fragment Size in Plain Film Radiology versus CT
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  • A Multicenter Phase 3 Trial of Biotherapy using Cryopreserved Human Umbilical Cord (TTAX01) for Late Stage, Complex Non-healing Diabetic Foot Ulcers (AMBULATE DFU)
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Meet Our Foot and Ankle Surgery Team
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Our team of orthopaedic foot and ankle surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained reconstruction surgeons evaluate and treat thousands of patients each year.
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Orthopaedics
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General Orthopaedics and Bone Health

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Orthopaedics and Bone Health
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From head to toe, our team collaborates on simple and complex orthopaedic problems.
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Orthopaedics and Bone Health
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Providing clinic locations throughout southwest Virginia for your aches and pains.
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Our Locations
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Department of Orthopaedics
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Outstanding patient-centered care in all orthopaedic specialties.
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Awards
Becker's Hospital Review
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Top 100 Hospitals with Great Orthopaedic Programs
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VT Health Care Provider
Official health care provider for Virginia Tech
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U.S. News & World Report
Best Regional Hospital Southwestern Virginia
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Top Orthopaedic Team
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Specialized
Specialized
With fellowship-trained surgeons in 8 orthopaedic subspecialties, we offer an evidence-based practice progressive in knowledge and skill.
Collaborative
Scholarly
We actively participate in the exchange of knowledge to advance the field of orthopaedic surgery through research and education.
Experienced
Experienced
We are the largest academic practice in Virginia: 45 board-certified physicians, 25 advanced care practitioners and 25 athletic trainers.
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Awards
Patient Education
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Osteoporosis 101
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Healthy bones need good nutrition
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We have all heard that it's important to eat healthy for our overall health. That's true for reducing your risk for osteoporosis too. Learn how specific nutrients help our bones stay healthy.
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What is it?
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Osteoporosis is a skeletal disorder characterized by decreased bone strength predisposing you to an increased risk of fracture.
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Virtual skeleton
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What causes It?
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It can have several causes including (but not limited to) age, hormonal changes, smoking, alcohol, medication use, and certain diseases.
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What does it mean?
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Osteoporosis 101
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Nutritional food for healthy bones
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Calcium
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Calcium is essential for your bones. It is best to obtain calcium from our diet through sources such as dairy, leafy green vegetables, and legumes.
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Calcium Rich Foods
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Vitamin D
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Vitamin D helps calcium absorb in our body. It can be obtained from foods, supplements, or sunlight.
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Sunlight
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Nutrition is important for bone health
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Healthy Eating
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We're here to help.
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Are you ready to schedule an appointment with one of our providers? Do you need more information?
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Leadership and Practice
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Bone Health
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Bone Health Clinic
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Carilion Clinic strives to provide comprehensive bone health to our communities and beyond. We provide focused bone health care to patients who have osteoporosis or are at increased risk of developing it. Our goal is to prevent recurrent fractures by developing a multi-disciplinary bone health assessment followed by bone health education and a plan of care to promote healthy bones and reduce risks of future fractures.
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Bone Health Evaluation
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Bone Health Evaluation
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Our comprehensive bone health evaluation includes a medical history, physical examination, laboratory tests, FRAX score calculation and a bone density scan.
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Bone Health Program Appropriate Patients
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Bone Health Program Appropriate Patients
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People who are 49 years of age or older, have a low vitamin D level and/or a fragility fracture are appropriate patients for our Bone Health program.
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Who Should Get Tested for Osteoporosis?
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Who Should Get Tested for Osteoporosis?
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People with early menopause/surgical menopause; fragility fractures, a family history of osteoporosis; low BMI; low calcium and vitamin D intake; low activity level; smoking; alcohol consumption; medication use (steroids, anticonvulsants); and certain medical conditions (rheumatoid arthritis, diabetes, gastric bypass, celiac disease) should get tested for osteoporosis.
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Treatment Options
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Treatment Options
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Several treatment options are available that can help manage your osteoporosis and prevent further fractures. Treatments could include medications, dietary changes, an exercise program and lifestyle changes, such as smoking cessation or decreasing alcohol consumption. Your health care provider will discuss your treatment options with you during your first visit. Your participation is important in managing osteoporosis.
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Amelia Rode
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Meet Our Bone Health Coordinator
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Amelia Rode received her undergraduate degree from the University of Virginia before receiving her graduate degree as a physician assistant from Jefferson College of Health Sciences. She is focused in treating osteoporosis and preventing secondary fragility fractures. She has joined the Institute for Orthopaedics and Neurosciences in Roanoke and provides treatment for at-risk patients.
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Institute for Orthopaedics and Neurosciences (ION)
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The Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients. ION serves as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

Research & Education
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Elevating care through innovative
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Research and Education
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Education
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Fellowship Training
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Fellowship Training
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The Orthopaedics Department provides fellowship training for surgeons from across the United States to help them provide better care.
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Education
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VTCSOM Virtual Tour
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VTCSOM
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We are proud to have nationally and internationally recognized faculty committed to educating the next generation of students at VTCSOM.
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Education
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Graduate Medical Education
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Graduate Medical Education
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HBsIo0mTBJ8
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When it comes to residencies and fellowships, finding the right fit is very important. Our GME program offers amazing support and training.
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Research
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Select Research Studies
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Select Research Studies
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At Carilion Clinic Orthopaedics, we are actively involved in finding innovative ways to improve the care we give to our patients. Here is a partial list of research studies currently taking place in the Department of Orthopaedics.

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  • Driving After Wide-Awake Hand Surgery
  • Fingertip Injury StudyVideo Education
  • Robotic Hand Orthosis Providing Grasp Assistance for Patients with Brachial Plexus Injuries
  • Carpal Tunnel Surgery Pain Treatment Study
  • Measurement Discrepancies in Posterior Malleolar Fragment Size in Plain Film Radiology vs. CT
  • Investigation of Amnios RT for the Treatment of Plantar Fasciitis
  • Dilatant Insole to Reduce Damage Inflicted by Peripheral Neuropathy
  • Effectiveness of Single-Use, Negative Pressure Wound Therapy System (PICO) vs. Traditional Negative Pressure Wound Therapy System (tNPWT) in the Treatment of Lower Extremity Ulcers
  • Diabetic Foot Ulcers Treated with Clostridial Collagenase (SANTYL) Ointment or with a Comparator Product Containing Silver
  • Establishment of Safe INR Level in Patients Undergoing Hip Fracture Surgery
  • Predicting Fracture Union Using Post-Operative RUST Scores
  • Incidence of Fractures and Biomarkers Among MGUS Patients in a Bone Health Clinic
  • Use of Locking Plates in the Treatment of Periprosthetic Fractures
  • Testing the Structural Properties of Bone Cement
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  • Prospective Evaluation of Exparel Adductor Canal Field Block for Pain Control After ACL Reconstruction
  • Measuring Landing Mechanics During Rehabilitation
  • The Effects of Ankle Braces on Foot Posture
  • Gait Biofeedback for Cerebral Palsy Study
  • Side-to-Side Asymmetry Changes During Running
  • Effects of Optimism on Functional Outcome Following Total Knee Arthroplasty or Total Hip Arthroplasty
  • Effect of Tibial Slope on Coronal Alignment in Total Knee Arthroplasty
  • Comparison of Headed vs. Headless Screws in Periacetabular Osteotomy
  • Outcomes of Total Hip Arthroplasty in Patients with Prior Spinal Fusion
  • BMI Association with 30- and 90-Day Readmissions
  • Predictive Value of Postoperative Anemia on Length of Stay for Patients Undergoing Minimally Invasive (MIS) Lumbar Fusion
  • Assessing the Clinical Value of Tranexamic Acid in Fusion Surgery for Lumbar Spinal Stenosis
  • Evaluation of the Thrombosis Risk of TXA Administration in Spine Surgery
  • Contribution of Postoperative Anemia to Length of Stay for Patients Undergoing Minimally Invasive Lumbar Interbody Fusion
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Meet Our General Orthopaedic Team
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Our team of orthopaedic surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained reconstruction surgeons evaluate and treat thousands of patients each year.
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Hand and Upper Extremity

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Offering the region's most comprehensive team.
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Hand and Upper Extremity
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Today's best treatments for your hands, wrists, elbows and shoulders.
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Orthopaedics and Bone Health
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From head to toe, our team collaborates on simple and complex orthopaedic problems.
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Awards
Becker's Hospital Review
Becker's Hospital Review
Top 100 Hospitals with Great Orthopaedic Programs
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Official health care provider for Virginia Tech
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US News & World Report
Best Regional Hospital Southwestern Virginia
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Top Orthopaedic Team
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Awards
Patient Education
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Do you need
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Shoulder or Elbow Surgery?
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When everyday tasks become difficult to perform or when sleeping through the night is interrupted because of pain, discuss with your surgeon the option of surgery. We're here to provide treatment options for you.
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Video Education
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Shoulder Videos
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Learn more about what to expect before, during and after shoulder surgery.
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Shoulder Surgery
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Elbow videos
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Learn more about what to expect before, during and after elbow surgery.
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Elbow surgery
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Shoulder and Elbow on-demand education
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Patient Education Videos
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Hand Surgery
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American Society for Surgery of the Hand
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We are proud that our surgeons are a part of the ASSH, the premier upper extremity surgery society for thousands of professionals.
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ASSH Certification
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Certified surgeons through ASSH
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Experience You Can Trust
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We're here to help
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Are you ready to schedule an appointment with one of our providers? Do you need more information?
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Leadership and Practice
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Proud of our
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Hugh Hagan III M.D.
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Hugh J. Hagan III M.D.
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Section Chief - Orthopaedic Hand
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Carilion Orthopaedic Surgery Series
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There is nothing like seeing a patient improve and knowing you had a role in their improvement.
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Hugh Hagan III M.D.
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Wide-Awake Surgery
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Wide-Awake Surgery
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Our team is trained in the most innovative treatments, including wide-awake surgery. This technique involves no IVs, sedation, anesthesia or tourniquets, while providing patients the same superior quality while being fully aware during the procedure.
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Brachial Plexus Clinic
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Brachial Plexus Clinic
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The Brachial Plexus Clinic at Carilion utilizes a unique multidisciplinary approach to care for patients with traumatic injury to the collection of nerves between the neck and shoulder. These nerves control critical arm and hand function. The effects of nerve damage in this area can be devastating. Using the most modern nerve reconstruction and nerve transfer techniques, we then restore function to areas where injury has occurred. The goal is to restore movement and sensation that otherwise would be lost.
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Hand Replantation
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Advanced Surgery
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Our hand surgeons use the latest techniques and technologies with the goal of offering improved quality of life for thousands of patients through improved function. Our team partners with our surgical staff to offer life altering procedures such as hand replantation or reattachment. During this process, our highly skilled surgeons are often racing against time to ensure a successful outcome.
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Hand Therapy
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Hand Therapy
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Our hand surgery faculty have board certifications in hand surgery, plastic surgery and general surgery. This expertise, coupled with four certified hand therapists, rivals some of the best hand centers in the nation.
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Institute for Orthopaedics and Neurosciences (ION)
Institute Description

The Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients, serving as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

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Research & Education
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Your care is elevated by innovative
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Research and Education
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VTCSOM Virtual Tour
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VTCSOM
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We are proud to have nationally and internationally recognized faculty committed to educating the next generation of students at VTCSOM.
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Education
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Fellowships
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Fellowship Program
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We are proud to offer an Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowship in hand and upper extremity allowing fellows the experience and resources they need to become skilled in hand surgery.
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Graduate Medical Education
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Graduate Medical Education
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When it comes to residencies and fellowships, finding the right fit is very important. Our GME program offers amazing support and training.
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Research
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Select Research Studies
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Select Research Studies
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At Carilion Clinic Orthopaedics, we are actively involved in finding innovative ways to improve the care we give to our patients. Here is a list of select research studies currently taking place in Hand and Upper Extremity.

 

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  • Can I Drive Myself Home? Driving After Wide-Awake Hand Surgery
  • Fingertip Injury Study: Video Education (An Ultrashort Video to Educate Healthcare Providers on Fingertip Injury repair)  
  • Robotic Hand Orthosis Providing Grasp Assistance for Patients with Brachial Plexus Injuries
  • What Do Patients Do With Outpatient Naloxone Prescriptions Provided With Opioids for Acute Post-surgical Pain After Orthopedic Surgery?
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  • A Randomized Controlled Trial Comparing Combination Therapy of Acetaminophen plus Ibuprofen versus Hydrocodone for the Treatment of Pain after Carpal Tunnel Surgery
  • Combatting Stigma and Turing Orthopaedic Surgery Providers into a Touchpoint for Intervention in the Opioid Crisis: SBIRT (Screening, Brief Intervention, and Referral to Treatment) Training
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Meet Our Hand and Upper Extremity Team
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Our team of orthopaedic hand and upper extremity surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained hand surgeons evaluate and treat thousands of patients each year.
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Joint Replacement
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Joint Replacement

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Joint Replacement
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Advanced certified by The Joint Commission for hip and knee surgeries.
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Joint Commission designation
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Meet Our Team
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Joint Pain
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If you are struggling with hip or knee pain, our team will work with you to provide relief.
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View Our Locations
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Orthopaedics and Bone Health
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From head to toe, our team collaborates on simple and complex orthopaedic problems.
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Gold Seal of Approval
The Joint Commission
Advanced Certified by The Joint Commission
Becker's Hospital Review
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Top 100 Hospitals With Great Orthopaedic Programs
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US News & World Report
High Performing for Hip/Knee Replacement at CRMH
Anthem Blue Distinction
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Blue Distinction Center for Hip and Knee Surgery
Hip and Knee Society
Hip and Knee Society
Elite International Member Groups
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Top Joint Replacement Team
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Downward Trend
Readmission
Lowest readmission rates in the state of Virginia for Medicare patients
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Procedures
Nearly 1,000 knee replacement surgeries and over 600 hip replacement surgeries performed annually
Recovery at Home
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Approximately 75 percent of hip and knee replacement patients are discharged the day after surgery
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Proud to be ranked as a
Patient Education
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Do you need
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Joint Replacement Surgery?
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At Carilion Clinic, we want to ensure you are prepared for your upcoming surgery. That's why we offer a patient education video library in addition to our Joint Academy class. We know you want to start living a more active life, so we're here to help you get started.
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Video Education
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Hip Replacement Videos
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Learn more about what to expect before, during and after hip replacement surgery.
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Hip Surgery
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Knee Replacement Videos
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Learn more about what to expect before, during and after knee replacement surgery.
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Knee Surgery
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Joint replacement on-demand education
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Patient Education Videos
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Recovery
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Intro Copy
What To Expect Before Surgery
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Our total joint coordinators will explain everything from the admission process to how to manage your pain.
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Hospital
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Getting Stronger After Surgery
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During class, you will participate in a hands-on therapy session to learn the exercises to do when you go home.
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Going Home
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Preparing you for your upcoming surgery.
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Joint Academy Class
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Are you ready to schedule an appointment? Do you need more information?
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Leadership and Practice
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Proud of our
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Joseph Moskal, M.D.
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Joseph T. Moskal M.D.
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Chair of Orthopaedics
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Carilion Clinic's Leader in Orthopaedic Care
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It’s been very flattering and an honor for me not only to be invited, but to collaborate with folks from all over the world who share the same passion and interests that we do to improve knowledge and improve patient care.
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Joseph Moskal, M.D.
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Seeing You Safely
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Don't put your health on hold—see us safely. Dr. Moskal shares an inside view of what we are doing to maintain our high level of care, with proper protections in place for our patients and employees.
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Joint Commission
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Advanced Certification
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The joint replacement program at Carilion Roanoke Memorial Hospital is the first in southwest Virginia to earn the advanced-level certification for hip and knee joint replacement surgeries from The Joint Commission. They first earned the accreditation back in 2007. This new designation goes beyond the core requirements, with additional clinical requirements of achieving consistent communication and collaboration among all health care providers involved in the care of the patient.
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Anterior Approach
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Anterior Approach to Hip Replacement
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With advanced imaging technology enabling computer-assisted techniques, surgeons perform anterior-approach hip replacements with increased accuracy and precision. Anterior-approach hip replacement is an innovative technique that uses an incision on the front of the body, rather than the side or back as with traditional hip replacement surgery. This brings less disruption to muscle and tissues, resulting in less pain, a lower risk of complications and a quicker recovery.
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Hip Preservation
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Hip Preservation
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Carilion Clinic’s orthopaedic surgery team provides treatments for hip pain with the goal of decreasing pain, slowing the progression of degenerative hip disease and restoring normal hip function. This early intervention should reduce the risk for premature arthritis and hip replacement surgery later in life. Athletes who use repetitive motions in the hip joint, such as dancers or adults who were diagnosed with hip dysplasia as children, are candidates for hip preservation procedures.
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Carilion Clinic's Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients. It serves as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

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The Orthopaedic Department provides fellowship training for surgeons from across the United States to help them provide better care.
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At Carilion Clinic Orthopaedics, we are actively involved in finding innovative ways to improve the care we give to our patients. Here is a list of select research studies currently taking place in joint replacement.

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  • Comparison of Screws in Periacetabular Osteotomies to Reduce the Risk of Symptomatic Hardware (Prospective)
  • Comparison of Headed vs Headless Screws in Periacetabular Osteotomy- A Biomechanical Study
  • Outcomes of Total Hip Arthroplasty in Patients with Prior Spinal Fusion
  • The Effects of Optimism on Functional Outcome Following Total Knee Arthroplasty or Total Hip Arthroplasty
  • ORIF Posterior Wall Fracture in Skeletally Immature Patient- Case Report
  • Effect of Tibial Slope on Coronal Alignment in Total knee Arthroplasty
  • Efficacy of an Intraoperative Marcain Adductor Canal Block During Total Knee Arthroplasty
  • A Prospective, Randomized, Multicenter Clinical Investigation Comparing Clinical Results of the Zimmer NexGen Flex Mobile Bearing vs. DePuy PFC Sigma Rotating Platform Total Knee Replacement
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  • Effect of Exparel (long acting Bupivicaine) on Post-op Pain Management in Total Knee Arthroplasty
  • 30 and 90 Day Readmission After Total Hip Arthroplasty
  • BMI association with 30 and 90 Day Readmissions
  • One Stage Versus Two Stage Exchange for Periprosthetic Hip and Knee Infection- A Multicenter Study
  • The Effect of Intrathecal Morphine on Postoperative Urinary Retention in Total Hip Arthroplasty
  • The Effect of Orthopaedic Referral on Decision for Weight Loss Management
  • The effect of Tranexamic Acid on Post-Operative Blood Transfusion for Acute Hip Fractures Requiring Intramedullary Nail or Hemiarthroplasty Surgical Fixation
  • Modified Extensile Anterior Approach to the Acetabulum for Complex Acetabular Defects
  • Biofeedback in TKA Adults During Walking
  • Gait Asymmetry, Balance and Fall Risk
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First total joint procedure performed at Carilion Roanoke Memorial Hospital in 1972
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All fellowship-trained adult reconstruction surgeons
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Active in state and national orthopaedic societies (AAOS, VOS)
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Quality outcomes exceed national averages
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Our team of orthopaedic joint replacement surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained reconstruction surgeons evaluate and treat thousands of patients each year.
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Children deserve specialized orthopaedic care in a friendly environment.
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Offering successful treatments for growing children with congenital deformities.
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Outstanding patient-centered care in all orthopaedic specialties.
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Multidisciplinary team providing expert orthopaedic care for growing children
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Jonathan J. Carmouche, M.D.
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Jonathan J. Carmouche, M.D.
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Section Chief, Pediatric Orthopaedics
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I believe that every patient and every case is unique, and I strive to provide the highest quality personalized and patient-focused care in the least invasive way available.
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Jonathan J. Carmouche, M.D.
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Our orthopedic surgeons have extensive experience in the treatment of fractures. Whether you have a minor fracture or a serious injury, we have the expertise to treat you. The goal of treatment is to control the pain, promote healing, prevent complications, and restore normal use of the fractured area. We're here to help you when the unexpected happens.

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Pediatric Sports Injuries
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We are committed to providing your growing athlete with the best possible care. Our team of fellowship trained pediatric orthopaedists and sports medicine surgeons not only treat athletes but are here to help prevent injuries in young athletes. Overuse injuries have become more prevalent in younger children and while we encourage kids to be active, we want to make sure they're being safe.
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Limb Deformity
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Limb deformities can be present from birth, develop over time or result from fracture, infection, arthritis or tumor. Some limb deformities can be life altering where some may be more of a cosmetic concern. Because deformities can also affect joint alignment, a deformity left untreated may result in musculoskeletal problems such as arthritis or back pain, and potentially prevent patients from participating in activities they enjoy.
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Scoliosis
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Scoliosis and Spinal Deformities
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Scoliosis affects 2-3% of the population and is most often diagnosed in childhood or early adolescence. Early detection and treatment, which includes observation, bracing or surgery, provides better outcomes for patients. We offer the region’s only program for deformity corrections such as scoliosis for kids and have the only pediatric orthopaedist in the region for spine deformity.
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Hip Preservation
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Hip Preservation
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Carilion Clinic’s orthopaedic surgery team provides treatments for hip pain with the goal of decreasing pain, slowing the progression of degenerative hip disease and restoring normal hip function. This early intervention should reduce the risk for premature arthritis and hip replacement surgery later in life. Athletes who use repetitive motions in the hip joint, such as dancers or adults who were diagnosed with hip dysplasia as children, are candidates for hip preservation procedures.
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Congenital Hand Deformities
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As the region's only center for congenital hand deformities, we offer expertise for evaluations and treatment. Our orthopaedic surgeons will determine the best surgical plan for your child depending on their age and type of deformity. We have a multidisciplinary team including hand therapists who will participate in the care of your child's recovery.
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The Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients. ION serves as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

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When it comes to residencies and fellowships, finding the right fit is very important. Our GME program offers amazing support and training.
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Our team of pediatric orthopaedic surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained pediatric orthopaedic surgeons evaluate and treat thousands of patients each year.
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Spine Surgery and Scoliosis
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Leading the region for complex spine procedures and revisions.
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Expert care for scoliosis and spine deformity.
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Orthopaedics and Bone Health
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From head to toe, our team collaborates on simple and complex orthopaedic problems.
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Best Regional Hospital Southwestern Virginia
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Perform approximately 400 minimally invasive spine operations annually
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100% of patients attend pre-surgical joint school educational class
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Regional resource for adult and pediatric complex spine surgeries.
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Spinal Surgery
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What you need to know
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Spinal surgery is an option when other treatments haven’t worked and pain interferes with daily activity. Our spine team has one goal, to help you heal physically so you can enjoy life. There is lot for you to know to get ready for your surgery.
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We invite you and a caregiver to attend our education spine class. You will learn what to expect before, during and after surgery.
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After surgery, your mobility will be limited.
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You will need some assistance when you're discharged, so we'll prepare you for what you'll need to know when you first get home.
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Preparing for the surgery
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Jonathan J. Carmouche, M.D.
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Jonathan J. Carmouche, M.D.
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Section Chief, Orthopaedic Spine
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I believe that every patient and every case is unique, and I strive to provide the highest quality personalized and patient-focused care in the least invasive way available.
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Don't put your health on hold—see us safely. Dr. Carmouche shares an inside view of what we are doing to maintain our high level of care with proper protections in place for our patients and employees.
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Cutting-Edge Treatments
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Cutting-Edge Treatments
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We provide the most advanced technology to offer minimally invasive surgery, including revision surgeries, decompression, spine fusions and scoliosis and deformity correction operations. Lateral spine surgery is a game-changing procedure that yields enhanced patient outcomes. At Carilion Clinic, we perform the most lateral spine surgeries in our region using image guided implant placement in surgeries.
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Scoliosis and deformity
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Scoliosis and deformity
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Scoliosis affects 2-3% of the population and is most often diagnosed in childhood or early adolescence. Early detection and treatment, which includes observation, bracing or surgery, provides better outcomes for patients. We offer the region’s only program for deformity corrections such as scoliosis for adults and kids and have the only pediatric orthopaedist in the region for spine deformity.
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MAGEC Growing Rods
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MAGEC Growing Rods
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MAGEC growing rods are a new surgical treatment for children with severe spinal deformities. The system, which includes implantable rods and an external remote control, are used to brace the spine while the child is still growing to minimize the progression of scoliosis. The MAGEC rods are lengthened magnetically every three to six months in a short, non-invasive procedure that takes place in a doctor’s office.
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Disc Replacement
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Patients suffering with symptoms of a degenerated disc or an acute unresolved herniated disc can benefit from disc replacement surgery. Following the procedure, patients can expect improved pain relief, less tingling, and increased mobility in daily activities. At Carilion Clinic, our team has the experience and training to provide successful outcomes. They will work with you to determine if a surgical procedure is right for you.

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Minimally Invasive Spine Surgery
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Minimally Invasive Spine Surgery
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Technological advances have allowed more back and neck conditions to be treated with minimally invasive surgical techniques. For patients who need surgery, these techniques avoid significant damage to the muscles surrounding the spine and often times offers less pain after surgery and a faster recovery. Minimally invasive techniques can be used for common procedures such as lumbar decompression and spinal fusion.
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The Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients. ION serves as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

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The Musculoskeletal Education Research Center (MERC) facilitates and fosters musculoskeletal research for students with faculty mentors.
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We are proud to have nationally and internationally recognized faculty committed to educating the next generation of students at VTCSOM.
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We are actively involved in finding innovative ways to improve the care we give to our patients. Having the opportunity to train the next generation of healthcare providers is inspiring and we are honored for our faculty to be recognized as an Outstanding Research Mentor from the Virginia Tech Carilion School of Medicine and Preceptor of the Year in 2020.

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  • The Predictive Value of Postoperative Anemia on Length of Stay for Patients Undergoing Minimally Invasive (MIS) Lumbar Fusion

  • The Ability of Visual Evoked Potentials (VEPs) Obtained During Spine Surgery to Predict Postoperative Visual Changes

  • Improved Diagnosis and Classification of Cervical Myelopathy Via Quantitative Magnetization Transfer MRI

  • Biomechanical Evaluation of a novel technique for bone grafting in Anterior Cervical Discectomy with Fusion Surgery

  • Evaluation of the Thrombosis Risk of TXA Administration in Spine Surgery

  • The Efficacy of Computed Tomography in Detecting Cervical Spine Fractures in Padded Football Players: A Cadaveric Study

  • The Contribution of Postoperative Anemia to Length of Stay for Patients Undergoing Minimally Invasive Lumbar Interbody Fusion

  • CT is Insufficient for the Emergent Imaging of Cervical Spine Injuries Without Removal of Football Equipment 

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  • Anterior Cervical Discectomy and Fusion (ACDF) Surgery Using a Local Source for Cancellous Autograft: A Prospective Study
  • Comparison of Osteogenic Potential of Autogenous bone Grafts from the Cervical Spine and Iliac Crest in Vitro
  • Assessing the Clinical Value of Tranexamic Acid in Fusion Surgery for Lumbar Spinal Stenosis
  • Predicting Hospital Length of Stay for Patients Undergoing MIS Lumbar Fusion Based on Occupational Therapy (OT) and Physical Therapy (PT) Evaluations of Postoperative Mobility
  • Rates of osteoporosis screening and treatment following fracture and development of bone health systems and fracture liaison services

  • Impact of direct lateral interbody fusion on functional performance: a clinical and bio mechanical study

  • Improved diagnosis and classification of cervical myelopathy using quantitative magnetization transfer MRI analysis

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Meet Our Spine Surgery and Scoliosis Team
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Our team of spine and scoliosis surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained reconstruction surgeons evaluate and treat thousands of patients each year.
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Sports Medicine

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One Orthopaedic surgeon’s Ironman journey
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T.K. Miller, M.D.
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Don't let an injury sideline your game.
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Carilion Sports Medicine
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From head to toe, our team collaborates on simple and complex orthopaedic problems.
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Top 100 Hospitals with Great Orthopaedic Programs
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One of the largest sports medicine practices in Virginia, averaging more than 700 visits and procedures each work day.
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Our sports medicine team performs over 12,000 surgical procedures annually.
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We provide team coverage to 22 area high schools and six colleges and universities.
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Sports Performance and Rehabilitation
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Our protocols are developed by your surgeon in collaboration with a multidisciplinary team of experts to establish a clear, concise, safe and effective pathway to get you from your injury and surgery to a complete recovery and back to full function without limitation.
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LAB Sports Performance Center
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Premier Training Facility
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We are uniquely positioned within LAB Sports Performance, a premier training facility for total body and functional movement.
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Our Sports Medicine surgeons and physical therapists will customize rehabilitation plans to fit your performance goals.
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Total body and function rehabilitation
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LAB Sports Performance
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Are you ready to schedule an appointment with one of our providers or do you need more information?
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Thomas K. Miller, M.D.
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Thomas K. Miller M.D.
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Section Chief, Sports Medicine
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Carilion Orthopaedic Surgery Series
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Patients should expect a thorough explanation of their diagnosis, options (and their rationale) in treatment, risks and benefits of all options and realistic expectations for relief of symptoms and recovery of function.
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Don't put your health on hold—see us safely. Dr. Miller shares an inside look at the safety measures we've put in place to keep you and our staff safe.
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In addition to being on the sidelines for 22 high schools and 6 colleges and universities, our faculty participate in events around the world.
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Event Involvement
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Event Involvement
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Ironman World Championship, Chief Physician
Ironman/WTC Global Medical Board Chair
World Athletics OPMER Advisory Group
USA Triathlon Medical Advisory Board
Blue Ridge Marathon Medical Director
UCI Cyclocross Event Coverage
NCAA Div. III Wrestling Natl. Championships
SOCON Indoor Track and Field Championships
All Academy Indoor Track Championships
All Academy National Wrestling Championships
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Sideline Support
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Sideline Support
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Carilion Sports Medicine proudly supports the following colleges and universities on the sidelines and for follow-up care: Ferrum College, Radford University, Southern Virginia University, Virginia Tech Athletics, Virginia Military Institute, Virginia Tech club sports, Virginia Tech Corps of Cadets, Washington & Lee. We also have athletic trainers at 22 high schools for treatment and triage. Carilion Sports Medicine donates over 2,500 volunteer hours to athletics each year.
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Community Physicals
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Carilion Clinic's Sports Medicine providers work to make sure students are safe to play sports. Our team is always here to provide care when needed, by providing community-based school physicals (or pre-participation physicals) for student athletes at no cost from Carilion in Roanoke or the New River Valley. In Roanoke, we offer same-day appointments.
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Collaboration
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Collaboration
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As a medical team, we are fortunate to have an extensive breadth of sports knowledge to keep our patients safe. Our providers collaborate within the fields of operative and non-operative sports medicine, primary care sports medicine, and sports medicine-directed physical medicine and rehabilitation. By bringing together these experts, we can provide shared event coverage and pre-participation evaluation clinics to the community.
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Treatments
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Our Sports Medicine team offers traditional and non-traditional treatment options. We are offering PRP (biological substances such as platelet-rich plasma) used to speed the healing process.
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Institute for Orthopaedics and Neurosciences (ION)
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The Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients. ION serves as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

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The Orthopaedic Department provides fellowship training for surgeons from across the United States to help them provide better care.
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VTCSOM Virtual Tour
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We are proud to have nationally and internationally recognized faculty committed to educating the next generation of students at VTCSOM.
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When it comes to residencies and fellowships, finding the right fit is very important. Our GME program offers amazing support and training.
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At Carilion Clinic Orthopaedics, we are actively involved in finding innovative ways to improve the care we give to our patients. Here is a list of select research studies currently taking place in Sports Medicine.

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  • Biomechanical Comparison of Double and Single Row Rotator Cuff Repair Techniques of Varying Lines of Tension
  • Opioid Consumption in Patients Undergoing Arthroscopic Rotator Cuff Repair using Interscalene Brachial Plexus Block with and without Liposomal Bupivacaine: A Randomized Control Trial
  • Validation of an Interventional Based Pain Scale and Comparison with the Visual Analog Scale (VAS) in a Postoperative Setting in Correlation with Patients’ Pain Management Needs
  • Prospective Evaluation of Exparel Adductor Canal Field Block for Pain control after Anterior Cruciate Ligament Reconstruction
  • Reduction of Risk Factors for ACL Re-injuries Using a Novel Biofeedback Approach
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  • Measuring Landing Mechanics During Rehabilitation
  • The Effects of Ankle Braces on Foot Posture
  • Gait Biofeedback for Cerebral Palsy Study
  • Side-to-Side Asymmetry Changes During Running
  • The Effects of Brace Wear on Sports Performance
  • Gait Assessment Following Total Ankle Replacement
  • A Prospective Clinical Trial Comparing General Anesthesia with Interscalene Nerve Block vs. TIVA-P Sedation with Interscalene Nerve Block in Outpatient Shoulder Arthroscopies
  • Gender Differences in the Performance Response to Brace Wear Following ACL Reconstruction
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Meet Our Sports Medicine Team
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Our team of orthopaedic sports medicine surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained sports medicine surgeons evaluate and treat thousands of patients each year.
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Orthopaedic Trauma

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Care and Treatment
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Orthopaedic Trauma
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When the unexpected happens, our highly trained multidisciplinary team is ready.
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Providing expert orthopaedic trauma and fracture care in our region’s only Level I Trauma Center.
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From head to toe, our team collaborates on simple and complex orthopaedic problems.
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Are you ready to schedule an appointment with one of our provider? Do you need more information?
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Proud of our
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Thomas E. Shuler M.D.
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Thomas E. Shuler M.D.
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Chief - Orthopaedic Trauma and Fracture Service
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Carilion Orthopaedic Surgery Series
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At Carilion Clinic we have the technology and resources to diagnose and manage the full spectrum of orthopaedic conditions. I strive to use that technology to treat the whole patient, not just the X-ray.
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Thomas E. Shuler M.D.
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Trauma Surgery
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Level 1 Trauma Center
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With a Level 1 Trauma Center, we are a regional resource providing the highest level of specialized trauma and critical care services to the Roanoke Valley and surrounding rural areas, supported by three Life-Guard helicopters for rapid response.

We’re prepared to treat whatever comes our way with a team of trauma surgeons, emergency room physicians and other specialists that are available to provide immediate care for critical injuries that must be treated in a very narrow window of time.
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Limb Deformity
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Limb Deformity
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Limb deformities can be present from birth; develop over time; or result from fracture, infection, arthritis or tumor. Some limb deformities can be life-altering and others may be more of a cosmetic concern. Because deformities can also affect joint alignment, a deformity left untreated may result in musculoskeletal problems such as arthritis or back pain, and potentially prevent patients from participating in activities they enjoy.
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Institute for Orthopaedics and Neurosciences (ION)
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The Institute for Orthopaedics and Neurosciences (ION) is an innovative convergence of leading medical practitioners who provide expert care to patients. ION serves as a model for medical students, research fellows and residents—the next generation of providers. ION provides a shared vision of collaboration and a team-based approach to healing.

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Research & Education
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Elevating care through innovative
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Research and Education
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Education
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Fellowship Training
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The Orthopaedic Department provides fellowship training for surgeons from across the United States to help them provide better care.
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We are proud to have nationally and internationally recognized faculty committed to educating the next generation of students at the VTCSOM.
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Our GME program offers residency training for UVA Orthopaedics and Larkin Community Hospital, as well as joint replacement and hand fellowships.
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At Carilion Clinic Orthopaedics, we are actively involved in finding innovative ways to improve the care we give to our patients. Here is a list of the active research studies currently taking place in Orthopaedic Trauma.

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  • The Use of Tranexamic Acid to Reduce the Need for Transfusion 1 Week Post-operatively for Hemiarthroplasty or Intramedullary Nailing Needing to Correct Acute Hip Fracture
  • Establishment of Safe INR Level in Patients Undergoing Hip Fracture Surgery
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  • Predicting Fracture Union Using Post-operative RUST Scores
  • Incidence of Fractures and Biomarkers Among MGUS Patients in a Bone Health Clinic
  • Use of Locking Plates in the Treatment of Periprosthetic Fractures
  • Testing the Structural Properties of Bone Cement
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Meet Our Orthopaedic Trauma Team
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Our team of orthopaedic trauma surgeons provides care at the Institute for Orthopaedics and Neurosciences in several locations throughout southwest Virginia. Our board-certified, fellowship-trained reconstruction surgeons evaluate and treat thousands of patients each year.
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Restoring Arm Functionality
Brachial plexus surgery provides a path forward.
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Innovative Scoliosis Treatment
Magnetic growing rods mean fewer surgeries for Malaya.
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Supporting the Virginia Tech Corps of Cadets
Sports Medicine is on the sidelines.
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Orthopaedic History
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Since 1940
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Continuing the legacy of excellence in orthopaedic care.
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Decade
1940
Years
Year
1940
Event Details

There are 23 orthopaedic surgeons in Virginia and none west of Roanoke.

The modern practice of orthopaedics in Roanoke begins with Roy M Hoover, M.D. and Heywood Wescott (1940), Louis P. Ripley, M.D. (1948), Charles B. Bray, M.D. (1950) and Phillip Trout, M.D. (1951).

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Blue Ridge Mountains
Decade
1950
Years
Year
1950
Event Details

The practice of orthopaedics in Roanoke becomes more diverse and wide ranging, including care of local patients as well as patients from much of Southwest Virginia and southern West Virginia. Roanoke orthopaedic surgeons round daily at the Jefferson Hospital, the Shenandoah Hospital in Roanoke, the Veterans' Hospital in Salem, Franklin Memorial Hospital in Rocky Mount and Stonewall Jackson Hospital in Lexington. The polio epidemics of the late 1940s and early 1950s have an epicenter in western Virginia. and the orthopaedic surgeons in Roanoke and Roanoke Memorial Hospital play a key role in managing these patients.

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Year
1955
Event Details

The Roanoke Orthopaedic Clinic is founded by Louis Ripley, M.D., Charles Bray, M.D., and Phillip Trout, M.D. as a private surgical practice.

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Roanoke Orthopaedic Clinic
Year
1957
Event Details

The physicians from Roanoke help create the Virginia Crippled Children’s Bureau, providing orthopaedic care for these patients on a voluntary basis. Since the doctors go to the patients, this involves considerable travel to the far corners of southwest Virginia, with the costs of travel and time away from home and practice borne by the physicians.

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1950s kids
Year
1957
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Established affiliated residency program between the Roanoke Orthopaedic Clinic (Roanoke Memorial Hospital) and the University of Virginia Orthopaedic Program.

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Residency
Year
1959
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A formal sports medicine program is created, providing coverage for Virginia Tech (VPI) and Virginia Military Institute.

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Sports Medicine
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1970
Years
Year
1972
Event Details

The first total hip and knee arthroplasty is performed at Roanoke Memorial Hospital.

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Hip arthroplasty
Decade
1980
Years
Year
1986-1988
Event Details

Roanoke Orthopaedic Clinic expands with addition of fellowship trained providers to form Roanoke Orthopaedic Center, relocating to Roanoke County and offers subspecialty services in Pediatric Orthopaedics, Sports Medicine/Arthroscopy, Joint Replacements, Orthopaedic Trauma, Hand and Upper Extremity, Foot and Ankle, Spine and Physical Medicine and Rehabilitation.

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Doctors
Decade
1990
Years
Year
1992
Event Details

Roanoke Memorial Hospital and Community Hospital merge, creating Carilion Health System.

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CHS Merger
Year
1992
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Development of joint replacement educational classes begins.

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Joint Academy
Year
1994
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First system-based orthopaedic provider, Thomas Shuler, M.D., joins Carilion's medical education department providing orthopaedic trauma coverage.

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Life-Guard
Year
1995
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Development of multidisciplinary Joint Council monthly meetings begin to review quality data, review complications, measure outcomes, measure patient satisfaction, clinical protocols, and pathways and innovative changes for improvement.

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Doctors
Decade
2000
Years
Year
2003
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Fellowship in Adult Reconstruction and Total Joint Arthroplasty begins.

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Fellowship
Year
2006
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Carilion Bone and Joint Center is established, offering orthopaedic and rehabilitation services.

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rehab
Year
2007
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Carilion Roanoke Memorial Hospital receives hip and knee disease-specific care certification from The Joint Commission.

Advancement in techniques and technology: minimally invasive procedures, computer assisted surgery, anterior hip replacements.

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Hip and knee pain
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The Joint Commission
Decade
2010
Years
Year
2010
Event Details

Roanoke Orthopaedic Center joins Carilion Bone and Joint Center to form a multispecialty, academic Orthopaedic practice.

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Carilion Roanoke Memorial Hospital
Year
2012
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Podiatry residency program begins.The podiatry residency program is integrated into the Department of Orthopaedics to ensure that our graduates have a breadth and depth of experience in foot and ankle. Two residents are accepted each year into this three-year program

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Podiatry Group
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2014
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The Department of Orthopaedic Surgery is created.

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Department of Orthopaedic Surgery
Year
2015
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Established affiliated residency program between Carilion Clinic and the Larkin Community Hospital program in Miami, Florida.

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Residency
Year
2016
Event Details

The Institute for Orthopaedics and Neurosciences opens, uniting complementary disciplines to benefit education, research and, most importantly, patient care.

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ION
Year
2019
Event Details

Fellowship in Hand and Upper Extremity Surgery begins.

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Hand Surgery
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Institute of Orthopaedics and Neurosciences
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All that we do takes place at ION, where we collaborate and share a vision of a team based approach to healing.
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