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Orthopedic Surgery

Orthopedic surgery or orthopedics, also spelled orthopaedic is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.ent Ductus Arteriosus Surger

Nerve Graft

What is Nerve Graft?
Nerve grafts are used when a patient has a nerve injury resulting in complete loss of muscle function or sensation. A nerve graft is a surgical technique in which a segment of unrelated nerve is used to replace or bridge an injured portion of nerve.

Surgery:
Surgery can be done in case a peripheral nerve has become cut or otherwise divided. This is called peripheral nerve reconstruction or Nerve Grafting.

Osteoarthritis

Also known as Degenerative Arthritis or Degenerative Joint disease or Osteoarthrosis, is the most common joint disorder, which is due to aging and wear and tear on a joint.

CAUSES:

  •  Ageing
  •  Hereditary
  •  Being Overweight
  •  Fractures or other joint injuries
  •  Work Demands jobs that involve kneeling or squatting for more than an hour a day
  •  Jobs that involve lifting, climbing stairs, or walking

Medical conditions that can lead to OA include:
Bleeding disorders that cause bleeding in the joint, such as Hemophilia Disorders that block the blood supply near a joint and lead to Avascular Necrosis Other types of arthritis, such as chronic Gout, Pseudogout, or Rheumatoid arthritis

TREATMENT:
Management is primarily aimed at controlling the Osteoarthritis Symptoms:

SURGICAL OPTIONS
Depending upon the severity of the disease, Surgery is done to replace or repair damaged joints

Arthroscopic Surgery :
To trim torn and damaged cartilage Arthroscopic surgery is a common orthopedic procedure that is used to diagnose and treat problems in joints. Arthroscopic surgery could potentially be performed on any joint.

Osteotomy :
Changing the alignment of a bone to relieve stress on the bone or joint. It is also one method to relieve pain in arthritis, especially of the hip and knee. It is replaced by Joint Replacement in older patients.

Arthrodesis :
Procedure which fuses the bones that form a joint, essentially eliminating the joint. The procedure is commonly referred to as joint fusion. It is usually performed on ankles and wrists, but it can be performed on other joints, including thumbs, toes, fingers, and the spine.

Joint Replacement :
The abnormal bone and lining structures of the involved joint are removed surgically, and new parts are inserted in their places. These new parts may be made of special metal or plastic (certain forms of polyethylene) or specific kinds of carbon-coated implants. The new parts allow the joints to move again with little or no pain.

Includes total or partial replacement of the damaged joint with an artificial joint (knee replacement, hip replacement, shoulder replacement, ankle replacement, elbow replacement)

BRACES
Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. They should be used only on Therapist recommendation.

PHYSICAL THERAPY
Physical therapy can help improve muscle strength and the motion of stiff joints, as well as sense of balance. Massage therapy may also help provide short-term pain relief.

MEDICATIONS
Over-the-counter pain relievers can also help with the symptoms. Drugs include Acetaminophen (Tylenol), Aspirin, Ibuprofen, and Naproxen.

LIFESTYLE CHANGES
Staying active and getting exercise helps maintain joint and overall movement. Besides this, the following things are recommended.

  •  Eating a healthy, balanced diet
  •  Getting rest
  •  Losing weight if one is overweight
  •  Protecting the joints

A total hip replacement (THR) – also called a Hip Arthroplasty- is a surgical procedure that re-forms the hip joint.

Hip Replacement Procedure:
Cemented procedure: – The cemented procedure utilizes a doughy substance mixed at the time of surgery that is introduced between the artificial component and the bone.

Non-cemented procedure: – Artificial joint covered with a material that allows bone tissue to grow into the metal. A tight bond of scar tissue if formed, which anchors the metal to the bone. This is called a cementless total hip replacement.

Post – Operative Care
Postoperative care begins with a team approach of health professionals within the hospital with special emphasis on Physiotherapy regime. The regime is focused on Circulation, Range of motion, Mild muscle strengthening exercises, Gait training, deep breathing exercises. These are all centered on getting the patient back to doing Activities of Daily Living.

Benefits Of Hip Replacement Surgery:

  1.  The general goal of total hip replacement is designed to provide painless and unlimited standing, sitting, walking, and other normal activities of daily living.
  2.  It Improves quality of life and restores mobility.
  3.  It has very high success rates, relieves the pain and disability from degenerative arthritis, meniscus tears, osteoarthritis, cartilage defects, and ligament tears

Artificial joint replacement for arthritis of hip is one of the most successful surgeries of the last century.
Individuals are able to begin walking the day following surgery and pain relief is achieved in greater than 95% of people.

Total knee replacement
Total knee replacement (TKR), also referred to as Total Knee Arthroplasty (TKA), is a surgical procedure where worn, diseased, or damaged surfaces of a knee joint are removed and replaced with artificial surfaces. Knee replacement surgery is performed to treat advanced or end-stage arthritis or to the patient who has severe pain in the knee joint.

Causes Of Knee Replacement:
Osteoarthritis resulting from “wear and tear” is the most common reason for individuals to undergo knee replacement surgery. Rheumatoid arthritis, an inflammation of the tissue surrounding the joints, can cause deterioration of cartilage and other parts of the joint and also result in the need for knee replacement.

When Does One Need Knee Replacement?
Generally a person would be considered for a Total Knee Replacement if the individual experiences daily pain, restricting not only work and recreation, but also the ordinary activities of daily living. There must also be evidence of significant destruction of the knee as seen on an x-ray.

Knee Replacement Procedure
Once the anesthesia has been given and the patient is prepared, the damaged joint surfaces are removed. An incision approximately eight inches in length is made on the front of the knee. The damaged joint surfaces are removed from all 3 bones making up the knee joint. Sometimes, depending on the surgeon, the back of the knee cap is left intact if it is not badly affected by the arthritis. The surrounding muscles and most of the ligaments are preserved. The lower end of the thigh bone (femur) is resurfaced with a metal cap. The upper end of the leg bone (tibia) is replaced with a plastic and metal implant with cement and or screws. The actual procedure takes about 1 ½ to 2 hours.

Types of Implants:
Cemented Implants: – The components of the implant are fixed to the bone with a grout-like cement known as polymethyl-methacrylate. This cement allows the implants to perfectly fit to the irregularities of the bone.

Non-cemented Implants: – In a non-cemented procedure, components of the implant have a roughened porous surface designed to allow bone to grow into it, eliminating the need for cement. The implants are “press fit” against the bony surfaces that are precisely cut through the use of multiple cutting jigs.

Hybrid Fixation Implants: – Consists of a combination of the cemented and non-cemented technique. In this method the femoral component is not cemented and the tibia component is cemented.

Post – Operative Care

Once the anesthesia has been given and the patient is prepared, the damaged joint surfaces are removed. An incision approximately eight inches in length is made on the front of the knee. The damaged joint surfaces are removed from all 3 bones making up the knee joint. Sometimes, depending on the surgeon, the back of the knee cap is left intact if it is not badly affected by the arthritis. The surrounding muscles and most of the ligaments are preserved. The lower end of the thigh bone (femur) is resurfaced with a metal cap. The upper end of the leg bone (tibia) is replaced with a plastic and metal implant with cement and or screws. The actual procedure takes about 1 ½ to 2 hours.

Benefits Of Knee Replacement Surgery:

  1.  The general goal of total knee replacement is designed to provide painless and unlimited standing, sitting, walking, and other normal activities of daily living.
  2.  It Improves quality of life and restores mobility.
  3.  It has very high success rates, relieves the pain and disability from degenerative arthritis, meniscus tears, osteoarthritis, cartilage defects, and ligament tears
  4.  Technology has led to the development of materials used in the artificial knee joint allowing it to last over fifteen years.
  5.  Artificial joint replacement for arthritis of the knee and hip is one of the most successful surgeries of the last century.

Individuals are able to begin walking the day following surgery and pain relief is achieved in greater than 95% of people.