The largest independent orthopedic treatment center in the Roanoke Valley is merging with Carilion Clinic.

Roanoke Orthopaedic Center, which currently has 10 physicians on a staff of about 100 at its Roanoke County location, and Carilion announced the deal Tuesday.

Officials at Roanoke Orthopaedic said they first approached Carilion about three years ago to discuss a possible merger, lured by the health system's conversion from a traditional hospital system to a physician-led clinic model.

"We wanted to be a part of the growth of Carilion, and the medical school, and to be able to provide better integrated care," said Dr. Hugh Hagan, president of Roanoke Orthopaedic.

The merger -- just the latest in a series of moves that have brought more local practices into the fold of the region's largest health care provider -- comes at a time of increased scrutiny for Carilion.

Earlier this year, the Federal Trade Commission found that Carilion's acquisition of two outpatient clinics would have stifled competition. Carilion has agreed to sell the two clinics as part of a settlement with the FTC.

Carilion spokesman Eric Earnhart said the merger announced Tuesday does not violate a consent order between the FTC and Carilion.

Earnhart cited two reasons why: The FTC's consent order does not apply to practices that approach Carilion about mergers, as Roanoke Orthopaedic did, and the talks that resulted began before the consent order took effect.

Jeff Perry of the FTC said the consent order -- which applied to Carilion's acquisition of the Center for Advanced Imaging and the Center for Surgical Excellence -- does not speak to whether "separate acquisitions that may occur are legal or illegal."

Perry, acting deputy assistant director of the FTC's antitrust division, declined to say whether Carilion had contacted the commission about the merger, or if an inquiry is under way.

Earnhart, however, said the FTC was aware of the deal with Roanoke Orthopaedic.

"It's not an invasion, or a takeover, or anything of that nature," Dr. Thomas Shuler of Carilion said of the merger, which creates the largest speciality of its kind in Southwest and central Virginia.

Had the two operations remained independent and continued to grow, "then what would have happened is that we would start to bump heads," said Shuler, section chief of orthopedics for Carilion. "We wouldn't be working together."

When the merger takes effect March 1, what had been known as Carilion Bone and Joint will take the new name of Carilion Clinic -- Orthopaedics.

At least for the short term, physicians and staff at Roanoke Orthopaedics will continue to work out of their current location at 4064 Postal Drive off Virginia 419 in Southwest Roanoke County. But the physicians, who have practiced at Roanoke Memorial Hospital for years, also will see patients at the adjacent Riverside Center medical complex.

All of the employees at Roanoke Orthopaedic will keep their jobs -- although as Carilion employees.

"Our commitment was to our staff; that's why we did what we did," Hagan said.

The merger will allow collaboration between Carilion, where orthopedic doctors often specialize in trauma to deal with accident victims brought to the emergency room, and Roanoke Orthopaedic's expertise in other areas, such as sports medicine.

Other services provided through the merger will include joint replacement and reconstruction; arthroplasty; spine, fracture and trauma care; hand and microvascular surgery; and pediatric orthopedics.

"We already have a common vision for the future of orthopedics in the region," Shuler said. "Forming a new, comprehensive practice is the best way to move that vision forward."

Carilion currently has 14 orthopedists -- a number that will grow to 24 with the merger.

The merger will leave just four orthopedic physicians in the Roanoke Valley who are not affiliated with a hospital, said Dr. Mark Hagy, who is one of the four partners of Virginia Orthopedics in Salem. About six orthopedic specialists work for Lewis-Gale Medical Center, owned by Carilion's chief competitor, HCA Southwest Virginia.

Hagy said he is not sure what impact the merger will have on his practice.

"It sounds like a bunch of people who are really smart felt like it was a good idea to consolidate and bring Roanoke Orthopaedic into the fold," Hagy said.

"I'm concerned about it, but I'm also indifferent because there's nothing that I can do."