BEST ORTHOPEDIC TREATMENTS AND PROCEDURES IN CHENNAI

When a patient is referred for a joint replacement program, the Orthopaedic Surgeon will suggest treatments based on the findings and diagnosis, taking into consideration the age, activity levels and medical history of the patient. The evaluations will be based on radiological, medical, physical and historical records of the patient. Both non-surgical and surgical options will be considered and discussed by the orthopaedic surgeon, as a part of counselling and educating the patient.

Joint replacement is a surgical procedure in which arthritic or damaged joints parts are removed and replaced with plastic, metal or ceramic prosthesis or devices which are designed to duplicate movement of the joint, as closely as the original joint.

Once you have chosen to have your joint replaced, the orthopaedic surgeon will schedule the surgical procedure. The surgical team will administer anaesthesia, which could be either be spinal or general. Once the anaesthesia takes effect, the surgical team will replace the damaged joint with a prosthesis.

The length of the surgery will depend on the extent of damage to the joint and therefore, each surgery will be different, depending on whether there are other complications involved. Post-surgery, the patient will be held in a recovery room, until such time the anaesthetic effect has worn off.

After a knee or hip replacement surgery, the process to help you regain your mobility will begin, such as standing or walking. To begin with, our trained and experienced physiotherapists will assist you in strengthening the muscles with gentle exercises, so that you can regain mobility, . If the joint replacement was in your shoulder, generally you will be encouraged to begin exercising it the very same day of the surgery.

An orthopaedic surgeon with the help of an arthroscopic instrument probes, diagnoses and treats problems with joints. It is a procedure that is generally used on the shoulder, elbow, wrists, knees and ankle joints. When a patient has joint problems such as swelling or stiffness an arthroscopy may be recommended by the orthopaedic surgeon, in the event the imaging tests have not revealed the crux of the swelling or stiffness.

Apart from permitting a surgeon to check inside a joint for probable cause of the problem, an arthroscopy is also used to treat a range of conditions that are the reason for pain. These conditions / problems are

• To repair any damaged cartilage present in the joints
• To remove fragmented bones or cartilage debris
• To treat shoulder contracture, also known as frozen shoulder or adhesive capsulitis – a condition where there is pain and stiffness in the shoulder joint.

Arthroscopy is also used to examine joints that are very painful due to a bad injury. The examination is done while the patient is under anaesthesia and it allows the surgeon to thoroughly examine the joint for obvious and subtle issues like joint movement and ligament tears.

Post-surgery, the patient is stabilized in the recovery ward, before being taken to their room and generally discharged that day. A bandage will be applied at the site of the surgery and this can be removed the following day. The punctured wounds will be stitched with paper strips of a single stitch which will be removed ten days after the procedure. Two weeks after the surgery, using either still pictures or an operative video taken during the surgery, the surgeon will discuss the intra-operative findings, after the patient’s joint has been examined.

For those patients who have undergone a knee joint arthroscopy procedure, crutches are generally not advised as they will be able to walk unaided. Within one to two weeks after the surgery, a patient may be able to do light physical activity and resume full physical activity like lifting or sports activity, after six to eight weeks.

• Swollen muscles
• Knee injuries
• Sprains and strains
• Pain along the shin bone
• Pulling a ham string
• Damaging the Achilles tendon
• Dislocating bones
• Fractures

Sports injuries are of two types. They are either chronic or acute in nature. Sudden injuries that occur (while participating in a sports activity or when exercising), like fractures to hands, legs, fingers, toes or a strained back or sprained ankles are acute injuries. Indications of an acute injury are:

• Swelling
• Extreme arm or leg weakness
• Sudden severe pain
• Being unable to move a joint naturally
• Unable to place weight on the ankle, leg or foot
• Tenderness in the limbs, wrist or fingers
• Visible signs of a bone or joint that is out of place

Chronic injuries pertain to pain that occurs after you have been strenuously exercising or after a sports activity and continues to be there for a long time. Constant nagging pain when you play, pain when you exercise, a dull ache when you are resting or swelling are all symptoms of a chronic injury.

Sports injuries like sprains and strains are generally treated by the RICE method – rest, ice, compression and elevation of the injured limb.

Anti-inflammatory drugs that are non-steroidal in nature will be prescribed, to reduce the swelling and the pain. Immobilization of the injured area is another form of treatment rendered to patients with sports injuries, so as to prevent more damages from occurring. Casts, leg immobilizers, slings and splints are used to immobilize. Surgery is performed when there are torn tendons or ligaments, and broken bones. Rehabilitation plays a key role in the treatment of patients with sports injuries. Finally, resting plays an important part in the healing of a sports injury. Though moving an injured part is good, adequate rest is also necessary and your doctor will guide you to maintain that balance between rehabilitation and rest.

Ligament damage often occurs from a sports injury. Ligaments are sinewy, strong elastic bands that surround a joint to support and limit the movement of the joint. The ligaments most prone to get damaged in a sports activity are the knee ligaments and the ankle ligaments. The ligaments tear or get stretched due to twisting during sudden motion.

Reconstructive surgery of a ligament tear is performed only when there is a complete tear of the ligament which consequently causes instability in the knee or ankle joints. During surgery the torn ligament is replaced with a piece of a healthy tendon from either the knee cap, ankle or hamstring. The tendon is grafted into place to hold the knee or ankle joint together.

Composition of the Shoulder

The shoulder comprises a ball and socket joint. Three bones conjoin to form this joint -

1. The shoulder blade or scapula
2. The collarbone or clavicle
3. The upper arm or humerus

The head of the humerus fits into the shallow socket of the shoulder joint, and the connective tissue also known as the shoulder capsule, envelops the joint. Synovial fluid present in the shoulder capsule, lubricates the shoulder capsule and the joint and thereby enables the shoulder to move more easily.

When the connective tissue in the shoulder capsule becomes rigid due to the formation of tight bands of tissue or adhesions, with a simultaneous decrease in the level of synovial fluid, it causes stiffness and limits the range of motion, of the shoulder. This condition is referred to as “Frozen Shoulder”.