Orthopedic Surgery Abroad

What is Knee Replacement Surgery?

With total knee replacement surgery, the goal is to improve your quality of life by making you more mobile so that you can lead the more active life that you used to have. More than 90% of individuals who undergo total knee replacement experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement will not make you a super-athlete or allow you to do more than you could before you developed knee problems. Activities that you can reasonably expect to be able to do after surgery are:

  • Recreational walking
  • Swimming
  • Golf
  • Driving
  • Light hiking
  • Recreational biking
  • Ballroom dancing
  • Stair climbing

One of the most important orthopedic surgical advances of the twentieth century, knee replacement was first performed in 1968. Improvements in surgical materials and techniques since then have greatly increased its effectiveness. Approximately 300,000 knee replacements are performed each year in the United States alone, making it one of the most common surgeries.The results are impressive.

The procedure itself takes approximately 1-2 hours. Your orthopaedic surgeon will remove the damaged cartilage and bone and then position the new metal and plastic joint surfaces to restore the alignment and function of your knee. Special surgical instruments are used to precisely measure an optimal fit of the implant.

Knee Replacment Surgery Prosthesis -- How Long Will the Knee Implant Last?

The longevity of the implant depends on many factors such as the patient's weight, the patient's activity level, and the presence or absence of disease in other joints of the lower extremities. Implants can last ten to fifteen years and even longer. New techniques allow for an implant to be removed and replaced, but our goal is to be able to implant a prosthesis that will last the patient a lifetime without revision.

Knee Replacement Surgery Results

Results are impressive and gratifying to both the patient and the surgeon. Most patients are pain-free and able to bend their knees from 90° to 100°, resuming daily activities without restriction. The remarkable results of total knee replacement are due to patient determination, the surgeon's skill, and the bioengineers' well-designed implants and instruments. Continued advances in the field can be expected to result in continuing success in the future.

What is Partial Knee Replacement Surgery?

Partial knee replacement, also called a unicondylar knee replacement, is a surgery that may be considered for treatment of osteoarthritis of the knee joint if the arthritis in the knee is confined to a limited area. Partial knee replacement is an alternative to Total Knee Replacement and can be recommended for patients who are:

  • Older than 55 years
  • Not obese
  • Relatively sedentary
  • Have intact ligaments (specifically the ACL)

Several studies have demonstrated the advantages of this treatment option over the more conventional Total Knee Replacement. These include: a smaller scar, less pain, a potentially shorter hospital stay, a faster rehab and recovery time, and possibly a greater range of motion when compared to standard total knee procedures. In addition, because more of the knee remains untouched, patients often report that the knee feels more normal to them.

Shortly after hospital admission, you will meet your orthopedic surgeon who will examine you and talk to you about your knee replacement procedure. Routine blood tests are performed on all pre-operative patients; chest X-rays and electrocardiograms are usually obtained as well.

Partial Knee replacement surgery details

The surgery takes about one and a half hours. An incision is made over the knee and the worn out cartilage is exposed. The rough edges of the end of the femur (a bone that goes from the hip to the knee) and top of the tibia (a bone that goes from the knee to the ankle) are cut flat, cleaned, and then the unicompartmental device is cemented in place. The devices used at our partner hospitals are western brand ones such as Biomet Oxford II

Partial knee replacement recovery

After your surgery, you can expect to start rehab almost immediately. Patients usually stay in the hospital for three nights but putting weight on your knee is usually permitted immediately. Patients can expect to walk with crutches or a walker, and to take the knee through a near-full range of motion on the day after surgery. Exercise training will depend on the age and activity level of the patient and are customized to that patient's abilities. Most patients are able to walk unassisted between one and two weeks after the surgery and able to drive between two and four weeks after the surgery.

What is Hip Replacement Surgery?

The purpose of total hip surgery is to remove the two damaged and worn parts of the hip joint - the hip socket, acetabulum, and the ball, femoral head - and replace them with smooth, artificial implants called prostheses, which will help make the hip strong, stable and flexible again.

The hip implant is comprised of four parts that work together to restore the original function of your ball-and-socket joint:

  • A metal hip stem that is inserted into the top of your thighbone
  • A metal cup which holds the cup liner
  • A cup liner which holds the femoral head
  • The femoral head or ball which is attached to the hip stem and inserted into the liner to form the ball-and-socket joint

Hip implants are not one-size-fits-all, therefore your orthopedic surgeon will choose the right hip implant for your body. Your surgeon will determine which design options will work best together to restore accurate leg length, while minimizing risks of dislocation and premature implant wear.

What is Hip Resurfacing Surgery?

Hip Resurfacing is a type of hip replacement which replaces the two surfaces of the hip joint.

The procedure is very bone conserving as the head of the femur is retained. Instead of removing the head completely, it is shaped to accept an anatomically sized metal sphere. There is no large stem to go down the central part of the femur and the surface of the acetabulum (the socket) is also replaced with a metal implant, which is press fit directly into the bone.

The resurfacing components are made of 'As Cast' cobalt chrome which is finely machined to produce a very high quality surface with a low friction finish, hence low wear. The BIRMINGHAM HIP Resurfacing has the largest independently verified clinical history of any resurfacing device available today.

This operation is primarily intended for use in people who are in need of a hip replacement at a younger age and therefore are likely to be more active. There are certain causes of arthritis of the hip which mean that this technique cannot be used - namely those which have resulted in extreme deformity of either the head of the femur or the acetabulum.

For people needing a replacement under the age of 55, regular consideration is given for this procedure. People aged between 55 and 65 who are very active and otherwise fit may also be suitable and this will be determined by their bone quality and activity level.

Patients who need to have hip replacements under the age of 50 - 55, assuming they have normal life span, have a very high chance that the conventional hip replacement will wear out and need to be replaced during their lifetime - hence the resurfacing procedure offers potentially significant advantages in this group.

What is Rotator Cuff Repair?

In order to repair a torn rotator cuff, the surgeon reattaches the damaged tendon (or tendons) to the upper arm (humerus).

This surgery involves several key steps:

  • In order to gain access to the injured rotator cuff, the surgeon makes a two- to three-inch incision in the shoulder, then cuts through the deltoid muscle. If an arthroscopic surgery can be performed, the incision will only be the size of a buttonhole.
  • The surgeon removes any scar tissue that has built up on the tendon.
  • The surgeon carves a small trough at the top of the upper arm, then drills small holes through the bone.
  • Finally, the surgeon sews the tendon to the bone, with the sutures going through the tiny holes in the upper arm. (Sometimes a surgeon will use permanent anchors to attach the tendon to bone).

Rotator Cuff Repair

During this operation, the surgeon also removes bone spurs and releases any ligaments that are pressing on the tendon. If a bursa is inflamed, the surgeon excises or removes it. The surgeon also may remove a small portion of the acromion to make sure the repaired rotator cuff has enough room to move. The surgery will take anywhere from 30-90 minutes and can be done on an outpatient basis, but our partner hospitals oversees will usually keep you admitted in the hospital for a couple of days. Afterwards, the patient's arm is placed in a sling. With time, healing occurs, as scar tissue connects the tendon to bone. Because tendons receive such poor blood supply, this is a slow process.