Wednesday 27 July 2016

Arthroscopy Knee


Patients with certain types of meniscal tears and cartilage damage are prime candidates for the minimally invasive surgical intervention called Arthroscopy Knee diseased by osteoarthritis, rheumatoid or psoriatic arthritis can also be treated using arthroscopy.


The following covers the different types of treatments for meniscal tears and cartilage damage with a partial focus on arthroscopy assisted procedures.

Meniscal Tears

The most common non-surgical treatments of meniscal tears are:
  • Rest, Ice, Compression, Elevation, (RICE)
  • Non-Steroidal anti-inflammatory medicines
The outer third of the meniscus has a healthy supply of blood so can heal successfully without the trimming of smaller tears using arthroscopy. Though the inner two thirds of meniscus plates have a much reduced blood supply meaning tears in the region are more likely to require arthroscopic intervention.

For surgical treatment of meniscal tears there is:
  • Arthroscopy: a miniature camera is inserted through a small incision to provide a view of the inside of the knee. Miniature surgical instruments are then inserted in separate incisions to trim or repair the tear.

Cartilage damage


As cartilage does not heal easily of its own accord, surgical techniques have been developed to assist cartilage regrowth. Cartilage restoration can relieve pain and delay the onset of arthritis. Arthroscopy has many different applications in treating cartilage damage, such as:

  • Microfracture: A small pointed tool called an awl is used to create small holes in the subchondral bone. This stimulates new blood supply and cell growth in the cartilage.
  • Drilling: stimulates the production of healthy cartilage. Multiple holes are made in the subchondral bone using drills or wires to initiate a healing response. Though the tools used are less precise than microfracture. Arthroscopy.
  • Abrasion Arthroplasty: instead of using drills or wires, high-speed burrs remove the damaged cartilage and reach the subchondral bone. Arthroscopy.
  • Autologous Chondrocyte Implantation: using arthroscopy of the knee this procedure extracts healthy cartilage tissue, then grows the cells in a laboratory over 4-5 weeks. Using open knee surgery, the cells are the re-implanted in the site of the damaged cartilage. Arthroscopy and arthrotomy, (open surgery).
  • Osteochondral Autograft Transplantation: healthy cartilage is lifted using a cylindrical plug from a non-weight-bearing area of the knee joint, then transferred to the defective area and pressed into place. A single plug or multiple plugs can be used. Arthroscopy and open surgery.
  • Osteochondral Allograft Transplantation: when the defect is larger, instead of autografts, allografts use tissue grafts taken from cadaver donors. Allografts usually use open knee surgery.

Monday 11 July 2016

Orthopaedic Surgeon brief on sub-specialties depending on the region of the body


Orthopaedics is a branch of medical surgery and therapy that treats injuries and diseases of the body’s skeletal system. This includes the bones, joints, muscles, ligaments and tendons. This vast system that enables the uprightness and movement of the human frame is called the musculoskeletal system.
When first practiced orthopaedics treated children with spinal, leg or arm deformities. Though orthopaedic surgeons now help patients of all ages and for a range of different conditions.
Within orthopaedics there are many different sub-specialties depending on the region of the body they treat. Orthopaedic surgeons can specialise in:
Hand surgery

Hand surgery treats a range of conditions from cuts, burns, crushing injuries or diseases of the hand. Some common conditions are congenital deformities; repetitive stress injuries, like carpal tunnel syndrome; arthritis; and tendon repair. The priority for orthopaedic surgeons is to adequately reconstruct the skin, bone, nerves, tendons and joints. This is to protect the anatomy of the hand for recovery of functionality and aid the healing process by limiting the chance of infection. Early intervention is very beneficial.

Shoulder and elbow

The shoulder is a complex and unstable joint which can get injured easily. The elbow is vulnerable to deterioration from age or injury related conditions as well. The orthopaedic surgeon has many means of treating the muscles, connective tissue, or damaged joints that come from the overuse or injury of the shoulder or elbow. Some common procedures are arthroscopy or arthroplasty.



Arthroscopy is a form of keyhole surgery that magnifies and creates a visualisation of the interior of the body around the joint being operated on. While arthroplasty is the surgical removal and replacement of a joint or a section of the joint.

Hip and Knee

The hips and knees are the largest joints in the body. They are designed to work in close coordination to provide the mobility most people take for granted. The hip is a large ball and socket joint susceptible to both injury and disease. Some of the most common forms of hip disease are:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Post-traumatic arthritis
  • Avascular necrosis

As with the shoulder and elbow, both the knee and the hip can be successfully treated by either arthroscopy or arthroplasty. Hip and knee replacement are two of the most common and successful procedures available to patients.
Pediatric orthopaedics
The pediatric orthopaedic surgeon specialises in children’s musculoskeletal problems. As children are still growing, the body's response to injuries, infections, and deformities can be quite different from the recovery of adults. Some of the conditions particular to this specialty are:
  • Limb and spine deformities, (clubfoot, scoliosis, limb length differences)
  • Gait abnormalities (limping)
  • Broken bones
  • Bone or joint infections and tumors
Foot and Ankle surgery

The treatment of the the foot and ankle is a sub-specialty of both orthopaedics and podiatry. The surgeon treats conditions that range from:
  • Trauma: such as fractures to the malleolar, tibial pilon, calcaneus, navicular, metatarsal, phalangeal
  • Arthritis: joints of the tarsals, metatarsals and phalanges, etc.
  • Congenital and acquired deformities: flatfoot, non-neuromuscular foot deformity, diabetic foot disorders, hallux valgus and several common pediatric foot and ankle conditions.
Spine Surgery

The are many potential causes for the need for spinal surgery. There is aging, improper body mechanics, trauma and structural abnormalities. These conditions can lead to back pain and symptoms such as leg pain and/or numbness or leg weakness. The most common procedures conducted are:

  • Discectomy or Micro-discectomy: removal of a herniated intervertebral disc.
  • Laminectomy: removal of the thin bony plate on the back of the vertebra called the laminae.
  • Laminotomy: removal of a portion of the vertebral arch, (lamina), that covers the spinal cord.
  • Foraminotomy: removal of bone or tissue at/in the passageway where nerve roots branch off the spinal cord.
  • Disc replacement: the injured disc is replaced with an artificial one.
  • Spinal fusion: technique used to join two vertebrae.


The three sub-specialties of orthopaedics not based on the body region where they occur are:
  • Musculoskeletal oncology, (cancer treatment)
  • Surgical sports medicine, (activity based injury)
  • Orthopaedic trauma, (accident based injury)