Orthopedics

1) Increase your upper body strength to enable you to use mostly your arms after surgery.

2) Lose weight, this will reduce the weight strain on your new hip.

3) Stop taking any anti-inflammatory medications or aspirins at least 10 days prior to surgery, discuss this with you doctors.

4) Stop smoking as early as you can before Hip Resurfacing surgery.

5) Rent or purchase special equipment to make your home life comfortable when you return from your surgery: some long-handled devices to avoid bending more than 90 degrees, elevated toilet seat, good chair cushions, and a shower chair.

6) It is generally safe to travel within a week of your surgery, discuss this with your doctors. Take advantage of the wheelchair services offered at the airports.

The recovery period following Hip Resurfacing surgery will vary depending on the patient. In general, the orthopaedic surgeon will encourage the patient to use the new joint soon after the operation. Usually the patient will be standing and beginning to walk within several days. The patient will normally use crutches or cane for a period of time. The patient will also learn to do appropriate exercises to move and strengthen the joint.

With the development of hip resurfacing surgery, many advantages exist for hip resurfacing surgery compared to the traditional full hip replacement.

• Smaller Device: It is smaller than a traditional total hip device. With a smaller device the recovery is quicker.

• Reduction in the Bone removed: Hip Resurfacing literally means retreading the bone with a metal prosthesis. Therefore, there is a significant decrease in the amount of bone removed. Only a very small amount of bone needs to be removed. The femur (thigh) bone does not need to be damaged.

• Decrease in Complication Rates: Hip surgery greatly reduces the disruption of the joint, therefore providing a shorter recovery period and a decrease in some complications. There is a dramatic reduction of dislocation rates and a reduction to the problem of lengthening or shortening of the leg.

• Shorter Recovery Time: Most hip patients are walking 4 hours after surgery. Total time spent in hospital is approximately 2 days. Within 2 weeks, most patients are back driving, resuming most of their normal activities. Hip resurfacing dramatically improves quality of life. For total hip replacement most people remain in hospital for 5-6 days and remain off driving for 6 weeks.

• More stable hip: Because hip replacements use a smaller ball (to allow thicker plastic for longer wear) the range of movement is less and the dislocation rate greater (up to 1 in a 25). The hip resurfacing has a dislocation rate of less than 1 in 500 because the ball is not removed and remains the same size as the patient’s original hip. The range of movement is greater. Because the hip is more stable and feels more normal, the recovery is quicker and the function generally better.

• Ease of Revision: Because hip resurfacing does not damage the thigh bone, when they fail they can be more easily converted to a total hip replacement. This is important in young patients who wear out total hip replacements, because it saves this procedure as a later option when they are older.

There are risks with any surgical procedure. Hip Resurfacing Surgery being a relative new procedure, it requires a well trained orthopedic surgeon. The person considering Hip Resurfacing surgery should tell the orthopedic surgeon about any additional medical conditions that might complicate the surgery. The patient’s regular doctor should be told of the proposed surgery. Before the operation, the patient should discuss with the anesthetists the type of anaesthetic and possible risks involved.

Hip Resurfacing surgery is approximately 2 hours of set up and operating time. There is approximately 1 hour in the recovery room after surgery. Hip resurfacing surgery requires the removal of the diseased bone only.

The pain usually decreases rapidly during the first few weeks, but the hip continues to improve for 12 months or even longer. The swelling is due to alterations in fluid return up the limb and will gradually diminish but may take many months. Mobilization helps, as does elevation when not exercising.

Mild and moderate exercise is beneficial, but over-exercise is painful. Be guided by the hip symptoms. Generally the more active you are, the better, but within your tolerance.

Driving is an individual matter. Some people regain their co-ordination and reflexes quickly and others take longer. Following hip surgery, you should avoid driving for at least 2-3 weeks, depending on your progress.

During the first days after surgery, you should learn to walk stairs with a physiotherapist at the hospital. The pace at which you regain agility on stairs depends on individual traits.

High heels should be avoided for the first few months. Otherwise, there are no rules regarding shoes.

Arthroscopy is a surgical procedure during which the internal structure of a joint is examined for diagnosis and treatment of problems inside the joint.

During arthroscopic surgery, either general, spinal, or a local anesthesia will be given depending on the condition. A small incision of the size of a buttonhole is made through which the arthroscope is inserted. Other accessory incisions will be made through which specially designed instruments are inserted. After the procedure is completed, the arthroscope is removed and incisions are closed.

Some of the possible complications after arthroscopy include infection, phlebitis (clotting of blood in veins), excessive swelling, bleeding, blood vessel, or nerve damage and instrument breakage.

It may take several weeks for the puncture wounds to heal and the joint to recover completely. A rehabilitation program may be advised for a speedy recovery of normal joint function. You can resume normal activities and go back to work within a few days. You may be instructed about the incision care, activities to be avoided, and exercises to be performed for faster recovery.

Getting a full range of motion, strength, and flexibility back after surgery usually takes time. That is where pre-operative exercise, education, and post-operative physical therapy programs come in, to ensure you are physically and emotionally prepared for surgery and to maximize your recovery after surgery.

The ACL is a ligament in the middle of the knee that connects the tibia (shinbone) to the fibia (thigh bone).

A key feature of a serious ACL injury is a feeling of instability (i.e. that the knee may collapse from underneath you).

Not always. Some people are able to function normally without surgery, so long as they have physiotherapy, but others need reconstructive surgery no matter how much physiotherapy they have. Whether or not you have your ACL reconstructed also depends on how active you are, and how your injury impacts on your daily and sporting activities.

Early surgical intervention to repair a torn ACL is not recommended in the vast majority of cases, and physiotherapy for at least four to six weeks is almost always recommended first in the amateur sportsperson. This approach has the advantage of allowing any other associated injuries to settle, and any inflammation to subside. Taking time to have physiotherapy also gives the patient and physiotherapist the opportunity to assess whether they feel there is a genuine need for reconstruction.

It is widely accepted that the best substitute for one’s own ACL is to use an autologous graft, which is a term used to describe another tissue, such as a ligament or tendon, taken from your own body. The autologous graft most usually used is that of the hamstrings. These are a large group of muscles in the back of the thigh that run from the hips down to the knees. The hamstrings most commonly used are that of semitendinosus and gracilis. Obviously, many other techniques exist, although the choice of graft will depend on your surgeon’s experience and familiarity with the preferred procedure.

Normally orthopedic surgeons does not prescribe a brace after a Laminectomy, unless you are also having a fusion performed.

While everyone’s pain tolerances and conditions differ, most recover from this type of surgery with a 4 to 6 week time period.

Most patients can return to driving 10 – 14 days after a laminectomy.

As a normal part of the post-operative period, we encourage you to get up and walk the morning after your surgery. You may walk as much as you can tolerate.