Physician-Owned & Operated · In New Braunfels Since 2006 · Serving Six South Central Texas Communities
Joint pain, sports injuries, fractures, and arthritis — most managed without surgery, with same-week appointments when an injury needs attention fast. Straight answers from a surgeon when an operation is on the table, and the same care team guiding you through recovery. Most insurance accepted, including Medicare and Tricare.
David B. Templin, M.D.
Board Certified Orthopedic Surgeon
Michael S. Vrana, M.D.
Board Certified Orthopedic Surgeon · Fellowship-Trained in Sports Medicine & Joint Replacement Surgery
Trent Twitero, M.D.
Board Certified Orthopedic Surgeon · Former Chief of Orthopedics @ Fort Hood
Sydney Georg, PA-C
Physician Assistant · Works with Dr. Templin
Ben Swanner, PA-C
Physician Assistant · Works with Dr. Vrana
Each PA is paired with one surgeon — through clinic, the OR, and recovery. Not a rotating cast. The same familiar team from your first appointment through healing.
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Main office · physician-owned
960 Gruene Rd., Suite 101 · New Braunfels, TX 78130
Most orthopedic problems don't need surgery. The first visit is usually about figuring out what's actually wrong and what the least invasive path to getting better looks like. Physical therapy does most of the work. Injections and bracing have their place when they fit the problem, not by default. A smaller operation — a knee scope, a partial joint — is always a better answer than a bigger one when it will do the job. But some problems, like end-stage knee arthritis, have a gold-standard operation, and the honest answer is the one that actually fixes it. Being trained in both sports medicine and joint replacement is what lets us tell you which of those you're facing.
Fellowship-trained orthopedic sports medicine is a meaningful distinction, and it's one we have at OSI. Dr. Vrana is fellowship-trained in sports medicine; Dr. Twitero brings additional fellowship training in joint reconstruction; Dr. Templin brings decades of sports medicine surgical experience. Together they cover the full range of sports injuries — ACL reconstructions, meniscus surgery, rotator cuff repairs, Achilles tendon repairs, shoulder instability and labral repairs, biceps and triceps tendon repairs, patellar instability, cartilage restoration, and the general care that gets athletes and active patients back to what they do. When an operation is the right call, we favor arthroscopic techniques with smaller incisions, and structured physical therapy carries the recovery the rest of the way.
Hip, knee, and shoulder replacement, tailored to the patient. For the knee, that includes partial knee replacement — a durable option many patients don't realize exists, and one that isn't limited to people over 65. When only part of the joint is worn, replacing only that part preserves healthy tissue. Implant sizing and position are planned from a preoperative CT or MRI of the patient's own anatomy, so the components fit the patient rather than the other way around. Most primary replacements go home the same day — sometimes the next morning — and we continue to see our patients back at ten and fifteen years, still doing well on their replacements. The implants themselves are designed to last longer than that.
If you come in through the ER with a fracture, an OSI surgeon evaluates the injury, decides whether it can wait for clinic the next day or needs to go to the operating room, and sets the plan from there. Most fractures are treated here, at our partner hospitals, and followed through to full recovery.
General orthopedics, joint replacement, and sports medicine — covering the hip, knee, shoulder, elbow, hand & wrist, spine, foot & ankle, and acute fracture care.
Every page opens with how we make the diagnosis, the non-operative care we try first, and the point at which surgery becomes the right call.
Start here · Education first
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.
Hand & wrist
Pain at the base of the thumb with pinching, jar-opening, and writing — the most common site of arthritis in the hand, and what the non-operative path looks like before surgery is ever on the table.
Read the guide
Knee
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 guideHip
Groin pain, stiffness after sitting, trouble putting on shoes — the classic hip-arthritis story, and every treatment option from injections to replacement.
Read the guideShoulder
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 guideKnee
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 guideHand & wrist
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 guideFull library
The full patient-education library — organized by body region, searchable, and written for people, not insurance codes.
Browse the libraryMost orthopedic problems never reach an operating room. When one does, the people around the table matter more than anything else in the room.
Placeholder imagery. The four photographs above are slots reserved for documentary photography of our own surgeons and PAs in the OR; the descriptions under each placeholder describe the exact frame planned for that slot.
Reference · Only if surgery becomes the right step
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.”
Knee · Considered after non-op fails
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
Hip · Considered after non-op fails
A last-resort option for hips that have worn through the cartilage and stopped responding to therapy, activity modification, and injections. Recovery is a months-long commitment.
Read the full guide
Shoulder · Specific indications
Designed for shoulders where the rotator cuff can no longer power the joint. Reversing the ball-and-socket geometry lets the deltoid do the lifting work the cuff used to do.
Who it's for
Hand · After splinting + injection
For basal-joint thumb arthritis that no longer responds to splinting or injection. The worn trapezium is removed and the thumb is stabilized with a soft-tissue reconstruction.
Read the full guide
Wrist · Displaced fractures
Open reduction and volar-plate fixation for distal radius fractures that can't be held in good position with a cast alone. Restores length, alignment, and joint congruity.
When it's indicatedFull list
Fractures, arthroscopy, ligament reconstruction, joint replacement, hand and wrist, sports medicine — the complete index.
Browse proceduresWhen you are ready
A member of our scheduling team will answer — no phone trees, no forms to fill out first. Tell them what is going on, and they will book you with the right surgeon.
Coming in for the first time? What to bring and what to expect →
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.
Medicare, Tricare, Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, Humana. Most commercial plans are accepted; call to confirm in-network status before your visit.
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
