What is arthroscopic surgery?
Arthroscopic surgery is one of common orthopaedic procedures that is performed using small instruments and cameras. Here, through this orthopaedic surgeon visualizes, diagnoses and treats problems that occur within the joints.
Arthroscopic Knee Surgery –
How is Knee Arthroscopy performed?
Knee arthroscopy can be performed under general or local anaesthesia and is started by surgeon by creating 'portals' to gain access to knee joint. These portals are then placed in specific locations so as to minimize potential for injury to blood vessels, surrounding nerves and tendons.
One portal is used for placement of the camera into the joint and others are used for bringing to the injured part small instruments that are used for addressing the problem. The length of knee arthroscopy procedure depends on what is the specific requirement of the surgery. Post surgery, knee is wrapped in soft bandage.
What are the Rehab procedures for Knee Arthroscopic surgery?
Depending on type of surgery performed, doctor may/may not allow patients to place weight on affected leg. Here, physical therapist is brought in who assists in regaining motion as well as strength of joints. The total length of rehabilitation varies depending on the type of procedure performed at time of surgery.
What are the complications for Arthroscopic Knee Surgery?
With knee arthroscopy considered a low-risk surgical procedure, there might be some complications of arthroscopic knee surgery including:
· Infection
· Swelling
· Blood clots in leg
Arthroscopic Knee Surgery – ACL
What is Non-operative Care of ACL Surgery?
ACL tears do not always relate to requirement of surgery. Senior Orthopaedic Surgeon Dr. L. Tomar considers several important factors before undergoing ACL surgery. These include:
· Do patients regularly perform activities requiring functional ACL
· Do patients experience knee instability
Further, if ACL is not completely torn, ACL reconstruction surgery is not necessary. Patients may start feeling better within few weeks of injury but at the same time problems related to instability may persist.
What is the Surgery procedure for ACL Tear?
The surgery performed for ACL tear is called ACL reconstruction that includes reconstruction of the ligament using another tendon/ligament as a substitute for torn ligament. With many options for performing ACL surgery, the common ones include:
· Single bundle ACL reconstruction
· Double-bundle ACL reconstruction
What is the associated risks in ACL Tear Surgery?
The associated risks of ACL surgery include:
· Infection
· Persistent instability and pain
· Stiffness
· Difficulty to return to previous level of activity
What is Post-Surgical Rehab procedure for ACL?
Rehab following ACL surgery maintains focus on restoring motion and strength, thus improving stability of joints as well as in preventing future injuries. Though general guidelines are provided for ACL rehab, it is critically important for each of the patients who have undergone surgery to progress as their knee allows. Further, the support of experienced therapist and physician also helps in maintaining a proper guidance for the rehab.
Arthroscopic Knee Surgery – PCL
How to confirm PCL injury?
Initial part of diagnosis of PCL tear is done by knowing how injury happened. Other than this, specific manoeuvres performed by doctors also help in testing the function of PCL of which most reliable is posterior drawer test. Further, other diagnostic procedures include:
· X-rays
· MRIs
How are these diagnostics procedures helpful?
These are helpful in clarifying diagnosis and detecting other structures of knee including ligament injuries or cartilage damage that may be injured when a PCL tear is found. The tears are graded by severity of injury (from grade I to grade III) with the grade determined by extent of laxity which is measured during examination.
What is the treatment procedure for PCL Tear?
The initial treatment comprises of using crutches, ice and elevation that helps in subsiding the pain and swelling. Once the symptoms are brought down to normal, physical therapy is used for improving knee motion and strength. Surgeons recommend non-operative treatment for most grade I and grade II PCL tears.
For whom the surgical reconstruction for ACL is recommended?
As per Senior Orthopaedic Surgeon Dr. L. Tomar surgical reconstruction of PCL is recommended for:
Grade III PCL tears
· Multiple ligamentligaments
· Patients who cannot do usual activities because of persistent knee instability condition
Arthroscopic Knee Surgery – Meniscus Tear
What is the symptom for Meniscus Tear?
Individuals experiencing meniscus tear experience following primary symptoms:
· Pain and swelling
· Joint locking
Other than these, some of the other common symptoms are:
· Knee pain
· Swelling of knee
· Tenderness when pressing on meniscus
· Popping/clicking within knee
· Limited motion of the knee joint
· Diagnosis of Meniscus Tear
What is the diagnosis procedure for Meniscus Tear?
Any patient suffering from knee pain is evaluated for possible meniscus tear. For this, specific tests are performed by us that include:
· X-rays - For evidence of degenerative/arthritic changes to knee joint
· MRIs - For visualizing meniscus
What is the treatment procedure for Meniscus Tear?
Meniscus tear treatment depends on factors including:
· Type of tear
· Activity level of patient
· Response of patient to simple treatment measures
The surgical treatment done involves trimming torn portion of meniscus (meniscectomy).
Arthroscopic Shoulder Surgery – Rotator Cuff Tear
What is the Non-operative Treatment procedure for Rotator Cuff Tear?
Most of the rotator cuff tears can be successfully treated without the need of surgery. The non-operative treatment mode may include:
· Physical therapy
· Anti-inflammatory pain medication
· Cortisone injection
The primary goal of treatment is bringing reduction in inflammation and to strengthen uninjured muscles around shoulder for compensating torn muscles.
What is the Surgical Treatment procedure for Rotator Cuff Tear?
Some patients may require surgery as a treatment option for Rotator Cuff Tear. As per Senior Orthopaedic Surgeon Dr. L. Tomar the surgery is performed depending on factors like:
· Type of rotator cuff tear
· Patient's activity level
· Past treatments that have been attempted
With several surgical options available for treatment of rotator cuff tear, the exact type of surgery depends on factors like:
· Size and location of tear
· Surgeon's preference
· Activities patients want to resume after surgery
What is the After Surgery Rehab procedure for Rotator Cuff Tear?
Healing from surgery for rotator cuff tear is entirely dependent on patient. Here, they need to take necessary care to perform proper rehabilitation as well as also avoid activities that may injure healing tendons.
Arthroscopic Shoulder Surgery – Subacromial Decompression
What is the Surgery procedure for Subacromial Decompression?
After completion of diagnostic surgery, number of specialized "micro motorized" instruments are inserted into subacromial space and bone from underside of acromion is removed. The bone removal allows tendons of rotator cuff to get free and glide between humeral head and acromion without pinching on bone. The completion of arthroscopic procedure leads to closure of surgical incisions with single suture. This is followed by dressing and sling applied and patient sent to recovery room.
What is the Post Operation care for Subacromial Decompression Surgery?
Discharge is given usually within an hour or two of the surgery with the patients receiving instructions regarding:
· Care that need to be taken of surgical area
· Pain medication prescription
As in case of non-operative management of subacromial impingement syndrome, Physical therapy should remain as mainstay of the treatment. Further, the patients should also not be discouraged if pre-operative pain does not improve after the surgery is conducted. The complete curing symptoms may take up to three months to show.
However, in majority of the patients, they can see dramatic improvement in symptoms soon after the surgery.
What are the Alarming Situations after Subacromial Decompression Surgery?
Patients should immediately consult their doctors in cases of:
· Temperature above 100 degrees
· Pain not controlling by prescribed medication
· Tingling and numbness in arm/hand
Arthroscopic Shoulder Surgery – Bankart Repair
What is the procedure for Bankart Repair Surgery?
Generally maximum numbers of cases are successfully treated using this procedure. As per Senior Orthopaedic Surgeon Dr. L. Tomar this procedure is carried out using small incisions around shoulder and requires an overnight Hospital stay only. Some of the steps involved in this procedure include:
· Mobilisation of glenoid labrum and shoulder ligaments
· Preparation of glenoid edge
· Insertion of drill holes to glenoid edge for bone anchor placement
· Passage of sutures through glenohumeral and labrum ligament
· Insertion of anchors into glenoid and repairing glenohumeral and glenoid labrum ligaments to edge of glenoid
What is the Post-Operative Recovery procedure for Bankart Repair Surgery?
The process of post recovery involves:
· Shoulder sling for around 6 weeks
· Simple activities to be followed during first 6 weeks that includes avoiding shoulder elevation above 90 degrees and external rotation beyond 30
degrees
· 6 weeks post operation the sling can be removed (on advice of Surgeon) and operated arm can be mobilised freely
· Starting of shoulder strengthening exercises at this stage
· 12 weeks post operation stretching exercises for the shoulder start
· Avoiding contact sports until 9 months of post surgery period
What are the complications that may happen in Bankart Repair Surgery?
Some complications may arise (in 1-2% of cases) that include:
· Infection
· Stiffness
· Nerve injury
· Other issues
Arthroscopic surgery is one of common orthopaedic procedures that is performed using small instruments and cameras. Here, through this orthopaedic surgeon visualizes, diagnoses and treats problems that occur within the joints.
Arthroscopic Knee Surgery –
How is Knee Arthroscopy performed?
Knee arthroscopy can be performed under general or local anaesthesia and is started by surgeon by creating 'portals' to gain access to knee joint. These portals are then placed in specific locations so as to minimize potential for injury to blood vessels, surrounding nerves and tendons.
One portal is used for placement of the camera into the joint and others are used for bringing to the injured part small instruments that are used for addressing the problem. The length of knee arthroscopy procedure depends on what is the specific requirement of the surgery. Post surgery, knee is wrapped in soft bandage.
What are the Rehab procedures for Knee Arthroscopic surgery?
Depending on type of surgery performed, doctor may/may not allow patients to place weight on affected leg. Here, physical therapist is brought in who assists in regaining motion as well as strength of joints. The total length of rehabilitation varies depending on the type of procedure performed at time of surgery.
What are the complications for Arthroscopic Knee Surgery?
With knee arthroscopy considered a low-risk surgical procedure, there might be some complications of arthroscopic knee surgery including:
· Infection
· Swelling
· Blood clots in leg
Arthroscopic Knee Surgery – ACL
What is Non-operative Care of ACL Surgery?
ACL tears do not always relate to requirement of surgery. Senior Orthopaedic Surgeon Dr. L. Tomar considers several important factors before undergoing ACL surgery. These include:
· Do patients regularly perform activities requiring functional ACL
· Do patients experience knee instability
Further, if ACL is not completely torn, ACL reconstruction surgery is not necessary. Patients may start feeling better within few weeks of injury but at the same time problems related to instability may persist.
What is the Surgery procedure for ACL Tear?
The surgery performed for ACL tear is called ACL reconstruction that includes reconstruction of the ligament using another tendon/ligament as a substitute for torn ligament. With many options for performing ACL surgery, the common ones include:
· Single bundle ACL reconstruction
· Double-bundle ACL reconstruction
What is the associated risks in ACL Tear Surgery?
The associated risks of ACL surgery include:
· Infection
· Persistent instability and pain
· Stiffness
· Difficulty to return to previous level of activity
What is Post-Surgical Rehab procedure for ACL?
Rehab following ACL surgery maintains focus on restoring motion and strength, thus improving stability of joints as well as in preventing future injuries. Though general guidelines are provided for ACL rehab, it is critically important for each of the patients who have undergone surgery to progress as their knee allows. Further, the support of experienced therapist and physician also helps in maintaining a proper guidance for the rehab.
Arthroscopic Knee Surgery – PCL
How to confirm PCL injury?
Initial part of diagnosis of PCL tear is done by knowing how injury happened. Other than this, specific manoeuvres performed by doctors also help in testing the function of PCL of which most reliable is posterior drawer test. Further, other diagnostic procedures include:
· X-rays
· MRIs
How are these diagnostics procedures helpful?
These are helpful in clarifying diagnosis and detecting other structures of knee including ligament injuries or cartilage damage that may be injured when a PCL tear is found. The tears are graded by severity of injury (from grade I to grade III) with the grade determined by extent of laxity which is measured during examination.
What is the treatment procedure for PCL Tear?
The initial treatment comprises of using crutches, ice and elevation that helps in subsiding the pain and swelling. Once the symptoms are brought down to normal, physical therapy is used for improving knee motion and strength. Surgeons recommend non-operative treatment for most grade I and grade II PCL tears.
For whom the surgical reconstruction for ACL is recommended?
As per Senior Orthopaedic Surgeon Dr. L. Tomar surgical reconstruction of PCL is recommended for:
Grade III PCL tears
· Multiple ligamentligaments
· Patients who cannot do usual activities because of persistent knee instability condition
Arthroscopic Knee Surgery – Meniscus Tear
What is the symptom for Meniscus Tear?
Individuals experiencing meniscus tear experience following primary symptoms:
· Pain and swelling
· Joint locking
Other than these, some of the other common symptoms are:
· Knee pain
· Swelling of knee
· Tenderness when pressing on meniscus
· Popping/clicking within knee
· Limited motion of the knee joint
· Diagnosis of Meniscus Tear
What is the diagnosis procedure for Meniscus Tear?
Any patient suffering from knee pain is evaluated for possible meniscus tear. For this, specific tests are performed by us that include:
· X-rays - For evidence of degenerative/arthritic changes to knee joint
· MRIs - For visualizing meniscus
What is the treatment procedure for Meniscus Tear?
Meniscus tear treatment depends on factors including:
· Type of tear
· Activity level of patient
· Response of patient to simple treatment measures
The surgical treatment done involves trimming torn portion of meniscus (meniscectomy).
Arthroscopic Shoulder Surgery – Rotator Cuff Tear
What is the Non-operative Treatment procedure for Rotator Cuff Tear?
Most of the rotator cuff tears can be successfully treated without the need of surgery. The non-operative treatment mode may include:
· Physical therapy
· Anti-inflammatory pain medication
· Cortisone injection
The primary goal of treatment is bringing reduction in inflammation and to strengthen uninjured muscles around shoulder for compensating torn muscles.
What is the Surgical Treatment procedure for Rotator Cuff Tear?
Some patients may require surgery as a treatment option for Rotator Cuff Tear. As per Senior Orthopaedic Surgeon Dr. L. Tomar the surgery is performed depending on factors like:
· Type of rotator cuff tear
· Patient's activity level
· Past treatments that have been attempted
With several surgical options available for treatment of rotator cuff tear, the exact type of surgery depends on factors like:
· Size and location of tear
· Surgeon's preference
· Activities patients want to resume after surgery
What is the After Surgery Rehab procedure for Rotator Cuff Tear?
Healing from surgery for rotator cuff tear is entirely dependent on patient. Here, they need to take necessary care to perform proper rehabilitation as well as also avoid activities that may injure healing tendons.
Arthroscopic Shoulder Surgery – Subacromial Decompression
What is the Surgery procedure for Subacromial Decompression?
After completion of diagnostic surgery, number of specialized "micro motorized" instruments are inserted into subacromial space and bone from underside of acromion is removed. The bone removal allows tendons of rotator cuff to get free and glide between humeral head and acromion without pinching on bone. The completion of arthroscopic procedure leads to closure of surgical incisions with single suture. This is followed by dressing and sling applied and patient sent to recovery room.
What is the Post Operation care for Subacromial Decompression Surgery?
Discharge is given usually within an hour or two of the surgery with the patients receiving instructions regarding:
· Care that need to be taken of surgical area
· Pain medication prescription
As in case of non-operative management of subacromial impingement syndrome, Physical therapy should remain as mainstay of the treatment. Further, the patients should also not be discouraged if pre-operative pain does not improve after the surgery is conducted. The complete curing symptoms may take up to three months to show.
However, in majority of the patients, they can see dramatic improvement in symptoms soon after the surgery.
What are the Alarming Situations after Subacromial Decompression Surgery?
Patients should immediately consult their doctors in cases of:
· Temperature above 100 degrees
· Pain not controlling by prescribed medication
· Tingling and numbness in arm/hand
Arthroscopic Shoulder Surgery – Bankart Repair
What is the procedure for Bankart Repair Surgery?
Generally maximum numbers of cases are successfully treated using this procedure. As per Senior Orthopaedic Surgeon Dr. L. Tomar this procedure is carried out using small incisions around shoulder and requires an overnight Hospital stay only. Some of the steps involved in this procedure include:
· Mobilisation of glenoid labrum and shoulder ligaments
· Preparation of glenoid edge
· Insertion of drill holes to glenoid edge for bone anchor placement
· Passage of sutures through glenohumeral and labrum ligament
· Insertion of anchors into glenoid and repairing glenohumeral and glenoid labrum ligaments to edge of glenoid
What is the Post-Operative Recovery procedure for Bankart Repair Surgery?
The process of post recovery involves:
· Shoulder sling for around 6 weeks
· Simple activities to be followed during first 6 weeks that includes avoiding shoulder elevation above 90 degrees and external rotation beyond 30
degrees
· 6 weeks post operation the sling can be removed (on advice of Surgeon) and operated arm can be mobilised freely
· Starting of shoulder strengthening exercises at this stage
· 12 weeks post operation stretching exercises for the shoulder start
· Avoiding contact sports until 9 months of post surgery period
What are the complications that may happen in Bankart Repair Surgery?
Some complications may arise (in 1-2% of cases) that include:
· Infection
· Stiffness
· Nerve injury
· Other issues