Shoulder, Knee, Hip, Joint Replacement Surgery
Total joint replacement is a surgical procedure in which parts of an arthritic or damaged joint are removed and replaced with a metal, plastic or ceramic device called prosthesis. The prosthesis is designed to replicate the movement of a normal, healthy joint.
Hip and knee replacements are the most commonly performed joint replacements, but replacement surgery can be performed on other joints, as well, including the ankle, wrist, shoulder, and elbow.
Several conditions can cause joint pain and disability and lead patients to consider joint replacement surgery. In many cases, joint pain is caused by damage to the cartilage that lines the ends of the bones (articular cartilage)—either from arthritis, a fracture, or another condition.
If nonsurgical treatments like medications, physical therapy, and changes to your everyday activities do not relieve your pain and disability, your doctor may recommend total joint replacement.
How is it performed?
Total joint replacement surgery takes a few hours. The procedure is performed in a hospital or outpatient surgery center.
During the surgery, the damaged cartilage and bone is removed from your joint and replaced with prosthetic components made of metal, plastic, or ceramic. The prosthesis mimics the shape and movement of a natural joint. For example, in an arthritic hip, the damaged ball (the upper end of the femur) is replaced with a metal ball attached to a metal stem that is fitted into the femur, and a plastic socket is implanted into the pelvis, replacing the damaged socket.
Treatment for Osteoporotic fracture
If you have severe pain that does not respond to nonsurgical treatment, then surgery may be considered. In the past, the only surgical options available to patients with vertebral compression fractures involved extensive procedures. Today, vertebral augmentation procedures offer a minimally invasive alternative.
The two types of vertebral augmentation methods available are kyphoplasty and vertebroplasty. The best candidates for these procedures are patients who suffer severe pain from recent vertebral compression fractures. If you are a candidate for kyphoplasty or vertebroplasty, your doctor will talk with you about which procedure may be better for you based on the type of vertebral compression fracture you have.
Kyphoplasty: In a kyphoplasty, a needle is inserted into the fractured vertebra using an x-ray for guidance. A small device called a balloon tamp is then inserted through the needle and into the fractured vertebra. The balloon tamp is inflated from within the vertebra, which restores the height and shape of the vertebral body. When the balloon tamps is removed, it leaves a cavity that is filled with a special bone cement that strengthens the vertebra.
Minimally invasive spine surgeries
MISS fusions and decompression procedures (such as diskectomy and laminectomy) are performed using many different approaches. The most commonly used technique involves using a tubular retractor. During the procedure, a small incision is made and the tubular retractor is inserted through the skin and soft tissues down to the spinal column. This creates a tunnel to the small area where the problem exists in the spine. The tubular retractor holds the muscles open (rather than cutting them) and is kept in place throughout the procedure.
MIS Lumbar Diskectomy
A herniated disk in the lower back that pinches a nerve may cause severe leg pain, numbness, or weakness. To surgically relieve these symptoms the disk is removed. This procedure is called a diskectomy.
For the surgery, the patient is positioned face-down and a small incision is made over the location of the herniated disk. The surgeon inserts the retractor and removes a small amount of the lamina bone. This provides the surgeon with a view of the spinal nerve and the disk. The surgeon carefully retracts the nerve and removes only the damaged disk.
This minimally invasive technique can also be used for herniated disks in the neck. The procedure is done through the back of the neck and is called an MIS posterior cervical foraminotomy/diskectomy.
MIS Lumbar Fusion
A standard open lumbar fusion may be performed from the back, through the abdomen, or from the side. Minimally invasive lumbar fusions can be done the same way. A common MISS fusion is the transforaminal lumbar interbody fusion (TLIF) Using this technique, the surgeon approaches the spine a little bit from the side, which reduces how much of the spinal nerve must be moved.
In an MIS TLIF, the patient is positioned face-down and the surgeon places one retractor on either side of the spine. This approach prevents disruption of the midline ligaments and bone. Using the two retractors, the surgeon can remove the lamina and the disk, place the bone graft into the disk space, and place screws or rods to provide additional support. Sometimes the surgeon will use additional bone graft besides the patient’s own bone to improve the likelihood of healing.
Minimally invasive spinal stabilisation
As the name suggests, Spine Stabilization surgery can now be performed using minimally invasive stabilization procedures that offer patients a safe and effective alternative to back fusion with a faster recovery. It is done through a tiny incision without cutting or damaging the surrounding muscles.
Endoscopic lumbar interventions
ESS is a surgical procedure using micro-sized incisions (less than 1-inch) and small tubular systems in combination with an endoscope to visualize the surgical field. While endoscopic surgical approaches are commonly used to treat other areas of the body (eg, gastrointestinal), advances in optics, visualization of tissues, and spinal imaging make ESS a surgical treatment choice for many patients.
Treatment for repetitive strain injuries
The initial treatment for RSI symptoms is conservative. This may include:
- RICE, which stands for rest, ice, compression, and elevation
- nonsteroidal anti-inflammatory drugs (NSAIDs), both oral and topical
- steroid injections
- exercises, which may be prescribed as part of a physical therapy treatment plan
- stress reduction and relaxation training
- wrapping the area or securing it with a splint to protect and rest the muscles and tendons
Your doctor and physical therapist can also suggest adjustments to your work station, such as readjusting your chair and desk if you work at a computer, or modifications to your movements and equipment to minimize muscle strain and stress. In some cases, surgery may be necessary.
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