Orthopaedic
Introduction
Orthopaedic surgery is an operative procedure performed by a qualified orthopaedist specialist or orthopaedic surgeon to treat musculoskeletal problems affecting the bones, joints, muscles, tendons and ligaments caused by accident, trauma, injury or chronic condition. Orthopaedic surgery can also correct problems of the nervous system linked to the spinal column, as well as congenital defects and musculoskeletal issues caused by aging.
Patients are usually referred by general practitioners to an orthopaedic specialist for treatment of accident or injury such as spine or limb deformity, bone fracture, chronic arthritis, among many others. Orthopaedists can treat very young patients, usually for congenital deformities such as scoliosis or clubbed foot, young athlete needing an arthroscopic operation, down to senior patients with mobility issues. Practically anyone with problems in the bones, muscles and connective tissues can seek the expertise of an orthopaedic expert to alleviate the symptoms and for appropriate treatment.
Types of Orthopaedic Surgeries
There are dozens of kinds of orthopaedic surgical operations performed by surgeons everyday. Some of the most common are the following:
Arthroscopy - an advanced minimally invasive technique for diagnosing and repairing damaged joint tissue performed with the use of probes, thin tubes and small instruments.
Bone fracture repair - surgical procedures for treating broken ankle, leg, hip, ribs, arm, collarbone (virtually any bone for that matter); involves incisions through which the bones are fixed and aligned, often with the use of screws or splints.
Arthroplasty - a range of techniques for replacing whole joints such as the hip or the knees, such as for chronic cases of arthritis; this involves replacing diseased joints with prosthetic rubbery material to restore movement in the joints
Damaged tissue repair - a surgical procedure where torn ligaments or tendons are reconstructed through grafts taken elsewhere in the body
Corrective surgery - a range of procedures performed to correct misalignment and deformities of the limbs or spine to improve and optimize movement; among usual procedures are fusion surgery (welding together two parts to form a single bone) and osteotomy (cutting and reposition of the bone).
Risk Factors
Risk factors include:
- Orthopedic surgeries do not generally entail major risks and complications. Surgeons are properly trained to avoid potential difficulties which might occur during an intervention, as well as to efficiently correct such problems if they appear. However, some of the risks and complications which may accompany an orthopedic surgical in procedure.
- Postoperative infections: In order to avoid this complication, you will be administered antibiotics before, during and after the surgery. If you have an ongoing infection (throat, urinary, dental etc.), it is highly recommended to treat it prior to the intervention, as it can reach your joint and a late infection could develop months or even years following joint replacement surgery.
- Blood clots: They may occasionally appear after a knee replacement surgery. Blood clots can be avoided with appropriate medication and physical exercise.
- Blood vessel damage: This complication may appear if blood vessels located in close proximity of the implant are affected during the procedure.Blood effusion in the joint
- Implant failure: Implant failure includes improper placement of the prosthesis, dislocation (if muscles are too weak), limited range of motion, malfunction, gradual detachment from the bone and wear or break of the prosthesis’s components.
- Nerve damage or neuroparalysis: It might appear if nerves close to the implant are severely damaged during the intervention.
- Allergic reactions: The patient might experience an allergic reaction to the cement used to fix the implant or to the metal components of the prosthesis (titanium, cobalt, chromium etc.).
Procedure
Procedure include:
- orthopaedic surgeons provide an extensive range of treatments. However, before a definitive treatment is suggested, patients are made to undergo extensive testing to determine the nature of the bone or muscle problem. The orthopaedist will ask you about the history of the disorder, previous treatment sought, and other pertinent information related to your condition. You may be asked to undergo tests such as x-rays, computed tomography (CT) scan, magnetic resonance imaging (MRI), blood tests or myelograms to elucidate the extent of the problem in detail.
- Depending on the diagnosis, you may be recommended to take medication, undergo surgery, perform rehabilitative or alternative therapies, or go through a combination of these treatment methods. Surgery is often the last resort if your ailment does not respond to other non-surgical treatment. If surgery is deemed the best option, preoperative procedures such as routine diagnostic testing will be performed prior to your operation.
- All orthopaedic surgeries, including the common operations mentioned above, are performed under local anesthesia (often with sedation) or general anesthesia. For major operations such as knee replacement, patients may be asked to donate some blood (or prepare) in case transfusion may be needed during the operation.
- After the procedure, a plaster cast or sling is often placed to protect the area repaired. The amount of time required for recovery depends on the procedure performed, although patients are often able to go home within a few days. However, it usually takes a few to several weeks for the bones and ligaments to regain full strength. As such, you will be advised to refrain from subjecting the injured area to rigorous activities unless it is already fully recovered. The usual rule of thumb for injuries of the bone, for instance, is that the period it takes to fully regain strength is about the same period for the fracture to completely heal. This means that if you have been in a cast for four weeks, you will need another four weeks to regain strength.
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Aside from time for complete healing, most of orthopaedic surgeries require rehabilitation to fully restore motion and function in all affected parts. As such, orthopaedic surgeons work hand-in-hand with physical therapists as well as occupational therapists who assist patients in enhancing their range of motion and getting back to their daily activities. The length of time needed and frequency for rehabilitation will depend on the surgery performed and severity of the condition. Total hip replacement surgery, for instance, require rehabilitation for at least six months.
The majority of patients who go through orthopaedic surgery fully-recover from their injuries. However, the degree of success is dependent on one's general health, age, medical problem and innate willingness to comply with therapy post-surgery.
Range of Treatment Cost
| Procedure | Duration In Hospital | Min Cost ₹(INR) | Max Cost ₹(INR) |
|---|---|---|---|
| Total Knee Replacement | |||
| TKR (Unilateral) - PFC Sigma Implant | 7 | 320000 | 500000 |
| TKR (Unilateral) - Hi Flex Implant | 7 | 300000 | 600000 |
| TKR (Unilateral) - Uni Knee | 5 | 307260 | 500000 |
| TKR (Bilateral) - PFC Sigma Implant | 9 | 550000 | 770000 |
| TKR (Bilateral) - RPF | 9 | 570000 | 870000 |
| Total Hip Replacement / Resurfacing | |||
| THR (Unilateral) - Routine 1 | 7 | 280000 | 350000 |
| THR (Unilateral) - Routine 2 | 7 | 350000 | 550000 |
| THR (Unilateral) - ASR | 7 | 390000 | 700000 |
| THR (Unilateral) - Unipolar ASR | 7 | 405000 | 600000 |
| THR (Unilateral) - Proxima | 7 | 429000 | 629000 |
| THR (Bilateral) - Routine 1 | 9 | 470000 | 670000 |
| THR (Bilateral) - Routine 2 | 9 | 550000 | 850000 |
| THR (Bilateral) - ASR | 9 | 700000 | 900000 |
| THR (Bilateral) - Unipolar ASR | 9 | 720000 | 820000 |
| THR (Bilateral) - Proxima | 9 | 700000 | 900000 |
| Ankle Replacement Surgery | 5 | 420000 | 620000 |
| Elbow Replacement Surgery | 5 | 420000 | 620000 |
| Total Hand Surgery | 5 | 210000 | 350000 |
| Ankle Replacement | Depends upon the treatment | 1800000 | 2500000 |
| Shoulder Replacement | |||
| Single (Including Implant) | 7 | 490000 | 750000 |
| Double (Including Implant) | 14 | 900000 | 1200000 |
| Arthroscopic | |||
| Menisectomy | Depends upon the treatment | 450000 | 650000 |
| Shaving of cartilage | Depends upon the treatment | 500000 | 700000 |
| Ligament Reconstruction - ACL, PCL | Depends upon the treatment | 1100000 | 1400000 |
| Ankle Arthroscopy | Depends upon the treatment | 540000 | 640000 |
| Knee Arthroscopy | Depends upon the treatment | 590000 | 790000 |
| Elbow Arthroscopy | Depends upon the treatment | 500000 | 800000 |
| Shoulder Arthroscopy | Depends upon the treatment | 600000 | 900000 |
| Hip Arthroscopy | Depends upon the treatment | 500000 | 700000 |
| Tendon Repair | Depends upon the treatment | 540000 | 750000 |
