Orthopedic & Sports Medicine Institute · Since 2006 · New Braunfels, Texas

Orthopedic Care for South Central Texas.

Board-certified orthopedic surgeons caring for patients at six clinics from New Braunfels to Yoakum. We treat joint pain, sports injuries, fractures, and arthritis — and our surgeons perform the procedures they recommend. Most insurance accepted, including Medicare and Tricare.

The People You'll Actually See.

The pairings you’ll actually see in the OR — surgeon and PA who have scrubbed the same cases together for years, not just the same clinic. Every one of our PAs has stood across the operative field, not just in the exam room.

Where We See Patients.

Hover a clinic to see a photo and open it on the map. Click for address, hours, and directions.

Map data © OpenStreetMap contributors © CARTO

  1. New BraunfelsFlagship

    Main office · physician-owned

    960 Gruene Rd., Suite 101 · New Braunfels, TX 78130

  2. Seguin

    Guadalupe Regional Medical Center

    1339 E. Court St., Suite 220 · Seguin, TX 78155

  3. Cuero

    Cuero Regional Hospital

    2550 N. Esplanade St. · Cuero, TX 77954

  4. Kenedy

    Otto Kaiser Memorial Hospital

    3349 US-181 · Kenedy, TX 78119

  5. Hallettsville

    Outpatient Specialty Clinic at Lavaca Medical Center

    1400 N. Texana St. · Hallettsville, TX 77964

    Dr. Vrana Outpatient specialty clinic · 3rd & 4th Wed each month

  6. Yoakum

    Outpatient Specialty Clinic at Yoakum Community Hospital

    1200 Carl Ramert Dr. · Yoakum, TX 77995

    Dr. Vrana Outpatient specialty clinic · 2nd Wed each month

Every Condition We Treat.

General orthopedics, joint replacement, and sports medicine — covering the hip, knee, shoulder, elbow, hand & wrist, spine, foot & ankle, and acute fracture care.

Pick a body region to narrow the list. Each condition opens a full patient-education page — how we make the diagnosis, the non-operative care we try first, and the point at which surgery becomes the right call.

Trauma

Acute trauma usually reaches us through the hospital. Our surgeons take call at local ERs — your initial care and any emergency surgery happen there. Follow-up, continued fracture management, and rehabilitation are handled at OSI.

Browse all surgical procedures →

Start here · Education first

Common Problems, Explained Honestly.

These are the first pages we wrote — long-form, patient-focused, and free of marketing puffery. No drama, no scare tactics, no surgical upsell. Just what the problem is, what the evidence says, and every non-operative option before surgery is ever considered.

Standing weight-bearing X-ray of a knee with medial joint-space narrowing from osteoarthritis

Knee

Knee Osteoarthritis

What “bone on bone” actually means, why the knee hurts the way it does, and what the non-operative and operative options really are.

Read the guide
AP pelvis X-ray showing hip osteoarthritis with joint-space narrowing and osteophytes

Hip

Hip Osteoarthritis

Groin pain, stiffness after sitting, trouble putting on shoes — the classic hip-arthritis story, and every treatment option from injections to replacement.

Read the guide
Shoulder MRI showing a full-thickness tear of the supraspinatus tendon

Shoulder

Rotator Cuff Tear

Not every tear needs surgery. Which ones do, which ones don’t, and why shoulder MRIs find tears in people who have zero symptoms.

Read the guide
Knee MRI showing a posterior-horn meniscus tear

Knee

Meniscus Tear

Why a twisting injury at 25 is a different beast than a degenerative tear at 55, and why the treatment that’s right depends on which one you have.

Read the guide
Axial wrist MRI through the carpal tunnel showing the median nerve and flexor tendons

Hand & wrist

Carpal Tunnel Syndrome

Numb fingers that wake you up at night, shaking out the hand to get feeling back — that’s the classic picture. Here’s what to do about it.

Read the guide
Sagittal T1 hip MRI showing a labral tear at the acetabular rim

Hip

Hip Labral Tear

A ring of cartilage around the hip socket that tears in people with a specific hip shape. Confused with a groin strain more often than you’d think.

Read the guide

Full library

Every Condition We Treat

The full patient-education library — organized by body region, searchable, and written for people, not insurance codes.

Browse the library

Most Orthopedic Problems Do Not Require Surgery.

We spend a large share of clinic time on activity modification, physical-therapy coordination, bracing, and image- or landmark-guided injections. These are the injection and biologic therapies we offer.

See all non-operative options →

When Surgery Is the Right Step, It’s a Craft.

Most orthopedic problems never reach an operating room. When one does, the surgeon making that call has trained specifically for it. OSI has fellowship-trained orthopedic surgeons on staff — each with their own area of concentration, so a case that reaches the OR is handled by someone with subspecialty experience in that problem rather than a generalist picking it up. The decision is slow, the work is precise, and technique sits in the surgeon’s hands. A glimpse of the work itself:

Placeholder imagery: the photos above are open-access orthopedic surgical teams (not OSINB physicians) shown while documentary photography of our own surgeons and PAs in the OR is commissioned. The marked slots are where those real-team photographs will replace the placeholders.

Reference · Only if surgery becomes the right step

Procedures, Explained.

Most orthopedic problems never need an operation. If surgery does come up in your visit, these are the procedures our surgeons are trained to perform — written as plain-language education, not advertising. No urgency, no outcome promises, no “book today.”

AP radiograph showing a total hip arthroplasty with femoral stem and acetabular cup

Hip · Considered after non-op fails

Anterior Total Hip Replacement

Reserved for patients whose hip arthritis no longer responds to activity changes, physical therapy, or injections. The anterior approach is one of several valid surgical techniques.

How it works
Post-operative knee replacement X-ray showing femoral and tibial prosthetic components

Knee · Considered after non-op fails

Total Knee Replacement

A last-resort option for knees that have worn through the cartilage and stopped responding to injections, bracing, and therapy. Recovery is a months-long commitment.

Read the full guide
Coronal shoulder MRI demonstrating rotator cuff tendon pathology

Shoulder · Not every tear needs it

Rotator Cuff Repair

Many rotator cuff tears improve with physical therapy alone. Repair is considered when pain or weakness persists despite non-operative care, or for specific acute tears.

When it’s indicated
Sagittal knee MRI showing a complete tear of the anterior cruciate ligament

Knee · Activity-level decision

ACL Reconstruction

Not every ACL tear requires surgery. Reconstruction is usually considered when the patient needs pivoting, cutting, or high-level activity; others do well with rehab alone.

Graft choices & trade-offs
Wrist MRI slice demonstrating the anatomy addressed during carpal tunnel release

Hand · After splinting + observation

Carpal Tunnel Release

Considered after splinting, ergonomic changes, and sometimes injection have been tried. Reliable for patients with clear nerve-compression findings on exam and testing.

Recovery timeline
Knee MRI showing a full-thickness cartilage defect at the medial femorotibial joint

Knee · Narrow indications

Cartilage Restoration

Appropriate only for specific focal cartilage defects in younger, active patients. Not a treatment for generalized arthritis and not a substitute for joint replacement when that’s what’s indicated.

Who qualifies

Full list

Every Procedure We Perform

Fractures, arthroscopy, ligament reconstruction, joint replacement, hand and wrist, sports medicine — the complete index.

Browse procedures

A Little Preparation Saves Time at Check-In.

Bring

Photo ID and insurance card(s); a current medication list with doses; any recent X-rays, MRI, or CT on disc or USB; a referral from your primary care physician if your plan requires one.

Accepted plans

Medicare, Tricare, Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, Humana. Most commercial plans are accepted; call to confirm in-network status before your visit.

Patient portal

For refills, visit summaries, and messages between appointments, call the front desk for portal access.

Request an appointment or call (830) 625-0009, Mon–Fri 8 AM–5 PM