Orthopedic surgery or orthopedics (or orthopaedics) is the stream of medicine concerned with conditions and treatment involving the human musculoskeletal system. Orthopedic surgeons implement both surgical and nonsurgical means to treat musculoskeletal trauma, degenerative diseases, sports related injuries, infections, tumors and congenital deformities.
Some of the different branches of orthopedic are:
* Pediatric orthopedics
* Orthopedic trauma
* Hand surgery
* Shoulder and elbow surgery
* Musculoskeletal oncology
* Total joint reconstruction or arthroplasty
* Foot and ankle surgery
* Spinal surgery
* Surgical sports medicine
Using arthroscopic techniques in Singapore has been particularly relevant for injured patients. Arthroscopy was first used in the early 1950s by Dr. Masaki Watanabe of Japan to undertake minimally invasive cartilage surgery and reconstruction of torn ligaments. Arthroscopy procedures helped patients recover from the surgery in a short span, rather than the weeks or months required by conventional, the so called 'Open' surgery. Knee arthroscopy is one of the very common procedures performed by orthopedic surgeons today. It is often combined with meniscectomy (the surgical removal of all or part of a torn meniscus) or chondroplasty (surgery of the cartilage). Many of the orthopedic procedures are nowadays performed arthroscopically.
The modern day total hip replacement was pioneered by Sir John Charnley in England in 1960s. Charnley discovered that joint surfaces can be replaced by metal or a very high density polyethylene implants cemented to the patient's bone with methyl methacrylate bone cement. Since Sir Charnley, there have been continuous improvements in the design, technique of joint replacement (arthroplasty) with other contributors like W. H. Harris whose team at Harvard college pioneered the uncemented arthroplasty technique with the patient's bone bonding directly to the hip implant.
Knee replacements using a somewhat similar technology were first tried out by McIntosh in rheumatoid arthritis patients. Later the same were used by Gunston and Marmor for osteoarthritis in 1970s. Uni-compartmental knee replacement is the kind in which only one weight-bearing surface of an arthritic knee is replaced. This is an alternative to a total knee replacement and used in a select patient population.
Different kinds of joint replacements are also available for other joints on a limited basis. Examples being the most notably shoulder, wrist, elbow, ankle, spine and even fingers.
Procedure of a Hip replacement Surgery :
-- The patient will arrive at the hospital usually on the day of surgery.
-- Then an anesthesiologist will sit with you to discuss various feasible options for anesthesia.
-- He may have a general anesthesia, in which you will be completely unconscious.
-- He may have regional anesthesia that will numb you from the waist down and keep you moderately sedated.
-- The doctor will expose your hip joint and dislocate the ball from the socket.
-- The surgeon removes the head from the femur (thigh bone) and reams away the surface of the socket.
-- The surgeon secures in place a prosthetic cup (socket) made of polyethylene.
-- The doctor then secures a metal head (ball) and stem into the femur either by a press fit or with bone cement.
-- The doctor places the ball into the cup and takes your new hip through a range of motion to ensure proper stability and mobility.
-- The doctor closes your incision, and you are brought to the recovery room.
Problems with Conventional Total Hip Replacement :
-- There can be Bone loss
-- There is Increased risk of dislocation
-- You might not able to squat or sit on the floor without the risk of dislocating the hip
-- Range of movement is less
-- The Patient cannot safely indulge in sporting activities
-- It is seen that Revision Surgery difficult
-- It Feels less like a normal natural hip
-- There is also Possibility of change in leg length after surgery
After the Procedure:
-- The patient will stay in the hospital for 4-7 days.
-- The first night after surgery you will be confined to bed with a wedge-shaped pillow between your legs to keep the new hip joint in place.
-- A tube which is placed in the new hip joint during surgery to drain any fluid or blood likely will be removed the next day.
-- If the patient is having trouble urinating, another tube will likely be placed in your bladder.
-- Usually the patient will begin physical therapy the day after surgery, and within days you can walk with a walker, cane, or crutches
Symptoms in which You should Contact the Doctor Immediately after the Surgery :
-- The Patient becomes short of breath or have difficulty breathing.
-- The Patient has pain or a crushing sensation in your chest.
-- The Patient might feel heart is racing or beating irregularly.
-- He develops a fever.
-- There is increasing redness and warmth along the incision site , there ia an Infection or drainage of fluid from the place where the Incision is done .
-- His calf, thigh, or hip becomes unusually swollen, warm, red, or painful.
-- If he develop problems or symptoms and cannot reach your doctor, go to the nearest emergency department for immediate consultation.
Other orthopedic treatments available in Singapore :
Slipped disc surgery
Shoulder replacement surgery
Knee replacement surgery
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