Orthopaedics and Spine

Orthopaedic surgery treats musculoskeletal ailments that develop in the bones, joints and ligaments of the body. Aliments generally stem from cognitive deformities, acute injuries, fractured bones and arthritis and are most commonly found in the knees, hips and shoulders.

Originally, orthopaedic surgeons straightened skeletal deformities in children, hence the term "orthopaedics" is derived from the Greek ortho, meaning straight, and pais, meaning child. Following suit, orthopaedic surgeons may add foreign material to the body to hold damaged or missing bones or connective tissue in proper alignment. Arthroscopic surgery has evolved to precisely pinpoint the location of damage and minimize incisions, which improves recovery time.

Orthopaedists provide a large range of treatments, from fracture repair to spinal fusion. Common treatments for orthopaedic medical travel are:

• Disk Replacement
• Rotator Cuff
• Total Hip Replacement
• Hip Resurfacing
• Total Knee Replacement
• Knee Resurfacing
• Spinal Fusion

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Disk Replacement

A laminectomy is a surgical procedure that removes the two small bones called the lamina that make up the vertebra of the spine. It is also used to remove bone spurs from your back. The goal of this procedure is to alleviate the spinal nerves or column of pressure.

Before this procedure patients suffer from a host of symptoms including:

• Leg pain
• Numbness of the legs
• Weakness in the legs or buttocks
• Heaviness in the legs or buttocks
• Increased symptoms when standing or walking
• Poor bowel or bladder control

These symptoms are caused by a condition called spinal stenosis. The symptoms of spinal stenosis typically become worse overtime. When the symptoms of this disorder have become severe or they are interfering with daily life surgery is usually merited.

Procedure Information

During your surgery you will be given general anaesthesia. You will lie face down on the operating table. The surgical area will be prepped with a sterile drape and an antiseptic liquid.

The surgeon will begin the procedure by making an incision either in the middle of your back or neck. They will carefully move the skin, muscles and ligaments aside. They will remove part or all of your lamina bones and disk fragments; bone spurs and damaged soft tissue.

The surgeon will also remove the sharp part of your spine called the spinous. Then, they will make the opening of the spinal column wider, so the spinal nerves have more room. In some cases the surgeon may do a spinal fusion to ensure the stability of the spine.

Risks of Procedure

As is with any surgery there are risks associated with laminectomy. The following is a list of the most common risks and complications:

• Infection
• Blood Clots
• Blood loss
• Reaction to medication
• Reaction to anaesthesia
• Breathing problems
• Damage to spinal nerves
• Arterial damage
• Weakness
• Pain
• Loss of feeling
• Return of pain or symptoms

Rotator Cuff

A rotator cuff repair is a type of surgery that is used to fix a torn tendon in the shoulder. The procedure can be done in two different ways. The procedure can be done with a large open incision or with shoulder arthroscopy which uses a small button hole sized incision.

The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in its "ball and socket" joint and help the shoulder to rotate. These tendons can be town from overuse or injury.

Rotator cuff repair is recommended to individuals who have a torn rotator cuff which is causing them weakness and pain, individuals who have pain using their arm overhead, and for individuals who have a bone spur or inflammation around their rotator cuff.

Total Hip Replacement

THR or total hip replacement is a common surgical procedure. The procedure rebuilds a deteriorated or damaged hip joint to make it more functional. During the procedure the damaged joint is replaced with an artificial prosthesis.

Signs that a hip replacement may benefit you:

• Hip pain is limiting your daily activities including walking and bending
• Hip pain persists when you are resting during the day or night
• Stiffness in the hip has reduced your ability to move or lift your leg
• Anti-inflammatory drugs or glucosamine sulphate do not provide relief
• Hip medications are causing harmful or unpleasant side effects
• Treatments like physical therapy or using a cane do not relieve your pain

Procedure Information

When you arrive for your procedure you will be prepped for surgery and administered anaesthesia. During the procedure your surgeon will remove diseased cartilage and bone first. They will also remove the ball and socket of the hip.

The ball and socket of the hip is then replaced with a metal ball and stem that is positioned inside the femur. Cement is used to attach this prosthesis to the femur. In some cases the prosthesis is placed without cement. This prosthesis has microscopic pores that connect to the femur bone over time.

Risks of Procedure

As with any surgery, there are certain risks and complications associated with total hip replacement including:

• Blood Clots
• Infection
• Dislocation
• Extra Bone Formation
• Femur Fracture
• Pain
• Stiffness
• Shortening of the Leg
• Arterial Injury
• Bleeding
• Allergy to Prosthesis
• Allergy to Anaesthesia
• Fat Embolism

It is important to discuss any concerns you have about the risks and complications with your surgeon before and after your total hip replacement.

Hip Resurfacing

Hip resurfacing is a procedure that replaces the arthritic surface of the joint but removes less bone then a traditional hip replacement. This procedure is recommended to younger individuals who may need a second hip replacement surgery as they grow older and wear out their artificial hip replacement. The most common cause for revision of an artificial hip is loosening of the pieces of the artificial hip joint where it attaches to the bone. Resurfacing eliminates the problem of loosing of the prosthetic femur shaft and preserves bone stock in the event of a revision surgery becoming necessary. The hip resurfacing procedure is not advised to anyone with bone cysts, inflammatory arthritis, or patients with osteoporosis.

Total Knee Replacement

Total knee replacement or TKR is a procedure that replaces a severely damaged knee joint with an artificial knee joint. During the procedure the knee will be resurfaced and cartilage and bone will be replaced with metal and plastic. This procedure is performed by an orthopaedic surgeon under general anaesthesia or epidural anaesthesia.

The knee joint is like a hinge that helps facilitate motion in the leg. Knees become damaged for a number of reasons; including arthritis and injury. Total knee replacement is in order when a patient's knee has been damaged beyond repair. This damage may cause continuous pain, stiffness and it usually impairs normal function.

Procedure Information

Before surgery can begin either general anaesthesia or epidural anaesthesia must be administered. Once the anaesthesia has taken effect the knee will be prepped for surgery. It will be scrubbed with an antiseptic liquid.

During the procedure the knee is flexed at a 90 degree angle using a special device that holds the lower leg and foot in place. The surgeon will make an incision. The damaged bone and cartilage will be removed first.

Bone will be removed from other areas to ensure proper fit of the artificial knee. The front and back of the femur will be removed. The top surface of the tibia will be removed along with the back of the knee cap.

To complete the procedure the surgeon will repair the attached muscles and ligaments. They will close the wound with sutures and wrap the knee in a sterile bandage. A tube may be placed to the wound to drain properly.

Risks of Procedure

Knee replacement surgery is rather common. However, that does not mean it is risk free. It is important to discuss the risks of total knee replacement before you consent to surgery. The most common risks would include:

• Blood Clots
• Blood Loss
• Infection
• Stiffness
• Hip Dislocation

Knee Resurfacing

Knee resurfacing is performed by replacing only the worn-out, artic, compartments of the knee instead of the entire knee itself. This procedure is recommended for younger individuals who are active and do not have any cartilage remaining on a portion of their knees. With a knee resurfacing procedure, there are no pre-manufactured cutting blocks or implants. The patient's own knee is utilized to make the model on which the patient's custom made implants are then manufactured. A positive aspect of knee resurfacing is that the surgeon does not have to remove as much bone as it would have with a knee replacement. After the procedure patients can usually return to a high level of activity.

Spinal Fusion

The lumbar spinal fusion procedure is used to unite two vertebrate together in order to eliminate motion or friction between them. Lumbar spinal fusion is used to treat a number of conditions including degenerated disk, slipped disk, herniated disk, scoliosis or injury. It is done only when conventional treatments have failed to alleviate pain.

This surgery may be done alone or in conjunction with other spinal surgeries. There are a variety of techniques used to complete the procedure based on the type of damage being repaired. Patients who have this procedure are asleep and feel no pain.

Procedure Information

Your surgery begins with the administration of general anaesthesia. You will lie face down on the operating table so that your surgeon will have access to your spine. The spinal area will be prepped with a sterile drape and an antiseptic liquid.

The surgeon will make an incision to expose the spine. They will move muscle and tissue aside. If another procedure is being done simultaneously they will perform the other procedure first in most cases. Then, they will use a graft to hold the bones together.

Different methods of bone grafts used in spinal fusion:

• Bone graft strips are placed over the affected area of the spine
• Bone graft is placed between the two affected vertebrate
• Cages of graft material is placed between the affected vertebrate

Different bone graft materials used in lumbar spinal fusion:

• Pelvis bone
• Donor bone
• Synthetic bone

After the graft is placed the surgeon may use a cage, screws or plates to hold it in place. These things ensure that the vertebrate stay in place until they are fully healed. The surgeon will close the muscle and tissue upon completion of the spinal fusion.

Risks of Procedure

As is with any surgery there are risks associated with having a lumbar spinal fusion. The following is a list of the most common risks and complications:

• Infection
• Blood clots
• Breathing problems
• Blood loss
• Heart attack
• Stroke
• Reaction to anaesthesia or medication
• Damage of the spinal nerve
• Weakness
• Loss of sensation
• Bowel and Bladder problems
• Back problems