We mainly perform on the following surgical procedures:

Hip Procedures

 
Total Hip Replacement

Hip replacement surgery, also called total hip arthroplasty, involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis. Hip prostheses consist of a ball component, made of metal or ceramic, and a socket, which has an insert or liner made of plastic, ceramic or metal. The implants used in hip replacement are biocompatible — meaning they're designed to be accepted by your body — and they're made to resist corrosion, degradation and wear.

Hip replacement is typically used for people with hip joint damage from arthritis or an injury. Followed by rehabilitation, hip replacement can relieve pain and restore range of motion and function of your hip joint.

Hip Resurfacing

Hip resurfacing is a bone conserving alternative to conventional total hip replacement (THR). Unlike traditional hip replacement, hip resurfacing doesn't replace the "ball" of the hip with a metal or ceramic ball. Instead, the damaged hip ball is reshaped and capped with a metal prosthesis. The damaged hip socket also is fitted with a metal prosthesis — similar to what is used in a conventional hip replacement.

With newer materials, the artificial joint implants used for total hip replacement are lasting longer and may last for decades, although long-term data aren't yet available for newer implants. This isn't an issue for older people who receive a hip replacement late in life. But hip resurfacing might be a better choice for younger people because the procedure leaves more bone intact, which can make it easier to perform a total hip replacement if needed later.

Revision Hip Surgery

Hip revision surgery is performed to repair an artificial hip joint (prosthesis) that has been damaged over time due to an infection, or due to normal wear and tear of the prosthetic hip. Revision surgery helps to correct the problem so the hip can function normally again.

The use of artificial hip implants is extremely effective in improving hip joints that are damaged by injury or some form of arthritis. Artificial joints, including hip joints, do not last forever. The typical life of an artificial hip joint is 10-15 years, depending on the patient's daily use of the joint. Patients with artificial hip joints are typically over the age of 55 and have developed severe arthritis in the hip. After a period of normal wear and tear of the hip joint, the prosthesis does not fit as securely and is not as effective. In these cases, hip revision surgery may be recommended by your doctor.

Revision surgery may also be recommended if an infection has developed in the tissue surrounding the joint. If infected, the muscle, tendon and ligament tissues in the hip joint will become weakened and damaged. The infection will also damage the hip bone.

Knee Procedures

 
Arthroscopy

Arthroscopy is a procedure for diagnosing and treating joint problems. During arthroscopy, a surgeon inserts a narrow tube containing a fiber-optic video camera through a small incision — about the size of a buttonhole. The view inside your joint is transmitted to a video monitor.

Arthroscopy allows the surgeon to see inside your joint without having to make a large incision. Surgeons can even repair some types of joint damage during arthroscopy, with pencil-thin surgical instruments inserted through additional small incisions.

Total Knee Replacement

Knee replacement surgery — also known as knee arthroplasty — can help relieve pain and restore function in severely diseased knee joints. During knee replacement, a surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

The first artificial knees were little more than crude hinges. Now, you and your doctor can choose from a wide variety of designs that take into account your age, weight, activity level and overall health. Most knee replacement joints attempt to replicate your knee's natural ability to roll and glide as it bends.

Revision knee Surgery

Knee revision surgery, which is also known as revision total knee arthroplasty , is a procedure in which the surgeon removes a previously implanted artificial knee joint, or prosthesis, and replaces it with a new prosthesis. Knee revision surgery may also involve the use of bone grafts. The bone graft may be an autograft, which means that the bone is taken from another site in the patient's own body; or an allograft, which means that the bone tissue comes from another donor.

Unicompartmental Knee Replacement

Unicompartmental knee replacement is an option for a small percentage of patients with osteoarthritis of the knee. Your doctor may recommend partial knee replacement if your arthritis is confined to a single part (compartment) of your knee.

Your knee is divided into three major compartments: The medial compartment (the inside part of the knee), the lateral compartment (the outside part), and the patellofemoral compartment (the front of the knee between the kneecap and thighbone).

In a unicompartmental knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and bone in the rest of the knee is left alone.

Osteotomies

Knee osteotomy is a surgical procedure that may be recommended if you have arthritis damage in just one area of your knee. In knee osteotomy, a surgeon removes or adds a wedge of bone to your upper shinbone (tibia) or lower thighbone (femur). This helps shift your body weight off the damaged portion of your knee joint.

Knee osteotomy is most commonly performed on people who may be considered too young for a total knee replacement. Total knee replacements wear out much more quickly in people under the age of 55 than in people over the age of 70.

Many people who undergo knee osteotomy will eventually need a total knee replacement — usually about 10 to 15 years after the knee osteotomy.

Ligamentous Surgery

Anterior cruciate ligament (ACL) reconstruction is surgery to repair a tear in your ACL, one of the major ligaments in your knee. An ACL reconstruction may help an athlete get back on the field, but many people with torn ACLs can continue normal activity without ACL reconstruction.

Tearing of the ACL is the most common knee ligament injury. Sports and fitness routines that involve running, pivoting, turning and jumping lead to many torn ACLS.

The ACL is one of the main stabilizing ligaments of your knee. It prevents the lower leg bone (tibia) from going too far forward. Once torn, the ACL won't heal, so fusing the torn ends is not an option. With ACL reconstruction, the torn ligament's function is not restored. ACL reconstruction involves creating a new ACL from grafted tissue.

Shoulder Procedures

 
Decompression Surgery

Subacromial decompression, also called shoulder decompression surgery, is a treatment for shoulder impingement syndrome. In this condition, the rotator cuff tendon becomes caught between a bone called the acromion and the ball-joint of the shoulder. It is characterized by inflammation, pain and reduced range of motion.

Rotator Cuff Repair

Your rotator cuff is made up of the muscles and tendons in your shoulder. These muscles and tendons connect your upper arm bone with your shoulder blade. They also help hold the ball of your upper arm bone firmly in your shoulder socket. The combination results in the greatest range of motion of any joint in your body.

A rotator cuff injury includes any type of irritation or damage to your rotator cuff muscles or tendons. Causes of a rotator cuff injury may include falling, lifting and repetitive arm activities — especially those done overhead, such as throwing a baseball or placing items on overhead shelves.

About half of the time, a rotator cuff injury can heal with self-care measures or exercise therapy.

Shoulder Joint Surgery

The surgical replacement of the shoulder joint is the third most common joint replacement after replacement of the hip and knee joints. Like the hip, the shoulder is a ball and socket joint. However, the shoulder 'socket' is much more shallow to allow a greater range of movement at the cost of bony stability. 

Shoulder joint replacement can be:

  • Partial: one articular surface is replaced, the humeral head; also known as shoulder hemiarthroplasty.
  • Total: both articular surfaces are replaced by prostheses; also known as shoulder arthroplasty.
  • Reverse: both articular surfaces are replaced but with the 'ball' on the glenoid and the 'cup', or 'socket' on the humerus.This is to medialise the joint centre of rotation in order to maximise the lever arm of the deltoid muscle in rotator cuff deficiency.

Computer Assisted Surgery

Computer-assisted orthopedic surgery or computer-assisted orthopaedic surgery is a discipline where computer technology is applied pre-, intra- and/or post-operatively to improve the outcome of orthopedic surgical procedures. CAOS is an active research discipline which brings together orthopedic practitioners with traditionally technical disciplines, such as engineering, computer science and robotics.
The principal idea behind CAOS is that operative outcomes will be improved through the use of computer technology. Taking the example of joint replacement, the task of the surgeon is to integrate the new joint components into the patient's existing anatomy; CAOS technologies allow the surgeon to:

  • Plan the component placement in advance, including determination of the appropriate component sizes;
  • Measure the intra-operative placement of the components in real time, making sure that the plan is adhered to;
  • Measure the post-operative result

It has not yet been proved that CAOS technologies result in a significant long-term improvement in operative outcome. Whilst the surgeon can achieve better results in terms of planned vs. achieved placement of components, it is not clear whether the plan has been constructed optimally. Further, because of the functional adaptability of bone, errors in component placement may become unimportant in the long term. Because of the relatively short time period over which CAOS has developed, long-term follow-up studies have not yet been possible.

With CAOS, the surgeon can more accurately pinpoint anatomical landmarks that might be hard to see in a small incision. This navigation system then guides the surgeon through different bone cuts and finally to implantation. Computer-assisted orthopedic surgery is mostly used in knee implant surgery because of the precision the surgeon get with femoral and tibial bone cuts. It is also used to navigate acetabular components placement where correct cup inclination is crucial.

Computer-assisted orthopedic surgery is a system where a computer interacts with body parts via infrared lights and gate detectors. There are systems that require C-Arm images or CAT scans, flourabased systems and the newest and most evolved systems are imageless systems, this means that no pre scans of any kind are necessary. The imageless systems are far less complicated, are lower cost and more patient friendly since the pre scans are not necessary. The imageless systems will also bring down operation time. The negative aspect of imageless systems is that they might be less accurate, this is yet to be proven.

General Orthopaedic Surgery

The range of treatments done by orthopedists is enormous. It can cover anything from traction to amputation, hand reconstruction to spinal fusion or joint replacements. They also treat broken bones, strains and sprains, and dislocations. Some specific procedures done by orthopedic surgeons are listed as separate entries in this book, including arthroplasty, arthroscopic surgery, bone grafting, fasciotomy, fracture repair, kneecap removal, and traction.

In general orthopedists are attached to a hospital, medical center, trauma center, or free-standing surgical center where they work closely with a surgical team including an anesthesiologist and surgical nurse. Orthopedic surgery can be performed under general, regional, or local anesthesia.

Much of the work of the surgeon involves adding foreign material to the body in the form of screws, wires, pins, tongs, and prosthetics to hold damaged bones in their proper alignment or to replace damaged bone or connective tissue. Great improvements have been made in the development of artificial limbs and joints, and in the materials available to repair damage to bones and connective tissue. As developments occur in the fields of metallurgy and plastics, changes will take place in orthopedic surgery that will allow the surgeon to more nearly duplicate the natural functions of the bones, joints, and ligaments, and to more accurately restore damaged parts to their original range of motion.

   
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