Orthopedic Surgery – Farrer Park Hospital
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What is Orthopedic Surgery?
​Orthopedic surgery is the medical specialty involving the surgical treatment of problems that develop in the bones, muscles, joints, and ligaments of the human body. It may also deal with some problems of the nervous system, such as those that may arise from entrapment syndromes, injury or dengeneration of the spine. 
Conditions

​Torn Meniscus
The C-shaped discs that cushion the knee are called meniscius and can be damaged when you twist or rotate your knee, such as rapid pivoting or sudden stops and turns. Even kneeling, squatting or lifting something heavy can sometimes lead to a torn meniscus or it could be due to aging and degeneration of the knee secondary to deformities like bowleggedness.

Damaged Knee Cartilage
Wear and tear over the years can damage the cartilage in your knee joint. Symptoms include swelling and pain while walking, and climbing or going down stairs.

Hip joints are usually damaged by diseases such as some types of arthritis that attacks such joints, and osteonecrosis, which is caused by less blood flow to be supplied to the hip joint, resulting in bone collapse or deformity. If you have a damaged hip joint, you may experience:
 
- Pain despite taking medication;
- Pain that worsens when walking;
- Pain that keeps you awake at night;
- Difficulty in taking the stairs;
- Problems when rising from a seated or squatting position.
 
During hip replacement surgery, your orthopedic surgeon removes diseased and damaged bone and cartilage, and implants an artificial socket into your pelvic bone to replace the damaged socket. The top of your thigh bone is also replaced with an artificial ball and stem. They can be cemented or uncemented depending on age and quality of the bone.
 
Upon recovery, you will be able to walk without pain and perform your daily activities without discomfort. However it is advisable that squatting is avoided due to the risk of dislocation of the ball.
 
Spinal stenosis is narrowing of the spinal canal that puts pressure on the spinal cord. You may feel pain, numbness, or weakness in your legs, back, neck and arms. This is worse when walking and climbing down stairs or slopes and relieved by sitting.
 
Scoliosis is a sideways curvature of the spine that occurs often around the time of puberty. It may be caused by conditions such as cerebral palsy and muscular dystrophy, although the majority is of unknown cause. Most cases of scoliosis are mild, but some children develop spine deformities that grow more severe.
Signs and symptoms of scoliosis may include tilted shoulders and unbalanced hips. The spine may also curve so much that it reduces the space within the chest, making it difficult for the lungs to function properly, causing breathlessness during exertion.
 
Spinal deformities can be caused by accidents or diseases such as spondylolisthesis (spinal slippage), ankylosing spondylitis (a form of rheumatoid arthritis in the male), cerebral palsy and multiple wedge fractures from osteoporosis.
Treatments
​In most cases, rest, ice compresses and medications can relieve the pain and torn meniscus will heal on its own. In some circumstances, however, a torn meniscus requires surgical repair or removal as many do not heal well.
 
Arthroscopy is the surgical procedure to remove or repair or replace a damaged meniscus. It can be done by arthroscopic surgery (keyhole surgery) as an outpatient procedure so you need not be warded in hospital. To recover fully, you may need to perform exercises to strengthen the knee and regain motion.
 
For damaged knee cartilage, the partial knee (unicondylar) resurfacing procedure can be done using a robotic arm, which allows surgeons to treat only the damaged part of the knee, thus  ensuring that the surrounding healthy bone and ligaments are spared. It is ideal for those suffering knee pain from unicompartmental osteoarthritis, but are not suitable for those who require a total knee replacement for tricompartmental osteoarthritis. Before surgery, you may have pain in your knees even when you resting.
 
Total knee replacement surgery aims at relieving pain and replacing knee joints extensively damaged through injury or by diseases with metallic artificial joints. During knee replacement, a surgeon removes damaged bone and cartilage from your 3 parts comprising the knee and replaces it with an artificial joint made of metal alloys, cushioned with high-grade plastics. You will be able to walk normally after some physiotherapy. However there may be limitation of movement depending on how stiff the knee is before operation.
 
After a thorough examination for spinal stenosis, your orthopedic surgeon might suggest a course of physiotherapy or at worst spinal surgery such as decompression laminectomy. This is a surgical procedure to relieve pressure on the spinal cord or spinal nerve roots caused by spinal stenosis. It involves surgery to your back to remove the offending bone spurs and thickened ligaments or protruding discs that is causing the pressure on the spinal nervese. Laminectomy can also be used to treat spinal injuries, slipped discs, and spinal tumors.
 
For scoliosis, wearing a brace can stop the smaller curves from worsening. There is also surgery to straighten severe cases of scoliosis. The spinal fusion surgical procedure involves surgeons connecting multiple bones in the spine (vertebra) together, so they do not move independently while straightening the curve. Pieces of bone or a bone-like material could be placed between the vertebrae. Metal rods, hooks, screws or wires will be implanted to hold that part of the spine straight and still while the old and new bone material fuses together. If done in the young, some shortening of stature is expected.
 
Spinal deformities may be repaired by surgery known as spinal corrective surgery. It is commonly performed as part of a spinal reconstructive procedure to correct the misalignment of the spine. A part of the vertebrae is cut and removed to realign the spine in a proper position. Surgery may also be needed for patients whose deformity is worsening or who have malalignments that affect the nerves.
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