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ORTHO

There are many conditions that affect our body’s musculoskeletal system, that require clinical care by a physician or any other healthcare professional. These include arthritis, fractures, lower back pain, osteoporosis and shoulder pain. The Department of Orthopaedics& Joint Replacement at B.P.PoddarHospital offers the entire range of modern Orthopaedic Management Services. The objective is to get patients back on their feet quickly by avoiding complications and decreasing the period of confinement. The services are patient-friendly, result oriented and geared to enable patients to return to their normal life within a short span of time.

CONDITIONS

ANKLE PROBLEMS

We treat a variety of ankle problems every day. We do an analysis of the best treatment plan for you, based upon the severity of your problem and your lifestyle needs. Treatment plans mayvery from medication, physical therapy, surgery or a combination of them.

We regularly treat issues such as:

  • Footballer’s ankle (Anterior impingement)
  • Achilles tendon problems
  • Sprains
  • Flat feet
  • Ankle instability
  • Ankle osteoarthritis

Some surgical options for ankle issues are:

  • Debridement and removal of pinching bone spurs
  • Ligament tightening procedure
  • Debridement and tendon reconstruction
  • Ankle fusion
  • Bone grafts

If you have a question about a particular procedure, you can send us a message on our Inquiry page, or simply request an appointment to meet with a doctor.

ANTERIOR CRUCIATE LIGAMENT (ACL) TEARS

Anterior Cruciate Ligament (ACL) Reconstructive Surgery

Reconstructive surgery is a common treatment option for anterior cruciate ligament (ACL) tears. The surgery aims to prevent the shinbone (tibia) from moving too far forward, and restore the normal functioning of the knee in order to prevent further damage to its surrounding cartilage.

During ACL surgery, the doctor will remove what remains of the torn ligament and install a replacement in the same location. In the last ten years, the techniques used in ACL surgery have changed significantly, and improvements have been made that now allow patients to recover from the surgery much faster than before. A knee arthroscopy, for example, is a new technique which has evolved significantly in recent years as a treatment option for a torn ACL.

  • Types of Surgery
  • Risks of Surgery
  • Preparations Before Surgery

Types of Surgery

The three main types of ACL surgery are known as single-bundle, double-bundle and selective bundle reconstructive surgery.

  • Single-bundle ACL reconstruction: Doctor usually choose this type of surgery to operate on a torn ligament that does not require rotation, or when the patient has only limited control of joint movement, such as after repeat surgery following previously unsuccessful surgery.
  • Double-bundle ACL reconstruction: This method is the new standard for ACL reconstructive surgery. It is supported by a wealth of research which demonstrates that double-bundle ACL surgery can restore greater strength to a torn ACL that requires rotation, when compared with single-bundle surgery (Am J Sports Med 2010;38(1):25 and Am J Sports Med 2008;36(2):290).
  • Selective bundle reconstruction: This type of surgery is used in cases where many parts of the ACL have suffered injury. With selective bundle reconstruction, it is not necessary for the doctor to remove the whole of the ACL, but only the injured parts of it. This method uses natural fiber replacements, which helps to stabilize the position of the shinbone and the functioning of surrounding muscles, so that the patient can regain control of the bones of the leg (Knee Surg Sports TraumatolArthrosc 2010; 18:47–51).

Risks of Surgery

  • Risks associated with use of an anesthetic.
  • Numbness or weakness in the legs due to long-term posture changes.
  • Bleeding during and after surgery.
  • Damage to nearby organs during surgery, such as nerve endings, blood vessels and kneecaps.
  • Infection of bones or joints, which may occur immediately or shortly after surgery.

Preparations Before Surgery

  • Do not eat or drink for around 6 - 8 hours before surgery.
  • Do not take aspirin or other blood-thinning medications for at least one week before surgery. Patients should also inform their doctor if they are using any other medication.
  • Undergoing physiotherapy before surgery helps the knee to return to its original functioning as quickly as possible. Patients who receive ACL surgery while the knee is still in pain or still swollen after injury usually have problems rehabilitating the knee following surgery.
BUNIONS (HALLUX VALGUS)

Bunions , or hallux valgus, are a bone deformity at the joint of the big toe. Bunions develop when the big toe begins to point inwards and overlap nearby toes, causing the joint of the big toe to grow larger and become swollen. Bunions can also cause the skin at the base of the big toe to turn red, which results in sometimes being mistaken for a skin disorder. As bunions develop gradually, people soon notice that their big toe is starting to look crooked or unsightly. In some cases, people with bunions may also experience pain when walking and wearing shoes.

  • Causes of Bunions
  • Symptoms of Bunions
  • Diagnosing Bunions
  • Treating Bunions
  • Preventing Bunions

Causes of Bunions

Bunions are caused by abnormalities in the bone structure of the foot. These abnormalities are usually hereditary, such as flat feet or a slanted big toe. Wearing high heels or shoes with little toe room is not a cause of bunions, but it is a factor which may cause symptoms to worsen.

Symptoms of Bunions

In the early stages of this condition, when the big toe is only slightly slanted, there may not be any problems. However, when the big toe begins to severely slant, or in the event that a person continuously wears shoes that are too tight, consistently squeezing the toes together, the pressure exerted on the big toe may begin to produce noticeable symptoms, such as:

  • A bulge around the base of the big toe
  • Swelling, redness, or pain around the base of the big toe
  • Intermittent or continuous foot pain
  • Thickening of the skin at the base of the big toe
  • Loss of the full range of movement in the big toe, resulting in difficulty walking

Complications

Although bunions are not always problematic, if left untreated they can cause further complications including:

  • Bursitis : an inflammation and swelling of a bursa, a fluid-filled sac which acts as a cushion in areas where bone, tendon, and muscle converge around a joint. Bursitis inflammation causes pain.
  • Hammer Toe : develops when the joint of a toe becomes bent or curls downward due to dislocation, causing pain and increased pressure.
  • Pain and swelling on the sole of the foot.

Diagnosing Bunions

In order to diagnose bunions, the doctor will need to perform a clinical examination of the outside of the foot. However, in cases where further confirmation is required, the doctor may also have an x-ray done.

Treating Bunions

Treatment of bunions depends on the severity of the symptoms, pain, and pressure on the patient's toe. Treatment may begin with simple measures such as changing the type of shoes one patient wears, or wearing insoles to help support the affected area. Patients may also be advised to take over-the-counter painkillers, avoid physical activities which aggravate symptoms, or place the affected foot in an ice massage to alleviate pain and swelling.

In the event that these treatment options do not improve symptoms, or if the patient still can’t perform everyday activities without being in pain, then surgery may be needed to rearrange the protruding bone, tendon, and nerves into their correct positions.

Preventing Bunions

Choosing comfortable shoes, which puts less pressure on the joints and bones in our feet, helps to alleviate the symptoms of bunions and stop them from developing. Make sure to always keep comfort as a priority when purchasing footwear.

ELBOW PROBLEMS

We treat a variety of elbow problems every day. We do an analysis of the best treatment plan for you, based upon the severity of your problem and your lifestyle needs. Treatment plans mayvery from medication, physical therapy, surgery or a combination of them.

We regulary treat issues such as:

  • Acute elbow injuries
  • Dislocations
  • Bicep tendon rupture
  • Tennis elbow (tendonitis/ lateral epicondylitis)
  • Golfer’s elbow (Medial epicondylitis)

Some surgical options for elbow issues are:

  • Elbow Arthroscopy
  • Ulnar Collateral Ligament Surgery

If you have a question about a particular procedure, you can send us a message on our Inquiry page, or simply request an appointment to meet with a doctor.

OSTEOPOROSIS

Osteoporosis is a type of bone disease that involves bone denigration due to a loss of calcium in the bones. This condition is generally not painful, unless bones are fractured or broken. It is most commonly found in the spine, hips, and wrists, but can also occur in other parts of the body. In addition, osteoporosis is a major cause of spinal fractures or spinal deformities in older women.

  • Causes of Osteoporosis
  • Common Risk Factors
  • Treatment of Osteoporosis

Causes of Osteoporosis

  • The loss of estrogen due to menopause is the most common cause of osteoporosis. In fact, 25% of women older than 60 years old are found to have osteoporosis.
  • Women who go through menopause early or those who have had their ovaries surgically removed before the age of 45 are at risk.
  • The aging process is a major factor because, by the age of 50, bones start thinning by 1-3% every year.

Common Risk Factors

  • A family history of osteoporosis
  • European or Asian lineage
  • Lack of vitamin D or calcium
  • Regular consumption of alcohol or caffeine
  • Smoking
  • Sharp decreases in weight due to excessive exercising or dieting
  • Overuse of steroids
  • Conditions such as hormonal imbalances or thyroid disease
  • Chronic diseases such as liver disease or gastrointestinal disorders

Osteoporosis in Men

Osteoporosis can also be found in men, but it is more commonly found in women. The main risks in males come from alcoholism or a lack of testosterone.

Ways to Protect Yourself

  • Eat healthy, especially foods rich in calcium and Vitamin D, which are important minerals for building strong bones. These two minerals should be taken from childhood to ensure bone strength, which will reach its peak in a person’s late 20’s or early 30’s.
  • Exercise regularly.
  • Don’t smoke.
  • Avoid drinking beverages that contain alcohol or caffeine.
  • Have regular bone health screenings, especially when over the age of 50, in order to prevent bone loss at an early stage.

Treatment of Osteoporosis

Once someone is diagnosed with osteoporosis, a doctor may recommend medication. The type of treatment varies based on what the doctor considers to be the most appropriate for the patient.

PLANTAR FASCIITIS

Plantar fasciitis is a common foot condition that causes pain in the heel, across the sole, and sometimes into the arch area of the foot.

  • Symptoms
  • Causes
  • Testing and Diagnosis
  • Treatment

Symptoms

The main symptom of plantar fasciitis is a sharp pain in the heel, sole, or arch of the foot. The pain is sometimes described as a burning or aching sensation and tends to come on gradually. It is often most severe when weight is first placed on the foot after a long period of rest or inactivity, such as when getting out of bed in the morning or standing up after a long period of sitting. The pain also tends to worsen after standing, walking or jogging for extended periods.

Causes

Plantar fasciitis is caused by ligament damage, which can be a simple part of the aging process. The condition is most common in people over the age of 40. However, there are several other contributing factors which are usually associated with excessive or extended stress being placed on the ligament.
The main risk factors associated with activities include the following:

  • Standing for prolonged periods
  • Jogging or running long distances
  • Suddenly increasing the distance when running
  • Running on hard surfaces
  • Wearing inappropriate footwear (non-cushioned soles)
  • Walking barefoot for extended periods

Certain physical factors can also cause plantar fasciitis. These include the following:

  • Being overweight
  • Flat feet or high arches
  • Tightness in the Achilles tendon
  • Rheumatoid arthritis
  • Ankylosing spondylitis

Testing and Diagnosis

Preliminary diagnosis is usually based on a review of the patient’s history and recent activities together with a physical examination to assess the severity of the symptoms. In some more severe cases, the doctor will request additional imaging tests to rule out more serious causes of the pain, such as fractures or tumors. Additional tests include:

  • X-rays
  • Ultrasound
  • MRI

Treatment

Once the condition is diagnosed, the doctor will choose the most appropriate treatment based on the severity of the symptoms and the extent of damage to the ligament. Medication may be prescribed to reduce inflammation. However, non-medicinal treatments can also be very helpful in treating the condition.

Orthotic devices, such as arch supports or heel cushions, can help take the strain off the ligament. Physiotherapy in the form of stretching the foot, ankle and Achilles tendon is also an effective form of treatment in many cases.

If the symptoms persist and do not respond to the treatments already mentioned, then steroid injections may be required in some rare cases. Steroid injections are effective in curing more than 98% of patients’ symptoms. However, they can take up to 18 months to take full effect and the symptoms may also re-occur later, requiring a new round of injections to be given. Surgery is only recommended in the most severe cases.

ROTATOR CUFF TEAR

The rotator cuff is a group of tendons and muscles in the shoulder that connect the humerus (upper arm) to the scapula (shoulder blade). The rotator cuff tendons provide stability to the shoulder, while the muscles allow the shoulder to rotate. Tears to the rotator cuff cause pain and affect the ability to lift the arm normally.

Rotator cuff tears are most common in people older than 40 years of age who have had shoulder problems in the past. For instance, lifting heavy objects may cause damage to the tendon. However, young people may also experience rotator cuff injuries due to long-term overuse or accidents.

  • Causes of Rotator Cuff Tears
  • Symptoms of Rotator Cuff Tears
  • Diagnosis of Rotator Cuff Tears
  • Treatment Options of Rotator Cuff Tears
  • Risks and Complications

Causes of Rotator Cuff Tears

  • Wear and tear of the tendon tissue: The more blood supply any tissue has, the better and faster it can repair and maintain itself. The areas of poor blood supply in the rotator cuff make these tendons especially vulnerable to degeneration from aging, which can in turn lead to tendon damage and tears. Rotator cuff tears are very common in elderly people.
  • Repetitive shoulder movements: As the tendon tissues degenerate, the symptoms will also become worse. The tendons of the rotator cuff can tear from long-term repeated actions. This is common in athletes who regularly use repetitive arm motions, such as baseball players. However, the damage can be caused by a wide variety of repeated daily activities, such as cleaning windows, washing cars and painting.
  • Overuse of the rotator cuff: Damage and tears can also be caused by lifting objects that are too heavy, by falling, or by sustaining certain types of injury such as from being hit in the shoulder.

Symptoms of Rotator Cuff Tears

  • Pain and weakness of the affected shoulder: The pain and weakness increases in line with the severity of the rotator cuff tear. When you have a small rotator cuff tear, you can often still raise your arm with mild pain. In most cases, the pain occurs only when lifting the arm. In some cases, patients can’t sleep due to the relentless pain.
  • Inability to move the arm normally or lift the arm to the side: A full thickness rotator cuff tear makes it impossible to perform simple actions such as moving or lifting the arm.

Diagnosis of Rotator Cuff Tears

  • Medical history and shoulder examination: Diagnosis includes a review of the patient’s medical history, including previous illnesses, accidents and pain. The doctor will then examine the shoulder. Rotator cuff tears can be easily tested. If the doctor can move your arm fully, but you can’t do it by yourself, then it is possible that you have a rotator cuff tear.
  • X-ray: Although x-ray images do not show rotator cuff tears, the doctor may use an x-ray to check for bone spurs, fractures or abnormalities associated with rotator cuff tears. In addition, x-ray images can also reveal if a calcium deposit within the tendons (calcific tendonitis) is causing the symptoms.
  • Magnetic Resonance Imaging (MRI): The doctor may also use an MRI scan, which uses magnetic waves to create highly detailed images of the muscles, bones and tendons in the shoulder. This technique is painless and involves no needle or injection.

Treatment Options of Rotator Cuff Tears

Non-surgical treatments

  • Resting and using anti-inflammatory medications: Aspirin or ibuprofen may relieve the pain and inflammation. If the pain does not go away, cortisone injections may be recommended.
  • Physical therapy: The doctor may consult with a physical therapist to develop a rehabilitation program for the patient. Initially, the objective is to relieve the pain and inflammation by applying hot or cold packs to the affected shoulder. Next, exercises will restore movement and strengthen the shoulder. After that, physical therapy exercises will improve the flexibility and strength of the muscles surrounding the shoulder joint. Physical therapists will help ensure that the ball of the humerus is firmly maintained in the shoulder socket, enabling the patient to move the arms normally. In most cases, patients can perform routine activities and use their arms normally after 6-8 weeks of physical therapy.
  • Surgical treatments: If the patient wants to regain normal use of the arms, surgery may be required. However, surgery is not an option for patients who are elderly or at greater risks due to certain health conditions. It has been proven that the best results occur when the rotator cuff repair surgery is performed within 3 months of the initial damage. However, patients should consult with their doctor about the appropriate time for surgery. In patients with partial rotator cuff tears, surgery may not be required due to the body’s natural ability to repair damage. However, surgery may be considered in cases of relentless pain or any inability to use the arms.
  • Arthroscopic debridement: In some cases, small rotator cuff tears can be treated through minimally invasive surgery. The surgeon inserts a tiny camera through a small incision in order to locate and remove dead tissue from the tendon. The camera displays pictures on a television screen. With this technique, no sutures are sewn into the tendon due to the body’s natural ability to repair small damage.
  • Acromioplasty: If the rotator cuff tear is deep, arthroscopic debridement and acromioplasty may be required. With acromioplasty, the surgeon will use a burr file to file away any rough edges on the upper part of the acromion (shoulder bone). This procedure is simple and effective. However, surgery may also be needed for the surface tear.
  • Arthroscopic repair: To secure torn tendons back onto the humerus, the surgeon makes small button-hole sized incisions in the area around the shoulder, removes dead tissue carefully, and stitches the tendon back onto its attachment to the humerus through the small incisions. Once the surgery is complete, the biological healing process begins.
  • Suture anchor repair: With this technique, the surgeon will use special fasteners to secure the tendon back onto the humerus. During this procedure, the surgeon inserts suture anchors into the humerus. The suture is then inserted into the rotator cuff and used to pull the tendon back down on to the humerus.
  • Open repair: In some situations, an open tendon repair may be considered a better option. During the procedure, the surgeon makes a large opening into the muscles of the shoulder and reattaches the damaged tendon to the bone.

Risks and Complications

There is the possibility of some complications, including damage within or close to the joint:

  • Nerve injury
  • Bleeding in joint, resulting in swelling and pain
  • Joint infection
  • Anesthesia complications

To reduce risks or complications, it is important to follow the doctor’s pre-operative and post-operative guidelines.

SHOULDER PROBLEMS

We treat a variety of shoulder problems every day. We do an analysis of the best treatment plan for you, based upon the severity of your problem and your lifestyle needs. Treatment plans mayvery from medication, physical therapy, surgery or a combination of them.

We regularly treat issues such as:

  • Shoulder pain
  • Tendon/rotator cuff tears
  • Loose shoulder
  • Multiple shoulder dislocation
  • Stiff shoulder

Some surgical options for shoulder issues are:

  • Arthroscopic rotator cuff repair
  • Arthroscopic shoulder stabilization
  • Arthroscopic shoulder release

If you have a question about a particular procedure, you can send us a message on our Inquiry page, or simply request an appointment to meet with a doctor.

WRIST PROBLEMS

We treat a variety of wrist problems every day. We do an analysis of the best treatment plan for you, based upon the severity of your problem and your lifestyle needs. Treatment plans mayvery from medication, physical therapy, surgery or a combination of them.

We regulary treat issues such as:

  • Tendonitis
  • Sprain
  • Carpel tunnel syndrome
  • Arthritis
  • Flexor tendon injuries
  • Ganglion cysts

Some surgical options for wrist issues are:

  • Removing arthritic bones
  • Wrist fusion
  • Joint replacement
  • Cyst aspiration
  • Carpel tunnel release

If you have a question about a particular procedure, you can send us a message on our Inquiry page, or simply request an appointment to meet with a doctor.


PROCEDURES

ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTIVE SURGERY

Ligaments are tough bands of connective tissues that connect one bone to another. The anterior cruciate ligament (ACL) is located in the center of the knee and extends diagonally from the end of the thigh bone (femur) down to the shinbone (tibia). The ACL is responsible for stabilizing the shinbone so that it has a full range of movement, and is made up of two bundles of tissues which crisscross inside the knee, namely the anteromedial and posterolateral bundles. The two bundles work together to allow the knee and the shinbone to move in a range of directions.

  • Symptoms of Anterior Cruciate Ligament (ACL) Tears
  • Treatment of Anterior Cruciate Ligament (ACL) Tears

Symptoms of Anterior Cruciate Ligament (ACL) Tears

ACL tears normally occur when a person suddenly changes direction or turns heavily on the knee, such as when playing football, when landing from a basketball jump, or from falling down when skiing. Common symptoms of a torn ACL are as follows:

  • A sensation of having something irritating the shin from the inside.
  • Inability to use the knee at the time of injury.
  • A sudden swelling of the knee, or a swelling of the knee within a few hours of injuring it.
  • Symptoms of severe pain that prevent you from performing other activities.

Treatment of Anterior Cruciate Ligament (ACL) Tears

Patients who suffer a torn ACL require treatment to prevent further damage to the knee and reduce the risk of subsequent knee injuries. Generally, treatment options for an ACL tear are divided into surgical and non-surgical forms of treatment.

  • Non-surgical treatment, which is the first stage of treatment for an ACL tear, uses the RICE technique combined with medication, as described below:
    • R = rest
    • I = ice
    • C = compression
    • E = elevation

Patients should use this method in order to train the joints and muscles around the knee so that it can move as before, and should exercise using range-of-motion techniques to strengthen the knee as quickly as possible, with the aim of returning the knee to its normal functioning. When the patient's symptoms have improved and the injured knee has increased in strength, the doctor will examine the knee again to assess whether the patient can perform certain physical activities, and at what level of intensity. If the patient is still unable to use his or her knee as before, then the patient must reduce his or her level of physical activity. If the knee does not recover naturally using this method, then the patient may need to undergo reconstructive surgery.

  • Reconstructive surgery is commonly used for the treatment of ACL tears. This type of surgery aims to prevent the shinbone from moving too far forward and return the knee to its normal functioning, thus preventing further damage to surrounding cartilage. During reconstructive ACL surgery, the doctor will remove what remains of the torn ligament and install a replacement.
ARTHROSCOPY (ORTHOPEDIC SURGERY)

What is Arthroscopy?

Arthroscopy is a procedure to look inside a joint by using an arthroscope. An arthroscope is like a thin telescope with a light source used to magnify the structures inside a joint allowing evaluation and treatment of problems. In arthroscopic surgery, a doctor can use fine instruments which are passed into the joint through a small incision in the skin. These instruments are used to cut, trim, biopsy, grab etc, inside the joint.

  • What is Arthroscopy?
  • How is it done?
  • Why is it done?
  • Risks & complications
  • Alternatives
  • Candidate eligibility

How is it done?

Arthroscopy and arthroscopic surgery generally lasts about one hour and may be done under local or general anesthesia depending on the joint being examined and various other considerations. During the procedure the surgeon will pass an arthroscope through a small cut in the skin and into a joint.

Why is it done?

Arthroscopy may be done to investigate symptoms such as pain, swelling, or instability of a joint. An arthroscopy may show damage to cartilage or ligaments within a joint, fragments of bone or cartilage which have broken off, or signs of arthritis. Arthroscopic surgery can often treat and repair joints without the need for more traditional ‘open’ surgery of a joint which involves a large cut. Generally there is less pain following the procedure, less risk of complications, a shorter hospital stay and a quicker recovery.

Risks & complications

Although rare, complications do occur during or following arthroscopy. They include:

  • Accidental damage to structures inside or near the joint- Excessive bleeding inside the joint, which can cause swelling and pain
  • Infection within the joint
  • Risks and complications associated with anesthesia, including respiratory and cardiac malfunction
  • Patients undergoing arthroscopy can have varying diagnoses and pre-existing conditions. Surgeries vary widely and are patient specific.
  • Risks can be reduced by following the surgeon's instructions before and after surgery.

Alternatives

The surgeon may discuss alternative approaches to the Arthroscopy procedure. For example ‘open surgery’ may be indicated in cases where arthroscopic intervention will be ineffective.

Candidate eligibility

The best candidates for Arthroscopy are healthy adults with no previous surgeries or scarring in the area being treated. The surgeon will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient.

ARTHROSCOPIC MENISCUS TREATMENT (ORTHOPEDIC KNEE SURGERY)

What is Arthroscopic Meniscus Treatment?

Arthroscopic Meniscus Treatment is a procedure to look and perform some procedures inside the knee by using a thin telescope. The meniscus is a special cartilage inside the knee that fills in the space between the thigh bone and the leg bone. Arthroscope can be used to repair meniscus tear and to trim irreparable part of the meniscus which may cause pain or catching inside the knee.

  • What is Arthroscopic Meniscus Treatment?
  • How is it done?
  • Why is it done?
  • Risks & complications
  • Alternative

How is it done?

The surgeon will pass an arthroscope through a small cut in the skin and into a joint. Healing potential can be enhanced by inducing healing reaction, either by inducing bleeding or fibrin clot. Special suture material will be used depending on the character of the tear. Arthroscopic meniscus surgery generally lasts about one hour under general anesthesia. After the procedure, the patient may have to limit their activity to some degrees but this will be kept to the minimal using strong and reliable suture material that allows early knee function.

Why is it done?

The meniscus is indispensable. When one lost meniscus, one create an unfavorable condition for nearby cartilage. The knee starts to degenerate, especially if there is associated ligament damage. Meniscus treatment is, therefore, not just a pain relieving procedure but also a preventive measure for arthritis. The most common associated ligament injury in meniscus injury is anterior cruciate ligament injury. This may have to be addressed as well. Otherwise the instability situation may cause repeated meniscus injury and result in failure of meniscus treatment.

Risks & complications

Although rare, complications do occur during or following arthroscopy. They include:

  • Accidental damage to structures inside or near the joint
  • Excessive bleeding inside the joint, which can cause swelling and pain
  • Infection within the joint
  • Risks and complications associated with anesthesia, including respiratory and cardiac malfunction

Alternatives

The surgeon may discuss alternative approaches. For Example ‘conservative treatment’ may be indicated in cases where the potential for healing is already high without need for arthroscopic procedure.

ARTHROSCOPIC SHOULDER SURGERY (ROTATOR CUFF SURGERY)

What is Arthroscopy and how is it useful in repairing rotator cuff injuries in the shoulder?

Arthroscopic rotator cuff reconstruction is a minimally invasive surgery to repair torn tendons in the shoulder.

How is it done?

Arthroscopic rotator cuff repair generally takes between one and two hours. It usually be performed under general anesthesia which means you will sleep through the surgery. An arthroscope is like a thin telescope with a light source used to magnify the structures inside the injured area of the shoulder allowing evaluation and treatment. After evaluating the shoulder joint using the arthroscopic camera, the surgeon can introduce surgical instruments via very few small incisions in the skin surrounding the shoulder to clean out damaged tissue, remove bone spurs, and reattach damaged tendons to the bones where they have torn off. Patients undergoing arthroscopic surgery can have varying diagnoses and pre-existing conditions. Surgeries vary widely and are patient specific.

Why is it done?

Rotator cuff repair relieves shoulder pain caused by torn ligaments, bone spurs, or inflammation around the rotator cuff.

Risks & complications

Although rare, complications do occur during or following arthroscopy. They include the possibility of:

  • Accidental damage to structures inside or near to the joint
  • Nerve injury
  • Excessive bleeding inside the joint which can cause swelling and pain
  • Infection within the joint
  • Reaction to anesthesia

Risks can be reduced by following the surgeon's instructions before and after surgery.

Alternatives

The surgeon may discuss alternative approaches to arthroscopic surgery. Cortisone injections and physical therapy are often recommended. Alternative surgical techniques known as ‘open’ and ‘mini open’ surgical repair may be indicated in cases where arthroscopic surgery is not viable.

Candidate eligibility

The best candidates for arthroscopic rotator cuff repair are healthy adults with no previous surgeries or scarring in the area being treated. The surgeon will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient.

HIP REPLACEMENT (ORTHOPEDIC SURGERY)

Hip Arthritis

Hip Arthritis Arthritis of the hip is a disease that wears away the cartilage in the ball-and-socket joint at the top of your leg bone (femur) and pelvis. This wear causes the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded, and uneven resulting in pain, stiffness, and instability. In some cases, motion of the leg may be greatly restricted.

What is a Hip Replacement?

Conventional Total Hip Replacement (Hip Arthroplasty) is a long-established procedure for the treatment of Hip Arthritis. The purpose of total hip replacement is to remove the two damaged and worn parts of the hip joint- the hip socket (acetabulum) and the ball (femoral head) – and replace them with smooth, artificial implants called prostheses, which help make the hip strong, stable, and flexible again. For younger, more active people needing a hip replacement there is a high chance that a traditional hip replacement will wear out during their lifetime and need to be replaced again.
A second replacement (called a revision) is much more difficult.

How is it done?

Hip replacement generally takes one to two hours. It may be performed under a general or spinal anesthesia. During the procedure the surgeon will remove the damaged or diseased portion of the hipbone replacing it with an artificial hip joint). You will return from surgery with a large dressing on the hip area. You may be required to wear “anti-embolism” stockings to reduce the risk of developing blood clots. A small drainage tube will be placed during surgery to help drain excess fluids from the joint area. Rehabilitation and physical therapy are started immediately following surgery and continue throughout hospitalization and at home for one year after surgery.

Why is it done?

Relief from pain is the greatest benefit and the major reason for hip replacement surgery. Reasons for replacing all or part of the hip joint include: severe pain from arthritis or injury in the hip that limits an individual’s ability to do the things they want to do, fractures in the elderly of the neck of the femur, and the occurrence of hip joint tumors.

Risks & complications

There are possible risks and complications associated with anesthesia, including respiratory or cardiac malfunction.

Other complications include:

  • Infection requiring antibiotics and in some cases hospitalization. Infection can sometimes occur around the hip joint years after the surgery.
  • Blood clots in the legs (deep vein thrombosis), which can dislodge and move to the lungs (pulmonary embolism).
  • Injury to nerves or blood vessels.
  • Fracture or dislocation of the new hip joint may necessitate additional surgeries.
  • Stiffness or instability of the joint caused by extra bone growth.
  • Blood clots in the legs (deep vein thrombosis), which can dislodge and move to the lungs (pulmonary embolism).

Candidate eligibility

You will receive an extensive pre-operative evaluation to determine if you are a good candidate for hip replacement. Candidates for Hip Arthroplasty will be valuated to assess the degree of disability, impact on your lifestyle and pre-existing medical conditions. The surgeon will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient. Commitment to a rehabilitation program is important since improvement of the new hip joint is largely determined by the patient’s effort.

HIP PROBLEMS: TOTAL SOLUTIONS

Solutions to Your Hip Problems from a Leading International Hospital

Hip Arthritis Arthritis of the hip is a disease that wears away the cartilage in the ball-and-socket joint at the top of your leg bone (femur) and pelvis. This wear causes the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded, and uneven resulting in pain, stiffness, and instability. In some cases, motion of the leg may be greatly restricted.

Total Hip Replacement

Total Hip Replacement ( HipArthroplasty) is a long-established procedure for the treatment of Hip Arthritis.

The purpose of total hip replacement is to remove the two damaged and worn parts of the hip joint- the hip socket (acetabulum) and the ball (femoral head) – and replace them with smooth, artificial implants called prostheses, which help make the hip strong, stable, and flexible again.

For younger, more active people needing a hip replacement there is a high chance that a traditional hip replacement will wear out during their lifetime and need to be replaced again. A second replacement (called a revision) is much more difficult.

Question to help you decide what's best.

  • 1. Have you already seen an orthopaedic surgeon about your hip problems?
  • 2. Did the surgeon recommend hip replacement as a treatment option?
  • 3. Do you have any medical conditions or complications you are aware of?
  • 4. Are you under age 55?
  • 5. Are you active?
TOTAL KNEE REPLACEMENT (KNEE SURGERY)

What is a Total Knee Replacement?

Total Knee Replacement is surgery to replace diseased or damaged joint surfaces of the knee with metal and plastic prosthetic devices.

How is it done?

Surgery may be performed under a general or spinal anesthesia. During the procedure the surgeon shaves the joint cartilage at the ends of the femur and tibia (sometimes the cartilage of knee cap) and fits them with prosthetic caps. These are then re-attached to the remaining bone with specialized cement. You will return from surgery with a large dressing on the knee. A drainage tube will be in place to help drain excess fluids from the joint in the days following surgery. You will be required to wear pressure stockings immediately after surgery to prevent blood clotting.

Why is it done?

Most knee replacements are performed to relieve severe pain from arthritis or injury in the knee that limits an individual’s ability to do the things they want to do. It might also be performed to remove tumors of the knee.

Risks & complications

There are possible risks and complications associated with anesthesia, including respiratory or cardiac malfunction. Other complications include the possibility of:

  • Infection requiring antibiotics and in some cases hospitalization
  • Infection occurring around the joint years after the surgery
  • Blood clots in the legs (deep vein thrombosis), which can dislodge and move to the lungs (pulmonary embolism)
  • Injury to nerves or blood vessels
  • Loosening or dislocation of the prosthetic devices
  • Joint stiffness

Risks can be reduced by following the surgeon's instructions before and after surgery.

Alternatives

The surgeon may discuss alternative approaches to the total knee replacement procedure, including:

  • Non-Surgical Alternatives:
    • Walking aids such as a walking stick or cane or fitting with specialized braces
    • An exercise program to strengthen the muscles around the knee joint to improve positioning and relieve pain
    • Non-steroidal anti-inflammatory drugs like aspirin, ibuprofen and celebrex to relieve pain
    • Corticosteroids such as prednisone or cortisone can reduce joint inflammation
    • Herbal supplements like glucosamine and chondroitin
  • Surgical Alternatives:
    • Arthroscopic surgery
    • Osteotomy
    • Cartilage transplant
    • Knee fusion

Candidate eligibility

Candidates for total knee replacement should be free of infection. You will receive an extensive pre-operative evaluation to determine if you are a good candidate for the total knee replacement procedure. The surgeon will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient. Post operative progress is determined largely by patient effort.