Category Archives: Surgery

What is Triple Fusion (Arthrodesis)?

Triple Fusion (Arthrodesis) is a surgical operation, which is mean to address a number of foot pain and deformity. This procedure simply fuses their joints over the back of the foot. All these joints are the talonavicular,  subtalar and calcaneocuboid. The surgeons often avoid the fusions, however, considering the severe kind of deformity and pain, the triple fusion in considered along with getting the better alignment. The procedure of triple fusions also helps in improving upon the stability and thus allow for simpler and easier standing and walking. The triple fusion is among the time tested and durable procedures found to fix the pain and deformity found in the legs.

Types of Triple Fusion

There are two types of triple fusion, which are as under:

1) Open Fusion: In this procedure, two cuts are made, one over the outer side of the foot, while the other is over the inner side. Generally, these are about 4 to 5 cm in length. Each of the three joints are seen opened up along with the joint surfaces that are removed in required.

2) Arthroscopic Fusion: In this procedure, the joints are often prepared over the keyhole fashion. This procedure is not often a feasible option in most of the cases, but come along with low risks or complications.

What Signs Indicates the Need of this Procedure?

Triple fusion can be considered like a salvage surgical option and is considered only after other options are not required. The basic objective of this surgery is to reduce the pain, fix the underlying deformities and get back a stable platform for ambulation. In conditions wherein fewer fusions/soft tissue procedures can suffice, the procedure of triple fusion is avoided. This is due to the presence of long term complications attached to it. The basic indications for the procedure are as under:

• Valgus foot deformities that fail to get adequately braced
• The failing Pes planovalgus deformity
• Advanced tibialis posterior tendon dysfunction
• Tarsal coalition
• Rheumatoid arthritis
• Degenerative arthritis
• Post traumatic arthritis
• Chronic pain
• Varus foot deformities that cannot be adequately braced
• Cavus and cavovarus
• Talipes equinovarus
• The Joint instability
• Neuromuscular disease

Triple Fusion (Arthodesis) Procedure

This procedure comprises of a surgical fusion of the three joints found in foot, which include the talocalcaneal (TC), calcaneocuboid (CC) and talonavicular (TN). One of the basic objectives of this procedure is to get rid of the pain due to this condition and fix the unstable joints.  The surgery involves removing the degenerative joints and thus fixes these joints in a right way together with an objective that bone would grow all over the fused joints. All the joints would then be seen rigid without having any pain. This is really vital as it helps in reducing the normal movement, though this can be often being lost owing to the arthritis.  The surgery is carried out by making an incision of 7 cm either side of the ankle and hind foot. The arthritis joint surfaces are simply cut out while the joints are fixed in a right ways using the screws. The surgery takes around two hours to complete.

Recovery

After the surgery, the leg of the patient would be immobilised over the backslap for around two weeks. The elevation of your foot for around ten days and is very much vital for infection prevention.  You would need small walks and standing postures, however, you shouldn’t lift weights for at least for six weeks. The back slab is removed and then the stitches are taken out after two weeks. After three months, you need to go for a review with your surgeon, which will be carried out with X rays. If everything goes perfect, then you are free to walk and get back to your usual activities. However, if any problem is noticed, you would take time to fix them.

Why Choose an Indian Hospital for Triple Fusion (Arthodesis) Procedure?

The Triple Fusion (Arthodesis) Procedure Speciality hospitals in India are competent in terms of treating the patients suffering from this ailment the best. These hospitals are equipped with ultra modern facilities comprising of one of the most modern kind of operating chambers and labs that helps in giving the best prevention measures and surgical options for these ailments. The hospital staff comprising of doctors, surgeons and nursing staff are highly competitive and known for their skills and experience in treating a wide range of ailments with professionalism and care. All these factors propel the influx of medical tourists coming to India for Triple Fusion (Arthodesis) Procedure in India along with other medical ailments.

Triple Fusion (Arthodesis) Procedure Cost in India

In terms of cost, India is simply the best. The Triple Fusion (Arthodesis) Procedure Cost in India is economically priced as compared to the cost for the same in the US. The huge cost difference gives the global patients enough reason to flock to India for the Triple Fusion and other treatment options.

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Metatarsal Surgery Overview

Any injury or deformity found in one of the five metatarsal bones (the big size bones seen behind on your each toe) can give you certain pinching pain, which in turn make the walking a difficult thing to do along with finding a number of other symptoms. Once you find the problems do not really responding to a number of non invasive treatment options including the physical therapy or any kind of therapeutic foot supports then the surgical options like metatarsal surgery becomes the mandatory treatment choice for one and all. This surgery also involves re-setting a number of metatarsal bones, pinning a number of bones over the place along with allowing the surgical site to get healed. Once you find the foot getting healed from this surgery, the patients are often seen as experiencing the relief from the pain and thus improving upon the functionality of the foot.

Reasons for Metatarsal Surgery

The metatarsal surgery is carried out for a number of reasons; however, it is more done for fixing the following conditions and problems found in the foot, which are as under:

• Fixing the Bunion deformities
• Calluses found over the bottom seen over the foot or the ball found in your foot.
• Fix all the foot problems that bring in due to the ailment of rheumatoid arthritis, diabetes, and several other kinds of diseases.
• Fixing a number of Metatarsal fractures

Metatarsal Surgery Procedure & Recovery

This Metatarsal Surgery is usually carried out using outpatient procedure when the patient is given anaesthesia, which is generally through general anaesthesia or intravenous sedation. After the patient is given the general anaesthesia, the surgeon is seen starting up the procedure by incision over the skin simply behind the toe, thereby simply accessing the metatarsal bone. He is then seen incising the bone; the places are seen in the proper position and the pins over the place using a metal screw or pin. Finally the surgeon is seen carrying out the incisions. The surgeon may be seen removing any kind of foot calluses and thus correcting any kind of issues if it required. After the surgery a number of patients have to wear a cast and thus seen using crutches for around 6-8 weeks and the skin and bone tissues are recovered. The patients can resume a number of normal activities once you find the surgical site is recovered completely. If you are diagnosed with any kind of metatarsal condition or injury, better consult a competent doctor to get things done the right.

Why Choose an Indian Hospital for Metatarsal Surgery?

When it comes to choosing the best destination for healthcare services, India is at the top for a number of medical treatments including Metatarsal surgery. Thanks to the high end Indian hospitals, catering Metatarsal surgical procedures. These hospitals and medical centres are equipped with one of the best and state of the art facilities, which play a vital role in fixing the medical ailment with ease and professionalism. These Indian hospitals, catering Metatarsal surgery and other treatments have one of the best surgeons and doctors who are competent enough to fix things right.  These medical professionals are highly competitive in terms of experience and expertise, which make the difference in fixing the medical ailment once for all.

Metatarsal Surgery Cost in India

When it comes to the cost of Metatarsal Surgery in India, no other developed nations can beat it. In fact The Metatarsal Surgery Cost in India has been one of the important USPs once you compare it with the developed countries. The Metatarsal Surgery Cost in India is comparatively lower than the cost for the same surgery in the developed nations.

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Ankle Arthritis Overview:

Arthritis can be an unnerving condition to bear for the obvious reasons the inflammation found in the joints. It causes pinching pain along with the stiffness in the joints over our body. Unfortunately, this medical ailment is among the most common ailments found in the same small joints over ankle and foot. As per experts, three are more than thousand forms of arthritis and most of them deal with the pain related to ankle and foot. All these kinds can really make things difficult to walk and carry out a number of activities you enjoy.

Causes:

The real cause of ankle arthritis is not often known, however the ones caused due to trauma or with any underlying medical condition, it is termed as primary ankle arthritis. These simply account for not less than 10 percent of the ankle arthritis cases. A number of people with this issue simply tend to fall under the old age group, so age is also one of the common causes of ankle arthritis along with other issues like obesity and family history.

Symptoms

The symptoms of arthritis can vary from one patient to the other as per the joints affected with this ailment. In a number of cases, these are inflamed and painful. Some of the common symptoms are under:

• Pain along with motion
• Pain getting flared up with extreme activities
• Tenderness with applied pressure over the joint
• Joint swelling, redness and warmth
• Increased amount of pain swelling during the morning time after resting or sitting
• Difficult while walking and getting any of the above discussed symptoms

Diagnosis

The diagnosis of ankle arthritis can be carried out with a combination of physical examination X rays or several other imaging tests. The diagnostic tests can include X rays, MRI/CT Scan for any unusual condition. On having ankle arthritis systemic condition, blood tests can be used for the diagnosis. At times, a bone scan is also carried out, while the other tests include injection over the joints.

Treatment Options:  -Nonsurgical Options:

1) Oral anti-inflammatory medication

The Oral anti-inflammatory medications are one of the treatment options for ankle arthritis, which can help in reducing the swelling and thus relieve the pain. Also, cortisone can be called an effective anti-inflammatory agent, which can be easily injected over the affected arthritic joints. You may find a relief, but more often it is temporary.

2) Physical therapy

There are certain exercises that can help in boosting up the motion range along with the flexibility and empowering the muscles over your ankle and foot. Your doctor/physical therapist can really help in developing a personal exercise program as per meeting up the lifestyle requirements.

3) Custom foot orthotics

These are custom made inserts for your shoes that are developed to address a number of foot and lower body conditions. These are meant to absorb the wear and tear over the foot and prevent the soft tissue denegation. These help in reducing the back pain, issues in the knee and diabetic ulcers.

4) Custom ankle brace

Braces help in managing the symptoms of ankle arthritis along with managing the acute conditions of arthritis. This can reduce the motion over the joint and thus off load even some amount of stress in it.

5) Custom ankle foot orthotic

It is a custom made device, which help in regulating excessive amount of supination and pronation while you carry out a number of physical activities like running, cycling and walking. These devices help in controlling the stabilizing the mechanics of your body.

6) Cortisone injection

These powerful medications are consumed by the patients of this ailment via injections and thus getting quicker relief at the tendons, bursa and inflamed joints. These often give a good amount of pain relief with a little bit of discomfort.

7) PRP injection

The PRP injections are nothing but medication, which hep in adding up more platelets than the usual found in our blood. By doing this, you can eventually help in reducing the symptoms of ankle arthritis.

Surgical Options

There are basically two types of surgical procedures, which are further classified into further options:

1) Joint Sparing Procedure:

1. i) Arthroscopic Debridement: This surgical procedure simply helpful in treating the ankle arthritis in the initial stage. This procedure helps in removing the loose cartilage, the inflamed synovial tissues, along with the bone spurs from over the joint.
2. ii) Exostectomy: It is among fruitful procedures and fit for the significantly less obese kind of person giving quicker results.

iii) Arthrodiastasis: This procedure helps in fusing a number of bones found in the joint completely and thus making it continuous bone among the two or more bones. This procedure helps in reducing the pain by reducing the motion over the arthritic joints.

2) Joint Destructive Procedures:

1. i) Ankle Fusion (Ankle Arthrodesis): This surgical procedure is fit for people with a condition known as degenerative arthritis, which helps in reducing the symptoms of the same.
2. ii) Ankle Replacement: This surgery helps in replacing the damaged bone along with the cartilages of ankle joints. The artificial joint parts are often used to replace your the bones.

Why Choose an Indian Hospital for Ankle Arthritis Surgery?

India has become one of the best destinations for medical tourists coming for various ailments, which certainly include Ankle arthritis surgery. Thanks to the best hospitals in India which are known to have one of the best and high end machines and facilities that help in treating and carrying out surgical procedures the best. The orthopaedic surgeries in these Indian hospitals are at par in terms of experience and skill sets that are known for higher success rates tolling to 99 percent.

Ankle Arthritis Surgery Cost in India

One of the striking feature of Ankle Arthritis Surgery in India is the reasonably lower cost compared to the ones carried out in the US or UK. The considerably low cost Ankle Arthritis Surgery in India helps the patients across the globe to make considerable savings when they choose India to get all their medical needs.

What is Toe Joint Replacement Surgery?

Toe Joint Replacement Surgery

Orthopaedics is the stream of medicine, which in a way is conferred as the modern surgical mechanism deals with the treatment of the bones and the joints. It involves a detailed analysis of the musculoskeletal system, which depicts the capacity of a human being or an animal to move with the help of their muscles and bone.

In the world of today, due to the trendy lifestyles pain in the joints as well as the muscles are a common phenomenon. The first thing the masses resort to in such a scenario is visit an orthopaedic surgeon. The surgeons have to exercise caution in treating the patients as surgery might not only be the viable option in all the cases. At times non surgical procedures depending on the conditions and symptoms of the disease could do the trick.

What to Expect During the Toe Joint Replacement Surgery?

The Toe Joint Replacement is performed under general anaesthetic. Most patients can go home the day after the surgery.

During this surgery, your surgeon will make a small incision near your big toe joint and examine the current damage to the joint. Any bone spurs or lumps will be shaved smooth. They will use a prosthesis or replacement components made me up of either plastic or metal for replacing the part or your entire toe joint.

The choice of the prosthesis and the extent of the surgery will depend on your medical situation. You should discuss all the options with your consultant.

What to Expect After the Toe Joint Replacement Surgery?

At the completion of your surgery, the wound will be closed with stitches or staples. Your foot will be covered with a dressing. You will receive help to begin walking the day following your surgery. You will be required to use the crutches. You will need a special shoe that will make it easier to avoid putting full weight on your new toe joint. A physiotherapist will visit you to show the exercises that will help you with range of motions.

What to Expect with Recovery at Home?

Take any pain medications that are given by your doctor. You should avoid putting full weight on your foot until 6-8 weeks or you are released to do so. After 10 to 14 days, your stitches and staples will be removed.

You will need to undergo an X-ray to ensure the bone is growing correctly around the new implants. If this is the case, then you are allowed to increase the weight bearing on your foot and gradually return back wearing the normal shoes. You need to continue performing the exercises recommended at the hospital.

Most of the patients are able to resume light exercises at about ten weeks. As with any other surgery, the swelling may persist for several months post surgery.

Why Choose an Indian Hospital for Toe Joint Replacement Surgery Hospital?

Toe Joint Replacement Surgery Hospital

Precise treatments pertaining to the pain in the bones and joints are available in the country. The icing on the cake stems from the fact that certain advanced forms of treatment like Birmingham hip resurfacing technique are present in the country which is not even mentioned in the medical charters of advanced countries like the United States. So the curiosity arises on what is this form of treatment which is a conventional replacement of the hip.

Precise treatments pertaining to the pain in the bones and joints are available in the country. The icing on the cake stems from the fact that certain advanced forms of treatment like Birmingham hip resurfacing technique are present in the country which is not even mentioned in the medical charters of advanced countries like the United States. So the curiosity arises on what is this form of treatment which is a conventional replacement of the hip.

The inflow of foreign patients to India is increasing with every passing day. The efforts and contribution of the surgeons have a huge say in this. They have had their education in the top medical institutions of the country along with practicing their skills among the best medical centres in the world. Even the doctors who practice in the country are of the highest order.

Of late Toe joint replacement surgery has been a revelation in the world of surgery. If the testimonies of the medical tourists coming to the country are an indicator the surgery tops the list. The low cost of treatment, quality health care and a well developed tourist industry are the pillars on which the medical tourism industry survives. “Yesterday’s regret and tomorrow’s hope is Today’s opportunity.

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Introduction-

Your doctor may recommend a thumb joint replacement surgery if the non-surgical treatments were not successful to ease the problems of thumb arthritis. In this article, we’ll help you to understand the following:

• Which parts of the thumb are involved?
• How the surgeons perform this surgery?
• What to expect before and after the surgery?

Anatomy-Which parts of the thumb are involved?

The carpometacarpal joint or CMC joint of the thumb is where the metacarpal bone of the thumb attaches to the trapezium bone of the wrist. Sometimes, it is referred as the basal joint of the thumb. The CMC joint allows you to move your thumb into your palm, a motion is called opposition.

Several ligaments hold the joint together to form the joint capsule of the CMC joint. The joint capsule is a watertight sac around the joint. The joint surfaces are covered with a material called as articular cartilage, which is a sticky, spongy material that covers and allows one side of a joint to slide against the other joint surface. When this material wears out, the joint develops osteoarthritis that becomes painful.

What does the surgeon hope to achieve?

The arthritic joint surfaces can be sources of pain, stiffness and swelling. It is used to replace the damaged joint surfaces so that patients can perform their activities with less pain. Unlike a fusion surgery, which binds the joint together, an arthroplasty can help to take away the pain while allowing the thumb joint to retain the movement.

How should I prepare for the surgery?

The decision to undergo the surgery should be jointly taken by you and your surgeon. You need to understand the procedure and clear your questions and concerns by talking with your surgeon. Once you decide on the surgery, you need to take several steps. You’ll be asked to undergo a complete physical examination by your regular doctor to ensure you are in the best possible condition to undergo the operation.

Secondly, this preoperative visit will prepare you for your surgery. You’ll begin to learn some of the exercises that you’ll use during your recovery. Your therapist will help you anticipate any special needs or problems that you may have at home, once you are discharged from the hospital.

You’ll probably be admitted to the hospital early in the morning on the day of the surgery. You shouldn’t drink or eat anything after midnight, the night before surgery.

What happens during surgery?

Before we describe the procedure, let us look at the artificial thumb joint. The surgeons will have several ways to replace thumb joint surfaces. One method is to attach the ends of a prosthesis implant into the bones of the thumb joint. A newer method uses a small, marble-shaped implant to form the new joint surfaces. The spherical implant works like a ball bearing to give the joint a smooth arc of the movement.

The procedure takes about two hours to complete. The new method using the ball implant takes about 30 to 60 minutes. The surgery may be performed under general anesthesia or local anesthesia. Once you have anesthesia, your surgeon will ensure that the skin of your hand is free of infection by cleaning the skin with a germ-killing solution.

During the prosthesis implant procedure, an incision is made across the base of the thumb while the soft tissues are spread apart with a retractor. Special care is taken not to damage the nearby nerves going to the thumb. The joint capsule is opened, exposing the CMC joint. The ends of the bones forming the CMC joint surfaces are then taken off, forming flat surfaces. A burr is used to make a canal into the bones to form the thumb joint. The surgeon sizes the stem of the prosthesis to ensure a smug fit into the canal and then inserts it. When the new joint is in place, the surgeon then wraps the joint with a strip of the nearby tendon to give the new implants some added stability and protection. Then the skin is stitched together and a splint is applied.

During the Spherical implant method, the thumb joint is used as a spherical implant that looks like a marble. Your surgeon makes a small, one-inch incision at the base of the thumb joint. The ends of the bones form the CMC joint surfaces which to removed to form the flat surfaces. A burr is used to make a small notch or canal at the ends of the two bones. Your surgeon shapes the notch so that the ball-shaped implant will fit smugly in the joint and places between the ends of the shaped bones. The soft tissues are then sewn together and the thumb is splinted and bandaged.

What happens after surgery?

After surgery, your thumb will be bandaged with a well-padded dressing and a splint for support. This splint will keep the thumb in a natural position during healing. Your surgeon will check your hand within five to seven days. The stitches will be removed after 10 to 14 days, though most of the stitches will be absorbed into your body. You will be given pain medication to control discomfort after the surgery. You should keep your hand elevated above the level of your heart for several days to avoid swelling and throbbing. Keep your hand propped up on a stack of pillows while sleeping or sitting up.

What to expect during my rehabilitation?

A physical or occupational therapist will direct your recovery program. The rehabilitation time will depend on the type of procedure used. It may take up to three months after replacement with a prosthesis implant. The patients wear an arm-length cast with the thumb pointing out for about three weeks after this surgery. The patients are able to return back to their normal activity within three to five weeks after the spherical implant surgery. Since the surgery doesn’t require the surgeon to disturb the tendons near the joint so the recovery is faster. You can start the range of motion exercises involving the use of ceramic ball within one week after surgery.

The first few physical therapy treatments will focus on controlling the swelling and pain from the surgery. Your therapist will use a gentle massage and other hands-on treatments to ease the muscle spasm and pain. Strengthening exercises will be used to provide added stability around the thumb joint. You’ll learn to grip and support the items to do your tasks safely and with the least amount of stress on your thumb joint. As with any other surgery, you should refrain doing too much too quickly.

Some of the exercises will be designed to get your hand and thumb working in ways that are similar to your work tasks and daily activities. Your therapist will find better ways to do the tasks that don’t put too much stress on your thumb joint. Before the end of your therapy sessions, your therapist will teach you a number of ways to avoid further problems.

The goal of the therapist is to help you keep the pain under control, regain the fine motor abilities with your hand and thumb and improve the strength and range of motion.

Thumb Joint Replacement Surgery Hospital India

Thumb Joint Replacement Surgery

Indian Hospitals are becoming a more important component of medical tourism. India is at the center of this concept. Based in Nagpur, the hospital provides all the amenities and services that one would require to get their health back to normalcy. It is well connected with Mumbai and Pune, two of the travelling behemoths in India, which makes it one of the most accessible hospitals in India.

Thumb joint replacement surgery is one of the most critical surgeries among all, and is mainly required because of arthritis of the thumb joint. There is no medical treatment available for thumb joint arthritis. This arthritis might become painful and decrease the movement of the thumb joint. The only option one has, is cortisone injections, but that too is a limited option, as one cannot take an unlimited amount of cortisone injections. Therefore, one has no other option but to sign up for thumb joint replacement surgery.

We have all the necessary, top of the line machinery and devices that = provide the right kind of support and service to people who sign up with us for medical treatment and medical surgeries. We have some of the most renowned and skilled surgeons and a large number of surgery related resources, which makes it easier to provide all the services that our patients and clients would require. We strive to be a single window service provider for all kinds of surgeries and related services.

Our hospital takes extreme care and concern when it comes to diagnosis of the medical issue that people are facing, to ensure that we, as well as our clients and patients get a clear picture of what they ail from, and how there can be a solution for it. We have a number of experienced and skilled doctors, surgeons and other medical personnel, who have been on our panel for a number of years. These surgeons are well known in the field, and provide only the best kind of service that would be required. With medical tourism, it is becoming a lot easier to travel to India for medical help. It is also the most economical option that is available. We understand the issues that people traveling from foreign countries for medical treatment might face, and therefore provide all the amenities and services – medical as well as non-medical – so that they have a safe and comfortable experience, and strive to be a single window service provider, ensuring that the patients and clients do not face any amount of inconvenience. With our country having diplomatic relations with almost every country, we as a hospital are well equipped to provide you with all the services, amenities and surgeries that you would require for a safe surgery and a healthy and safe future. Contact us today for your medical requirements, and we are sure that we will be able to provide you the best options.

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Introduction

The term “rotator cuff”refers to a group of four tendons that attach four shoulder muscles to the upper arm. Tendons are stringy tissues that attach muscle to bone.

A healthy shoulder is the most versatile joint in the human body. It has a wider “range of motion,” which means it can move more freely, and in more directions, than any other joint. The shoulder’s versatility enables us to retrieve soup cans from the cupboard, to hammer nails, swing golf clubs, roll bowling balls, and perform thousands of other activities.

The shoulder’s flexibility is due to its unique structure. Like the hip, the shoulder is a “ball-and-socket” joint – a “ball” at the top of the upper arm bone (the humerus) fits neatly into a “socket” formed by the shoulder blade (scapula).

But unlike hip joints, where the ball sits in a deep, well-protected socket, the shoulder socket is very shallow. As a result, the shoulder is the most frequently dislocated major joint in the body. It’s also prone to a variety of other injuries and chronic problems that can be painful and hinder a person’s ability to perform ordinary tasks.

Why it is done?

Surgery to repair a rotator cuff is done when:

• A rotator cuff tear is caused by a sudden injury. In these cases, it’s best to do surgery soon after the injury.
• A complete rotator cuff tear causes severe shoulder weakness.
• The rotator cuff has failed to improve with 3 to 6 months of conservative nonsurgical treatment alone (such as physical therapy).
• You need full shoulder strength and function for your job or activities, or you are young.
• You are in good enough physical condition to recover from surgery and will commit to completing a program of physical rehabilitation.

What to expect after surgery?

Discomfort after surgery may decrease with taking pain medicines prescribed by your doctor. The arm will be protected in a sling for a defined period of time, especially when at risk of additional injury. Physical therapy after surgery is crucial to a successful recovery. A rehabilitation program may include the following:

• As soon as you awake from anesthesia, you may start doing exercises that flex and extend the elbow, wrist, and hand.
• The day after surgery, if your doctor allows, passive exercises that move your arm may be done about 3 times a day (a machine or physical therapist may help the joint through its range of motion).
• Active exercise (you move your arm yourself) and stretches, with the assistance of a physical therapist, may start 6 to 8 weeks after surgery. This depends on how bad your tear was and how complex the surgical repair was.
• Strengthening exercises, beginning with light weights and progressing to heavier weights, can start a few months after surgery.

Candidates for rotator cuff repair surgery

• Persons who have tears to the rotator cuff tendon that don’t respond to treatment are candidates for surgery.
• Surgery is usually needed if there is a complete tear in the tendon.
• A complete tear results in a person being unable to raise the arm. Surgery may also be needed for a partial tear of the tendon, if the tear causes continued pain and weakness.
• In a complete tear, repair is usually done within 3 months of the injury.
• There are two typical types of people who suffer from a rotator cuff tear.
• Younger, athletic people often have an injury that tears the rotator cuff. Middle-aged or elderly people usually have repeated stress of the shoulder muscles over time that eventually causes the tendon to tear.

Advantages of rotator cuff repair surgery

• When combined with a good rehabilitation effort, rotator cuff surgery allows people to regain much of the lost comfort and function in shoulders with cuff disease.
• If the quantity and quality of the tissue is good, surgery can help repair the tendon back to the bone from which it has been torn. This is most likely to succeed, soon after a cuff tear in otherwise healthy shoulders of non-smokers who have not had multiple cortisone injections.
• Rotator cuff surgery will improve the mechanics of the shoulder.
• When performed by an experienced surgeon, rotator cuff surgery usually leads to improved shoulder comfort and function.
• The greatest improvements are in the ability of the patient to sleep, perform activities of daily living, and engage in non-contact recreational activities.

Symptoms

An acute rotator cuff tear as a result of trauma can occur on its own or in conjunction with another shoulder injury, such as a fracture or dislocation. An acute tear usually causes a sharp pain in the front of the shoulder that radiates down the side of the arm.

Rotator cuff tears caused by repetitive overhead activity or by wear and degeneration of the tendon usually have a more gradual onset of symptoms. In such cases, the pain may at first be mild and only present with overhead activities such as reaching or lifting, but as time passes, pain may result from little or no stressful activity at all, including just lying in bed on the affected side at night. Stiffness and loss of motion are also common, making it difficult to perform simple daily tasks such as combing your hair or twisting your arm behind your back to fasten a button on a blouse, or reaching up to adjust a hat or the hood of a coat.

Some of the signs of a rotator cuff tear include thinning (atrophy) of the shoulder muscles and pain or weakness when you lift your arm or when you lower it from a fully raised position. There may also be a crackling sensation (crepitus) when the shoulder is moved in certain ways.

Why the procedure is performed?

Reasons rotator cuff repair may be done include:

• You have shoulder pain when you rest or at night, and it has not improved with exercises over 6 – 12 months.
• You have a large or a complete rotator cuff tear.
• You are active and use your shoulder for sports or work.
• You have a lot of weakness and are unable to do everyday activities.

Surgery is a good choice in a person whose tear was caused by a recent injury. It is also a good choice when the tendons of the rotator cuff were not already frayed from chronic rotator cuff problems.

Some patients with a partial tear may choose not to have surgery, using rest and exercise instead. The best candidates for this approach are those who have only a partial tear and do not place a lot of demand on their shoulder.

• Shoulder pain will improve with this approach.
• However, any weakness will not improve, the tear become larger over time, and you may be limited in the sports or other act ivies you can do.

Diagnosis

Despite all the clues, diagnosing a rotator cuff tear isn’t always easy, because a number of conditions in the bones and soft tissues of the shoulder can present with similar symptoms, and a number of tests may be required for a conclusive diagnosis. A doctor will begin by taking the medical history, and then perform a physical examination, looking for tender areas, deformity, and restrictions in strength and motion. The physician may also examine the patient’s neck to ensure a “pinched nerve” in the cervical spine isn’t the pain source and to rule out other conditions, such as osteo- or rheumatoid arthritis.

Beyond that, he or she may request imaging tests, usually beginning with x-rays. Other tests may be ordered, including an ultrasound or a CT scan (computerized tomography) or MRI (magnetic resonance imaging), all of which can better visualize soft tissue structures such as the rotator cuff tendon.

An MRI is the gold standard, since it can even distinguish between a complete (full thickness) tear of the tendon and a partial tear, and whether the tear is within the tendon itself, or if the tendon is detached from the bone.

Rotator cuff surgery

During rotator cuff surgery, the patient is put in a half-sitting position, with the head supported. Most operations are performed under general anesthesia, where the patient is asleep. Sometimes a regional (or local) anesthetic is used to block the nerves leading to the arm. In that case, the patient is conscious but cannot feel pain. Usually a sedative is also given, putting the patient in a conscious but dreamy state. Rotator cuff surgery usually takes one to two hours.

Types of procedures include:

1. Open Surgical Rotator Cuff Repair: Prior to the development of arthroscopic surgery, all rotator cuff tears were repaired by looking directly at the torn tendon through an incision about 6 to 10 centimeters in length. The advantage of open rotator cuff repairs is the rotator cuff tendons are easily seen by this method. It is straightforward to repair the tendons down to the bone, and many surgeons find this a more secure repair. The downside is that the incision is large, and the recovery can be longer and more painful.
2. Mini-Open Rotator Cuff Repair: The mini-open method of repairing a rotator cuff involves an arthroscopic portion of the surgery, and a short incision to get direct access to the torn rotator cuff tendon. By using the arthroscope, the surgeon can also look into the shoulder joint to clean out any damaged tissue or bone spurs. Preparation for the rotator cuff repair can be performed arthroscopically. Once the arthroscopic portion is complete, a shorter incision is made to repair the tendon back to the bone. The incision used in a mini-open rotator cuff repair is about 3 cm, and the recovery may be less painful than the open cuff repair.
3. All-Arthroscopic Rotator Cuff Repair: An arthroscopic rotator cuff repair is done through small incisions, and the repair is done with the surgeon looking through a small camera to see the torn rotator cuff tendons and their repair on a television monitor. This is a more recent development in the treatment of rotator cuff tears, and not all types of tears can be treated by this method. Furthermore, arthroscopic rotator cuff repairs can be technically difficult and require experience in this method of repair. Not all surgeons are convinced the repair done arthroscopically is as strong as repair done through an open incision.
4. Shoulder Replacement Surgery: In large rotator cuff tears that have been neglected for a number of years, the cartilage of the shoulder joint may eventually wear out. This is a problem called rotator cuff tear arthropathy, and is a dual problem of shoulder arthritis and a large rotator cuff tear. Because the rotator cuff is no longer intact, a standard shoulder replacement is usually not adequate. Special implants help accommodate for the fact that the rotator cuff does not work normally. One of these special implants is called a reverse shoulder replacement.

Rehabilitation

After surgery, the arm is immobilized to allow the tear to heal. The length of immobilization depends upon the severity of the tear. You will be given an exercise program to help regain motion and strength in the shoulder. This begins with passive motion. It advances to active and resistive exercises. Your orthopaedic surgeon may recommend that you work with a physiotherapist. Complete recovery will take at least several months.

After surgery, the patient is taken to a recovery room for an hour or two. The injured arm is kept in a sling, often with a pillow behind the elbow. Patients initially drink only clear liquids before eating regular food. Ice is applied to the shoulder for comfort. Patients are encouraged to get out of bed with the arm in a sling. The sling can usually be released, but not removed, allowing the elbow to straighten without moving the shoulder. Patients who had open surgery usually stay in the hospital for a day or two. Patients who had arthroscopic surgery can often return home on the same day.

A strong commitment to rehabilitation is important to achieve a good surgical outcome. The doctor will advise you when it is safe to return to overhead work and sports activity.

Why Choose Joint Replacement Surgery Hospital India for Rotator Cuff Repair Surgery?

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

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Shoulder Arthroscopy Introduction

Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small incision (cut) in your skin.

The rotator cuff is a group of muscles and tendons that cover your shoulder joint. These muscles and tendons hold your arm in your ball and socket shoulder joint, and they help you move your shoulder in different directions. The tendons in the rotator cuff can tear when they are overused or injured.

Most people receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

First, your surgeon will examine your shoulder with the arthroscope. Your surgeon will:

• Insert the arthroscope into your shoulder through a small incision. The arthroscope is connected to a video monitor in the operating room.
• Inspect all the tissues of your shoulder joint and the area above the joint — the cartilage, bones, tendons, and ligaments.
• Repair any damaged tissues. To do this, your surgeon will make 1 to 3 smaller incisions and insert other instruments through them. A tear in a muscle, tendon, or cartilage will be fixed. Damaged tissue may need to be removed.

Your surgeon may do one or more of these procedures during your surgery:

• Rotator cuff repair: The edges of the muscles are brought together. The tendon is attached to the bone with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic. They do not need to be removed after surgery.
• Surgery for impingement syndrome: Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. Your surgeon may also cut a specific ligament, called the coracoacromial ligament, and shave off the under part of a bone. This under part of the bone is called the acromion. The spur can be a cause of inflammation and pain in your shoulder.
• Surgery for shoulder instability: If you have a torn labrum, the rim of the shoulder joint that is made out of cartilage, your surgeon will repair it. Ligaments that attach to this area will also be repaired. The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.

At the end of the surgery using the arthroscope, your incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.

Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues. Open surgery is a more complicated surgery.

Why the procedure is performed?

Arthroscopy may be recommended for these shoulder problems:

• A torn or damaged cartilage ring (labrum) or ligaments
• Shoulder instability, where the shoulder joint is loose and slides around too much or becomes dislocated (slips out of the ball and socket joint)
• A torn or damaged biceps tendon
• A torn rotator cuff
• A bone spur or inflammation around the rotator cuff
• Inflammation or damaged lining of the joint. Often this is caused by an illness, such as rheumatoid arthritis.
• Arthritis of the end of the clavicle (collarbone)
• Loose tissue needs to be removed
• Shoulder impingement syndrome, to make more room for the shoulder to move around

Before the procedure

Always tell your health care provider what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. During the 2 weeks before your surgery:

• Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
• Ask your health care provider which drugs you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
• Tell your health care provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your health care provider or nurse for help. Smoking can slow down wound and bone healing.
• Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of your surgery

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take your drugs your health care provider told you to take with a small sip of water.
• Your health care provider will tell you when to arrive at the hospital.

After the procedure

Recovery can take anywhere from 1 to 6 months. You will probably have to wear a sling for the first week. If you had a lot of repair done, you may have to wear the sling longer.

You may take medicine to control your pain.

When you can return to work or play sports will depend on what your surgery involved. It can range from 1 week to several months.

For many procedures, especially if a repair is performed, physical therapy may help you regain motion and strength in your shoulder. The length of therapy will depend on the repair that was done.

Operation

You will have a general anaesthetic, and will be asleep for the whole operation.

The arthroscope is a telescope about as wide as a pen, connected to a television. The operation is called an arthroscopy.

The surgeon will insert the arthroscope through one or two tiny half inch (about 1.2cm) cuts around your shoulder. He will use it to look at the inside of your shoulder and the tendons over the shoulder. The cuts will be closed with stitches, clips, or paper tapes. You will be in hospital for one night or so after the operation.

At home

You cannot drive whilst your arm is in a sling. If you were driving before the arthroscopy, you will be able to drive within a few days of leaving hospital.

How soon you can return to work depends on your job. If you are working now, you should be able to return to work 7 to 10 days after your operation.

Recovery from shoulder arthroscopy

The recovery depends on what type of surgery is performed. One of the problems with shoulder arthroscopy is that the procedure hurts much less than open shoulder surgery, and therefore patients may tend to do too much, too soon. It is very important that you only perform activities that your surgeon recommends following a shoulder arthroscopy. Even though your shoulder may feel fine, you need to allow time for repaired tissues to adequately heal. This is especially important for patients who have rotator cuff repairs and labral repairs.

Why Choose Joint Replacement Surgery Hospital India for Arthroscopic Shoulder Surgery?

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Our surgical unit is integrated with an onsite musculoskeltal ultrasnonography facility with very high diagnostic accuracy and it also comprises one of the finest shoulder rehab center. Th rehab compliments our surgical efforts to provide one of the most consistent and impressive results. We offer highly effective arthroscopic shoulder surgery at the most affordable prices. Many international patients have undergone their arthroscopic shoulder surgery in India due to reasonable rates.

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Finger Joint Replacement Surgery Hospital India

“Better Prevent and Prepare rather than repent and repair”.  In the fast paced life of today pain in the joints and the bones is a common recurrence and the first thing we do is to visit an orthopaedic surgeon. He has to exercise caution as surgery may not be the preferred option always, as depending upon the conditions and symptoms of the disease one could even resort to non surgical methods.

What should I do to prepare for surgery?

You should jointly decide with your surgeon to proceed with the surgery. You should understand the procedure and talk with your surgeon if you have any concerns or questions.

Once you decide on the surgery, your doctor will suggest a complete physical examination to ensure that you are in the best possible condition to undergo an operation. On the day of the surgery, you’ll be admitted to the hospital early in the morning. You shouldn’t eat or drink after midnight, i.e. the night before surgery. The length of time you spend in the hospital depends a lot on your recovery from anesthesia post surgery. Typically, a finger joint replacement surgery can be done on an outpatient basis, that means you can leave the hospital the same day.

What happens during the operation?

The surgeons use silicone plastic implants to replace the original joint surfaces. The artificial joint functions similar to a hinge on a door. The procedure takes about two hours to complete. It may be done either using a general anesthesia that puts you to complete sleep or a local anesthesia that only numbs your hand. With the local anesthesia you’ll be awake during the surgery, but you won’t be able to see the surgery.

Once you are given anesthesia, your surgeon will ensure that the skin of your hand is free of infection by cleaning them with a germ-killing solution. An incision is made across the back of the finger joints that are to be replaced. The soft tissues are them spread apart with a retractor. Special care is taken not to damage the nearby nerve that passes by the joint. Then the joint is exposed. The ends of the bones forming the finger joint surfaces are taken off, forming flat surfaces. A burr is used to create a canal into the bones forming the finger joint.

Then the surgeons sizes the stem of the prosthesis to ensure a snug fit into the hollow bone marrow space of the bone. The prosthesis is inserted into the ends of both the finger bones. When the new joint is in place, the surgeon wraps the joint with a strip of the nearby ligament to form a tight sac. This provides some added protection and stability to the new implant. The soft tissues are sewn together, and the finger is then splinted and bandaged.

What happens immediately after surgery?

After surgery, your fingers will be bandaged with a well-padded dressing and a splint for support. The splint will keep the finger in a straightened position during healing. Some patients are placed in an arm-length cast with the finger in a straightened position for about 3 weeks post surgery. Your surgeon will check your hand in five to seven days. Stitches will be removed after 10 to 14 days. You will be given pain medication to control discomfort after surgery. You should keep your hand elevated above the level of your heart for several days to avoid swelling and throbbing. Keep it propped up on a stack of pillows while sitting or sleeping.

What should I expect during my rehabilitation?

A recovery program will be directed by a physician or an occupational therapist. Recovery will take up to three months after a prosthesis is implanted. The first few therapy treatments focus on controlling the pain and swelling from the surgery. Your therapist may use gentle massage and other hands-on treatments to ease the muscle spasm and pain. Then you’ll be asked to begin with gentle range of motion exercise. The strengthening exercises are used to provide added stability around the finger joint. You’ll learn the ways to grip and support items in order to do your tasks safely and with the least amount of stress on your new finger joint. As with any other surgery, you’ll need to avoid doing too much, too quickly.

Some of the exercises are designed to get your hand and fingers working in ways that are similar to your work tasks and daily activities. The goal of the therapist is to help you keep the pain under control, improve your strength and the range of motion as well as regain the fine motor abilities with your fingers and hand. The regular visit to a therapist’s office will end when you are well underway.

Why Choose Joint Replacement Surgery Hospital India for Finger joint replacement surgery?

Since this involves a critical part of our body, choosing a top notch hospital would be the definite way to move forward. This brings us to the fundamental question on what are the advantages of choosing a good hospital. There are quite a few of them, but the expertise of skilled surgeons, superior support staff, state of the art facilities in terms of infrastructure are a few of them. In addition to this, English being the preferred mode of communication eradicates the communication barrier.

So, is there a hospital in the country which has all the above mentioned facilities. They have established their base in the city of Nagpur which belongs to the central portion of India. A visit to the hospital itself says a thing or two about the hospital. Their philosophy is simple and that is to provide quality health care at cost effective solutions to the patients.

All the operation theatres of the hospital are modelled as per the standards prescribed by the WHO and special attention is paid to the welfare and the safety of the patients. On the safety front there is a fire fighting system along with splinkers for the benefits of the patients. All the reputed surgeons in the country are part of their set up and the credentials of them are a testimony to the fact. They have hands on experience in performing several successful surgeries and their expertise is a sort out in various international conferences.

The buzz in the medical world is that any part of a joint can be replaced by an effective implant procedure. Most of the masses are well acquainted with hip, but Finger Joint Replacement Surgery is the newest craze in the medical world. It eradicates discomfort to a larger level and is more suitable for the older age group as compared to the younger lot. For the surgery to be performed the joints of the finger should be stable and have mobility. If these conditions are fulfilled, then only the surgery can be considered.

Though there are zero waiting lists in the hospital, it is recommended that the international patients book their surgery schedule in order to have any hassles in their medical journey. For this they can contact us via email or the phone numbers on the website and schedule their day in advance. In terms of payment, at least 30 % of the cost of surgery should be paid before flying down for the surgery and the outstanding can be cleared after coming down to the country.

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Shoulder Arthroscopy Introduction

Shoulder Arthroscopy

Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small incision (cut) in your skin.

The rotator cuff is a group of muscles and tendons that cover your shoulder joint. These muscles and tendons hold your arm in your ball and socket shoulder joint, and they help you move your shoulder in different directions. The tendons in the rotator cuff can tear when they are overused or injured.

Most people receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

First, your surgeon will examine your shoulder with the arthroscope. Your surgeon will:

• Insert the arthroscope into your shoulder through a small incision. The arthroscope is connected to a video monitor in the operating room.
• Inspect all the tissues of your shoulder joint and the area above the joint — the cartilage, bones, tendons, and ligaments.
• Repair any damaged tissues. To do this, your surgeon will make 1 to 3 smaller incisions and insert other instruments through them. A tear in a muscle, tendon, or cartilage will be fixed. Damaged tissue may need to be removed.

Your surgeon may do one or more of these procedures during your surgery:

• Rotator cuff repair: The edges of the muscles are brought together. The tendon is attached to the bone with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic. They do not need to be removed after surgery.
• Surgery for impingement syndrome: Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. Your surgeon may also cut a specific ligament, called the coracoacromial ligament, and shave off the under part of a bone. This under part of the bone is called the acromion. The spur can be a cause of inflammation and pain in your shoulder.

• Surgery for shoulder instability: If you have a torn labrum, the rim of the shoulder joint that is made out of cartilage, your surgeon will repair it. Ligaments that attach to this area will also be repaired. The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.

At the end of the surgery using the arthroscope, your incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.

Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues. Open surgery is a more complicated surgery.

Why the procedure is performed?

Arthroscopy may be recommended for these shoulder problems:

• A torn or damaged cartilage ring (labrum) or ligaments
• Shoulder instability, where the shoulder joint is loose and slides around too much or becomes dislocated (slips out of the ball and socket joint)
• A torn or damaged biceps tendon
• A torn rotator cuff
• A bone spur or inflammation around the rotator cuff
• Inflammation or damaged lining of the joint. Often this is caused by an illness, such as rheumatoid arthritis.
• Arthritis of the end of the clavicle (collarbone)
• Loose tissue needs to be removed
• Shoulder impingement syndrome, to make more room for the shoulder to move around

Before the procedure-

Always tell your health care provider what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. During the 2 weeks before your surgery:

• Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
• Ask your health care provider which drugs you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
• Tell your health care provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your health care provider or nurse for help. Smoking can slow down wound and bone healing.
• Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of your surgery-

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take your drugs your health care provider told you to take with a small sip of water.
• Your health care provider will tell you when to arrive at the hospital.

After the procedure-

Recovery can take anywhere from 1 to 6 months. You will probably have to wear a sling for the first week. If you had a lot of repair done, you may have to wear the sling longer.

You may take medicine to control your pain.

When you can return to work or play sports will depend on what your surgery involved. It can range from 1 week to several months.

For many procedures, especially if a repair is performed, physical therapy may help you regain motion and strength in your shoulder. The length of therapy will depend on the repair that was done.

Operation-

You will have a general anaesthetic, and will be asleep for the whole operation.

The arthroscope is a telescope about as wide as a pen, connected to a television. The operation is called an arthroscopy.

The surgeon will insert the arthroscope through one or two tiny half inch (about 1.2cm) cuts around your shoulder. He will use it to look at the inside of your shoulder and the tendons over the shoulder. The cuts will be closed with stitches, clips, or paper tapes. You will be in hospital for one night or so after the operation.

At home-

You cannot drive whilst your arm is in a sling. If you were driving before the arthroscopy, you will be able to drive within a few days of leaving hospital.

How soon you can return to work depends on your job. If you are working now, you should be able to return to work 7 to 10 days after your operation.

Recovery from shoulder arthroscopy-

The recovery depends on what type of surgery is performed. One of the problems with shoulder arthroscopy is that the procedure hurts much less than open shoulder surgery, and therefore patients may tend to do too much, too soon. It is very important that you only perform activities that your surgeon recommends following a shoulder arthroscopy. Even though your shoulder may feel fine, you need to allow time for repaired tissues to adequately heal. This is especially important for patients who have rotator cuff repairs and labral repairs.

Why Choose Joint Replacement Surgery Hospital India for Arthroscopic Shoulder Surgery?

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Our surgical unit is integrated with an onsite musculoskeltal ultrasnonography facility with very high diagnostic accuracy and it also comprises one of the finest shoulder rehab center. Th rehab compliments our surgical efforts to provide one of the most consistent and impressive results. We offer highly effective arthroscopic shoulder surgery at the most affordable prices. Many international patients have undergone their arthroscopic shoulder surgery in India due to reasonable rates.

Introduction

The Anterior or Medial Cruciate Ligament (ACL) is a cruciate ligament which is one of the four major ligaments of the human knee. In the quadruped stifle (analogous to the knee), based on itsanatomical position, it is referred to as the cranial cruciate ligament.

The ACL originates from deep within the notch of the distal femur. Its proximal fibers fan out along the medial wall of the lateral femoral condyle. There are two bundles of the ACL-the anteromedial and the posterolateral, named according to where the bundles insert into the tibial plateau. The ACL attaches in front of the intercondyloid eminence of the tibia, being blended with the anterior horn of the lateral meniscus. These attachments allow it to resist anterior translation and medial rotation of the tibia, in relation to the femur.

Anatomy-

The bone structure of the knee joint is formed by the femur, the tibia, and the patella. The ACL is one of the four main ligaments within the knee that connect the femur to the tibia.

The knee is essentially a hinged joint that is held together by the medial collateral (MCL), lateral collateral (LCL), anterior cruciate (ACL) and posterior cruciate (PCL) ligaments. The ACL runs diagonally in the middle of the knee, preventing the tibia from sliding out in front of the femur, as well as providing rotational stability to the knee.

The weight-bearing surface of the knee is covered by a layer of articular cartilage. On either side of the joint, between the cartilage surfaces of the femur and tibia, are the medial meniscus and lateral meniscus. The menisci act as shock absorbers and work with the cartilage to reduce the stresses between the tibia and the femur.

Causes-

This mostly happens amongst the sportsmen and this has lead to the invention of very successful operating techniques. The Anterior or Medial Cruciate Ligament or ACL are tough bands of tissue that connect the ends of bones together, located in the center of the knee and are stretched between the femur and the tibia. The main role of this ligament is to keep the tibia from advancing in relationship to the femurin position and rotation. A muscular compensation is only possible just to a certain limit. This instability by an ACL rupture can lead to consequence a risk of meniscuses and cartilage lesions.

Once ruptured it looses its mechanical qualities, even if the fragments are brought together and sutured. A natural tendon taken from the knee itself must be used and is known as ligamentoplasty.

Symptoms-

Though the symptoms following an ACL tear vary, swelling of the knee joint and a feeling of insecurity and instability of the knee when trying to change direction on the knees. Coming to a quick stop and difficulty in walking down a slope are the common other indications. Though the pain from the initial injury will usually be gone after two to four weeks, but the knee may still feel unstable.

Diagnosis-

Physical examination is the best way to diagnose a ruptured or deficient ACL. Though swelling is an indicator, aspirating or draining the fluid is another way to check. If blood is found when draining the knee, there is a greater chance of a torn ACL. A cartilage injury can also be indicative through this test.

Other methods that are used are the Lachman test, the pivot-shift test and the anterior drawer test. During these tests any excess motion or unexpected movement of the tibia relative to the femur is an indicator to ligament damage. An MRI is the most accurate way to diagnose a damaged or torn ACL.

Nonsurgical treatment-

In nonsurgical treatment, progressive physical therapy and rehabilitation can restore the knee to a condition close to its pre-injury state and educate the patient on how to prevent instability. This may be supplemented with the use of a hinged knee brace. However, many people who choose not to have surgery may experience secondary injury to the knee due to repetitive instability episodes.

Surgical treatment is usually advised in dealing with combined injuries (ACL tears in combination with other injuries in the knee). However, deciding against surgery is reasonable for select patients. Nonsurgical management of isolated ACL tears is likely to be successful or may be indicated in patients:

• With partial tears and no instability symptoms
• With complete tears and no symptoms of knee instability during low-demand sports who are willing to give up high-demand sports
• Who do light manual work or live sedentary lifestyles
• Whose growth plates are still open (children)

Surgical treatment-

Before any surgical treatment, the patient is usually sent to physical therapy. Patients who have a stiff, swollen knee lacking full range of motion at the time of ACL surgery may have significant problems regaining motion after surgery. It usually takes three or more weeks from the time of injury to achieve full range of motion. It is also recommended that some ligament injuries be braced and allowed to heal prior to ACL surgery.The patient, the surgeon, and the anesthesiologist select the anesthesia used for surgery. Patients may benefit from an anesthetic block of the nerves of the leg to decrease postoperative pain.

The surgery usually begins with an examination of the patient’s knee while the patient is relaxed due the effects of anesthesia. This final examination is used to verify that the ACL is torn and also to check for looseness of other knee ligaments that may need to be repaired during surgery or addressed postoperatively.

If the physical exam strongly suggests the ACL is torn, the selected tendon is harvested (for an autograft) or thawed (for an allograft) and the graft is prepared to the correct size for the patient. After the graft has been prepared, the surgeon places an arthroscope into the joint. Small (one-centimeter) incisions called portals are made in the front of the knee to insert the arthroscope and instruments and the surgeon examines the condition of the knee. Meniscus and cartilage injuries are trimmed or repaired and the torn ACL stump is then removed.

In the most common ACL reconstruction technique, bone tunnels are drilled into the tibia and the femur to place the ACL graft in almost the same position as the torn ACL. A long needle is then passed through the tunnel of the tibia, up through the femoral tunnel, and then out through the skin of the thigh. The sutures of the graft are placed through the eye of the needle and the graft is pulled into position up through the tibial tunnel and then up into the femoral tunnel. The graft is held under tension as it is fixed in place using interference screws, spiked washers, posts, or staples. The devices used to hold the graft in place are generally not removed.

Variations on this surgical technique include the “two-incision,” “over-the-top,” and “double-bundle” types of ACL reconstructions, which may be used because of the preference of the surgeon or special circumstances (revision ACL reconstruction, open growth plates).

Before the surgery is complete, the surgeon will probe the graft to make sure it has good tension, verify that the knee has full range of motion and perform tests such as the Lachman’s test to assess graft stability. The skin is closed and dressings (and perhaps a postoperative brace and cold therapy device, depending on surgeon preference) are applied. The patient will usually go home on the same day of the surgery.

Rehabilitation-

The goals for rehabilitation of ACL reconstruction include reducing knee swelling, maintaining mobility of the kneecap to prevent anterior knee pain problems, regaining full range of motion of the knee, as well as strengthening the quadriceps and hamstring muscles.

The patient may return to sports when there is no longer pain or swelling, when full knee range of motion has been achieved, and when muscle strength, endurance and functional use of the leg have been fully restored.

The patient’s sense of balance and control of the leg must also be restored through exercises designed to improve neuromuscular control.4 This usually takes four to six months. The use of a functional brace when returning to sports is ideally not needed after a successful ACL reconstruction, but some patients may feel a greater sense of security by wearing one.

Why Choose Joint Replacement Surgery Hospital India for Anterior or Medial Cruciate Ligament (ACL) Surgery?

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Since the ACL does not heal, the ligament needs to be replaced or reconstructed. We have an experienced surgical team and fully equipped operation theatre facility with excellent infrastructure for the post operative care and rehabilitation. The Anterior or Medial Cruciate Ligament Reconstruction (ACLR) Surgery helps restore the stability and function of the knee to allow return to your previous level of activity. The surgery for ACL uses an arthroscopically assisted technique which has proven to be quite effective.

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