Orthopedic surgery is the branch of surgery concerned with medical conditions related to the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical treatments to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.
The minimally invasive knee replacement (MIS-TKR) is a relatively new technique (started 10 years ago) aiming to the quick recovery of the patient who is being operated for osteoarthritis of the knee. The main advantages of the MIS-TKR compared to the conventional knee replacement are:
- Less pain.
- Less bleeding.
- Quicker mobilization (within 12 hours postoperatively).
- Length of stay in the hospital only 3 – 4 days.
- Reduced skin incision (8 – 10 cm) and less damage to the surrounding soft tissues (patella tendon, quadriceps, patella etc).
- No need for prolonged physiotherapy.
- The patient can abandon the walker or the crutches within 10 – 15 days postoperatively.
Around 80% of the patients who undergo MIS-TKR can walk unaided 3 – 4 days postoperatively.
- Quicker return to the usual activities (driving, stairs etc).
The MIS-TKR is becoming more and more popular the last years and the patients can enjoy a few benefits compared to the conventional technique. However, it remains a very challenging and difficult technique which should be applied only by experts. Our physicians has a great experience in minimally invasive knee and hip surgery and their centers applying modern rapid recovery protocols and guarantee excellent results and superior quality of services.
Minimally invasive hip replacement
The minimally invasive hip replacement (MIS-THR) is also successfully applied in our collaborative centers and the advantages are the same as the MIS-TKR.
Procedure: When you arrive for your procedure you will be prepped for surgery and administered anesthesia. During the procedure your surgeon will remove diseased cartilage and bone first. They will also remove the ball and socket of the hip.
The ball and socket of the hip is then replaced with a metal ball and stem that is positioned inside the femur. Cement is used to attach this prosthesis to the femur. In some cases the prosthesis is placed without cement. This prosthesis has microscopic pores that connect to the femur bone over time.
Duration: 1-3 hours
Hospital stay: 4-10 days
Recovery: When the procedure is complete you will be in recovery for about 2 hours. You will be bandaged for about 24-48 hours. IV antibiotics will be administered to prevent infection, along with pain medication to ensure your comfort level. Blood thinners will be given to prevent clot formation.
Dislocation is common after total hip replacement. Certain measures will be taken to prevent this for the first 6 to 8 weeks after the procedure. These Measures include:
- placing one pillows between your legs
- avoiding crossing your legs
- not bending forward 90 degrees
- using a higher toilet seat
- not letting your knees and/or toes turn in
- You will start physical therapy shortly after your procedure and continue with it for several weeks. Exercise will be prescribed for you to do independently and with a physical therapist. You will also use crutches or a walker for several weeks.
Your physical therapy regimen should include:
- Returning to sitting, standing, and walking up and down stairs
- Exercises several times a day that are designed to restore movement
- Exercises several times a day that are designed to strengthen your hip joint
- A graduated walking program that begins in your home and moves outside
- A walking program that slowly and steadily increases your mobility and endurance
- Returning to other normal household activities
Risks: As with any surgery, there are certain risks and complications associated with total hip replacement including:
- Blood Clots
- Extra Bone Formation
- Shortening of the Leg
- Arterial Injury
- Allergy to Prothesis
- Allergy to Anesthesia
- Fat Embolism
It is important to discuss any concerns you have about the risks and complications with your surgeon before and after your total hip replacement.
Procedure: Before surgery can begin either general anesthesia or epidural anesthesia must be administered. Once the anesthesia has taken effect the knee will be prepped for surgery. It will be scrubbed with an antiseptic liquid.
During the procedure the knee is flexed at a 90 degree angle using a special device that holds the lower leg and foot in place. The surgeon will make an incision. The damaged bone and cartilage will be removed first.
Bone will be removed from other areas to ensure proper fit of the artificial knee. The front and back of the femur will be removed. The top surface of the tibia will be removed along with the back of the knee cap.
To complete the procedure the surgeon will repair the attached muscles and ligaments. They will close the wound with sutures and wrap the knee in a sterile bandage. A tube may be placed to the wound to drain properly.
Duration: 1-3 hours
Hospital stay: 7-10 days
Recovery: Many patients feel dizzy, sick or tired immediately following their procedure. This is perfectly normal and is a result of the anesthesia. Hospital staff will closely monitor the patient for complications during this time.
Risks: Knee replacement surgery is rather common. However, that does not mean it is risk free. It is important to discuss the risks of total knee replacement before you consent to surgery. The most common risks would include:
- Blood Clots
- Blood Loss
- Hip Dislocation
Procedure: Your surgery will begin with the administration of either a regional or anesthetic block or general anesthesia. The surgical area will be prepped with an antiseptic liquid and sterile draping. Then, the surgeon will make an incision so they have access to the shoulder joint.
The surgeon will remove the humeral head or the ball of the joint first. They will also clear away any bones spurs by filing them off the socket. They will examine the glenoid socket. If it is severely damaged it will be removed or replaced, otherwise it will be repaired and left in place.
The artificial parts used in a shoulder joint replacement are made from metal and plastic. Surgeons use bone cement to secure the artificial parts in their desired positions. Once everything has been placed tendons are reattached to the bones and the surgical incision is closed.
Hospital stay: 2-4 days
Recovery: After the procedure you will be moved to recovery first. You will be monitored carefully until you recover from your anesthesia. Then, you will be moved to a regular hospital room for the remainder of your stay.
You will be given IV pain medication for the first 24 hours following your procedure. A drain will be placed in your shoulder, but removed within 24 hours. Your arm will be in a sling and your shoulder will wrapped in bandages.
During the first few days of your hospital stay a continuous motion device will be used to apply gentle movement to the shoulder joint. A physical therapist will prescribe you some flexibility and strength exercises to do during your recovery.
Upon leaving the hospital the following precautions should be taken:
- Keep the incision dry
- Check incision for swelling or drainage
- Avoid use of deodorant
- Avoid lifting heavy objects
- Follow discharge instructions
Risks: As is with any surgery there are certain risks associated with shoulder joint replacement. The following is a list of the most common risks and complications:
- Loosening of the artificial joint
- Arterial damage
- Nerve Damage
Any concerns you have regarding these risks and complications before or after your procedure should be discussed with your physician.