The Adult Reconstructive Service concentrates on the care of patients with major joint arthritis and receives patient referrals throughout Northern California. Patients represent all adult age groups and a wide variety of types of arthritis. Common referrals are for osteoarthritis, post-traumatic arthritis, avascular necrosis and arthritis secondary to hemophilia. Common surgical procedures include total hip replacement, total knee replacement, osteotomy for realignment of extremities and arthroscopy with chondroplasty. The department frequently employs revision total joint replacements and two-stage reconstructions for infection. The total joint components include modern cementless modular total joint replacement, custom prosthetic components and allograft replacement when medically indicated.

The department also offers a unique program in joint preservation surgery of the knee and hip. The program is designed to maximize the function of native joints and to potentially prevent or delay the ultimate need for total joint arthroplasty. The various procedures with this aim include fresh cartilage transplantation (osteochondral allografting); mosaicplasty; unicompartmental knee arthroplasty; realignment of the pelvis, femur and knee (osteotomies); and resurfacing hip arthroplasty.