Advanced Joint Surgery
Medical services in advanced joint surgery encompass a range of procedures and treatments. They involve diagnosing and evaluating joint conditions through medical history review, physical examination, and imaging. Preoperative planning is done to develop personalized treatment plans, while minimally invasive techniques are utilized to reduce tissue damage and promote faster recovery. Joint replacement surgeries replace damaged joint surfaces with prosthetic components, and computer-assisted navigation systems aid in precise implant alignment. Revision surgeries address complications or joint replacement failure. Rehabilitation programs and postoperative care help with healing and function restoration, and regular follow-up appointments monitor progress and address concerns. Consulting with an orthopedic surgeon is crucial to receive specialized and individualized care for joint conditions.
Hip Replacement
Hip replacement surgery, also known as total hip arthroplasty, involves the removal of damaged sections of the hip joint and the insertion of artificial components typically made of metal, ceramic, and durable plastic. This prosthetic joint aims to alleviate pain and enhance function. When hip pain significantly hampers daily activities and non-surgical interventions prove ineffective, hip replacement surgery may be considered. The primary cause for requiring hip replacement is arthritis-related damage.
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Hip joint damage can arise from various conditions, potentially necessitating hip replacement surgery. Osteoarthritis, a degenerative condition, erodes the protective cartilage covering the bone ends within the joint, leading to pain and restricted mobility. Rheumatoid arthritis, an autoimmune disease, triggers inflammation that can damage the joint's cartilage and underlying bone, causing joint deformities. Osteonecrosis, resulting from inadequate blood supply to the hip joint, often due to injury or fracture, may lead to bone collapse and deformity. In cases where hip pain persists despite pain medication, worsens during movement even with assistive devices, disrupts sleep, hampers stair climbing, or impairs rising from a seated position, hip replacement surgery may be considered as an option for relief.
Hip dysplasia is a condition characterized by a shallow acetabulum (socket) in the pelvis, which fails to properly support the femoral head (ball-shaped bone) at the top of the thigh bone. While individuals with hip dysplasia are typically born with the condition, symptoms often manifest in adulthood. If left untreated, hip dysplasia can lead to osteoarthritis and may eventually necessitate a hip replacement.
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Common signs of hip dysplasia include increasing groin pain with activity, limping, a sensation of catching, snapping, or popping in the hip, reduced range of motion, and difficulty sleeping on the affected hip. Additionally, hip dysplasia can contribute to other hip injuries such as labral tears, especially in women. When hip dysplasia is identified as the underlying cause of a labral tear, comprehensive treatment is provided to address both conditions and minimize the risk of reinjury.
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Diagnosis of hip dysplasia involves advanced imaging tests like MRI and 3-D CT scans to accurately assess the condition. Treatment plans are then tailored to alleviate pain, correct deformity, and preserve long-term hip joint structure and function. Non-surgical approaches are initially attempted, but if symptoms persist, surgical interventions like periacetabular osteotomy (PAO) or Ganz osteotomy may be recommended. PAO involves reorienting the hip socket to enhance femoral head coverage, particularly effective for shallow dysplastic hips.
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Following surgery, patients typically require crutches for approximately two weeks and gradually transition to bearing weight at around four weeks. Normal activities can typically be resumed between two to four months after surgery, depending on the underlying cause of hip dysplasia. The comprehensive care provided by specialists at the Penn Hip Preservation Center ensures thorough evaluation, accurate diagnosis, and effective treatment for individuals with hip dysplasia and related conditions.
Dysplastic Hips
Knee Replacement
Knee replacement, also known as knee arthroplasty, is often referred to as knee "resurfacing" since it primarily involves replacing the surface of the bones rather than the entire joint.
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The damaged cartilage surfaces at the ends of the femur (thighbone) and tibia (shinbone) are removed, along with a small amount of underlying bone. Metal components are positioned to recreate the surface of the joint, replacing the removed cartilage and bone. These metal parts may be either cemented or press-fit into the bone. In some cases, the undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. However, not all surgeons choose to resurface the patella, as it depends on individual circumstances. A medical-grade plastic spacer is inserted between the metal components. This spacer creates a smooth gliding surface, facilitating movement within the joint.
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The decision to undergo total knee replacement surgery should be made collaboratively between you, your family, your primary care doctor, and your orthopedic surgeon. Your doctor may refer you to an orthopedic surgeon for a comprehensive evaluation to determine if you could benefit from this surgical intervention.
A unicondylar knee replacement, also known as a partial knee replacement, is an alternative to total knee replacement specifically for patients with osteoarthritis that is localized to one compartment of the knee joint. In the past, knee replacement surgery was primarily performed on elderly individuals. However, advancements in implants and surgical techniques have expanded the eligibility for unicondylar knee replacement, allowing more osteoarthritis patients to benefit from it.
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Partial knee replacement is commonly used to treat osteoarthritis, a condition that affects approximately 30% of world population. Osteoarthritis is characterized by the deterioration of cartilage within the knee joint, leading to bone-on-bone contact and subsequent discomfort.
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During a unicondylar knee replacement, only the damaged portion of the knee cartilage is replaced with a prosthesis, in contrast to a total knee replacement that involves addressing the entire knee joint. This targeted approach helps preserve healthy tissue and may result in a quicker recovery and improved overall function.
Unicondylar Knee Replacement
Shoulder Arthroplasty
Total shoulder replacement is a complex surgical procedure that involves the replacement of the shoulder joint with artificial components.
Shoulder replacement is a suitable option for individuals experiencing pain due to arthritis or severe fractures/breaks in the shoulder. Arthritis occurs when the cartilage on the ends of the bones deteriorates, leading to bone-on-bone contact within the joint. This can be caused by factors such as fractures, rheumatoid disease, torn rotator cuff tendons, or general wear and tear over time. In such cases, an artificial shoulder or shoulder replacement can provide relief by replacing the damaged joint with prosthetic components.
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The shoulder joint is a ball and socket joint consisting of the humeral head (the ball) and the socket, which is part of the shoulder blade. Ligaments and the rotator cuff tendons hold the ball in the socket. During shoulder replacement surgery, the damaged ball is replaced with a metal ball attached to a stem. The stem is inserted into the humerus, and in some cases, cement may be used to secure it. The socket may also be replaced with a plastic piece, which is typically fixed to a groove in the socket using cement. The decision to replace the socket depends on the severity of arthritis in the shoulder and the integrity of the rotator cuff tendons.
Ankle replacement is a surgical procedure used to treat ankle arthritis by replacing damaged bone and cartilage with prosthetic implants. The prosthesis used in a total ankle replacement consists of three components. The tibia is fitted with a titanium metal component, the talus is connected to a cobalt-chrome piece, and a polyethylene (plastic) implant is positioned between the two. The goal of ankle replacement surgery is to alleviate pain caused by arthritis while preserving joint mobility and function.
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Ankle replacement surgery is recommended for patients who have exhausted nonsurgical treatment options and continue to experience significant pain and swelling due to ankle arthritis. Nonoperative approaches, including physical therapy, ankle braces, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections, are typically the initial course of treatment. However, if these methods fail to provide adequate relief, ankle replacement surgery may be considered as a viable option to address the persistent symptoms of arthritis in the ankle joint.
Ankle Arthroplasty
What you need to do before surgery
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To prepare for your surgery, it's important to discontinue all unnecessary medications and support pills, such as aspirin, hormonal drugs, vitamins, and birth control, at least two weeks prior to your scheduled surgery. Additionally, you should avoid substances that may increase bleeding. If you are receiving ongoing treatment for heart conditions, hypertension, thyroid disorders, or diabetes, please inform us of your situation.
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The healthier you are before surgery, the faster your recovery time will be. It's crucial to avoid smoking and alcohol for at least three days before your surgery and consume mainly fruits and vegetables to promote speedy recovery.
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On the day of surgery, please remove any jewelry, hearing aids, contact lenses, makeup, and other accessories that may be on your body. Comfortable clothing is recommended for the day of surgery.
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Depending on the procedure you have chosen, it will be performed under either local anesthesia with sedation or general anesthesia. You will be required to fast for up to eight hours prior to your surgery.
What you need to do after surgery
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From the moment you arrive at the airport, we will be with you every step of the way, providing guidance and support. Our team will ensure that you receive excellent care, assist you with communication, monitor your recovery, and oversee your after-surgery medication.
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It's normal to experience soreness and discomfort after surgery. We recommend that you get plenty of rest to help alleviate any discomfort.
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It's important to attend all of your scheduled check-ups and cleanings, as well as complete any medication given to you after surgery.
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To promote a speedy recovery and achieve optimal results, it's crucial to avoid smoking and alcohol consumption for at least four weeks following your surgery.