Orthopedic specialists work together to offer head-to-toe care


Dean’s aches and pains have turned him into a repeat patient at Goshen Orthopedics. Since 2020, Dean Hiles, age 50, has made the rounds with several specialists on the multidisciplinary team. He also returns frequently to Goshen Rehabilitation for physical therapy.
Type 1 diabetes complicates Dean’s health problems. This puts him at higher risk for orthopedic problems, particularly in the hand, wrist and shoulder.

Knee treatment

In 2020, Dean injured his left knee while swimming in a wave pool. A sudden twist in the joint ruptured the meniscus, a crescent-shaped structure of cartilage that acts as a shock absorber in the knee. It left Dean with a wobbly knee that swelled up with fluid and caused uncomfortable pain in the joint.
Dean’s primary care provider sent him to the specialists at Goshen Orthopedics for an evaluation and treatment. That’s where he first met Orthopedic Surgeon David Koronkiewicz, DO.
“At the time, I worked in Syracuse, and I could get in early at their office for physical therapy before I headed into work,” Dean said.
A cortisone shot, medications and physical therapy restored the knee, and Dean was back to swimming and working out every day.

Finger treatment

In 2022, Dean’s finger in his left hand got stuck in a bent position. He knew all about trigger fingers after going through treatment on his right hand in 2007.
“I had a hard time typing,” Dean said. His job as an environmental health and safety manager means he is at his computer filling out forms nearly every day.
This time, Dr. Koronkiewicz brought in his Colleague Robert Lane, DO, who specializes in hand surgeries, to evaluate Dean’s stubborn joint.
Dean decided to have minimally invasive surgery called tenolysis to free the tendon of scar tissue that had built up in his finger. The outpatient procedure worked, giving Dean full use of all his digits again.

Shoulder treatment

Wear and tear from construction work had taken its toll on Dean’s upper joints. Arthritis set into the right shoulder and left him with limited mobility.
“I couldn’t raise my arm above my shoulder,” Dean said.
This summer, a cortisone shot, anti-inflammatory medications and physical therapy somewhat eased the pain and stiffness. More sessions with a physical therapist at Goshen Rehabilitation eventually got the joint in better working order and gave Dean more mobility.
The tear in Dean’s left rotator cuff proved more difficult to treat.
“Dr. Koronkiewicz said everything that could be wrong with my left shoulder is wrong,” Dean said.
In September 2022, Dr. Koronkiewicz brought in Nicholas DeFauw, DO, and Christopher Owens, MD, to evaluate Dean’s shoulder.
Dean’s team of doctors is particularly concerned about his risk of frozen shoulder, which often occurs in people with diabetes. The syndrome causes the shoulder capsule to thicken and become stiff and tight. It can cause severe pain and an inability to move the shoulder.
For now, Dean will continue home-based physical therapy for his shoulder. He also may consider another cortisone shot in the joint, depending on his progress with daily exercises.
“I’m up for whatever is going to work,” Dean said.
Goshen Orthopedics takes an all-inclusive approach to caring for your bones, muscles and joints. Our experienced surgeons, physicians, nurse practitioners and therapists join forces to personalize your treatment.