Orthopaedics & Joint Replacement Overview
Orthopaedic care has progressed by leaps and bounds and new techniques for better mobility as well as pain management are constantly cropping up. The Department of Orthopaedics & Joint Replacement at the Gleneagles Global Health City offers world-class services and is striving continuously to provide patients with the best treatment techniques. The department’s surgeons have received their training from the best specialists in the world which is evident in their skills.
Patients on arrival will be taken care of immediately, and their condition will be diagnosed by the doctors in the orthopaedic department in conjunction with imaging services. A personalized treatment plan will then be worked out to ensure quick recovery and to regain mobility. Patients’ welfare is always a top priority.
Joint replacement surgeries too are performed here by highly qualified and experienced doctors. Patients have always been happy and satisfied with the surgical outcome.
Why Choose Us for Your Orthopaedic Care?
State-of-the-art Surgery Centre
Technology is constantly advancing and we stay up-to-date with it always. We never compromise on our equipment as we understand that our doctors’ experience and expertise is most effective and beneficial to our patients when used with the best technology and infrastructure. Our surgery centre is comparable with the best in the world and patients can rest assured that they will receive the finest care.
24×7 Comprehensive Orthopaedic Care
Day or night, patients can avail our services whenever they are in need as we are open to serve 24 hours a day, 7 days a week. At the Gleneagles Global Health City’s Orthopaedic Department, patients can always enter with the confidence that they will never be turned away.
Highest Level of Infection Control Protocols
All our staff are well-versed with the infection control protocols to be implemented and understand the need for adhering to them uncompromisingly. The fact that surgical outcomes and the patient’s welfare are dependent on the compliance to these protocols are well-entrenched in the minds of our staff and they accordingly stick to the infection control protocols with no deviation whatsoever.
Ultra-Modern Facilities
Not only are our operation theatres fitted with the best and most advanced instruments, our wards too are well-equipped and offer the patient the best comfort and care.
An Experience You Can Trust
Patients come to us apprehensive and scared, and we understand and empathize with their condition. All doubts and questions are answered with patience and we make sure the patient is well-informed about the treatment procedure that we intend to carry out.
Salient features
Complex Primary Hip and Knee Replacement Surgery
For relief from hip and knee pain due to arthritis, hip and knee replacement surgeries are suggested. Here, the hip and knee joints are replaced with implants. These surgeries are usually done for arthritic pain management in the final stages or following a fracture. We are skilled at these surgeries and patients are always happy with the mobility and the freedom they get from pain after these surgeries.
Revision Hip and Knee Replacement
While the results from primary hip and knee replacement are very good, with time, a second surgery might be needed to replace with new prostheses. This is called a revision hip/knee replacement. This procedure is more complex than a primary hip replacement and is done for the patient to regain mobility.
Oxinium (Ceramic) Total Knee Replacement
Here, oxinium (which is an alloy) is the preferred material of choice to be used as an implant in relatively young patients (50-60 Years of age), as it has increased resistance to scratching and friction is also less. With the use of an implant made of oxinium, patients get an implant that can last longer.
Complex Pelvic and Acetabular Fracture Fixation
Acute pelvic fractures are usually the result of high velocity road accidents and may be life threatening. Multi-disciplinary approach has saved many lives. Reconstruction of these fractures & acetabular fractures require special skill and training. Our doctors are experts in these.
Reverse Shoulder Replacement
For patients with massive rotator cuff injuries and those who suffer from shoulder damage due to arthritis, this surgery is suggested. As the ball and socket implants’ position is reversed, this surgery gets the name reverse shoulder replacement. We have performed this surgery successfully with satisfactory and long-lasting results.
Conditions we treat
Hip
Hip Arthritis
When patients complain of hip pain, arthritis is one of the most significant causes. With arthritis, the pain is progressive (with time the pain increases). Treatment options include physical therapy, pain killers, corticosteroid injections and surgery. The patient must refrain from high-impact activities that worsen the condition. This may become crippling if left untreated.
Osteonecrosis
Being a condition that can cause excruciating pain, it is a result of the blood supply to the femur being stopped. Cells need oxygen to survive, and in its absence they die. The hip joint, as a result, may suffer damage leading to chronic arthritis.
Hip Fractures
One of the more common hip conditions that is prevalent among the older population (above 60 years), its incidence increases further in the over 70 years age category. In older people, hip fractures can result from just a trivial fall, but the good news is if the person is otherwise healthy, with timely treatment and rehabilitation, a normal life can be restored.
Other Painful Hip Conditions
- Bursitis: Liquid sacs called bursae are present in between tissues. Their purpose is to facilitate ease of movement and reduce friction. When this bursa gets infected, or inflamed a condition called bursitis results, which is characterized by hip pain.
- Tendinitis: Bones and muscles are attached to each other by tendons. Due to overuse, the tendons might get sore, resulting in hip pain.
- Muscle Strain: The hip joint is reinforced by muscles and tendons. When these are overworked, they get strained, causing hip pain.
- Hip Labral Tear: The hip joint is cushioned by a layer of cartilage around the socket (Acetabulum). This is called the labrum. The labrum helps in keeping the thigh bone and socket together. A tear in this cartilage causes hip pain.
- Cancer: Cancers can either originate in the hip, or they can spread to the hip from other parts. These can cause hip pain or result in fractures (Pathologic Fractures).
Knee
Knee Arthritis
The knee is the most common joint that is afflicted with arthritis. Arthritis can affect any joint in the body, causing pain and inflammation. When the knee is affected, daily activities like walking become painful. Arthritis can be controlled with proper treatment.
Fractures
In the front part of the knee, is the kneecap (patella). An injury to the kneecap in the form of an accident or a fall can cause it to crack or break. This is called a kneecap fracture and the pain from this fracture is felt immediately. Tibia and femoral fractures are major injuries and can lead to serious problems, if not attended to properly. They require immediate treatment.
Deformity Correction
Misalignment of the legs can occur due to conditions like knock knees and bow legs. In these conditions, the legs will not be straight and will look visibly deformed. The pressure borne by the knees in such cases will result in pain. Surgical correction can rectify this condition to relieve pain and give a better appearance as well.
Knee cap Pain (Patella Femoral)
Medically known as the patella femoral pain syndrome, the pain in this case can be felt anywhere around the kneecap. Being a condition common in teenaged girls, it prevents activities like running, climbing stairs, etc.,
Anterior Cruciate Ligament (ACL) Injury
The thigh bone and shin bone are connected by many ligaments. One sturdy ligament present inside the joint is called the anterior cruciate ligament. When this ligament tears (which mostly occurs during sporting activities) severe knee pain and inflammation will result. Treatment can vary as per the injury’s severity.
Other Painful Conditions and Instability
- Meniscus Tear: The knees are cushioned by cartilages called meniscus. This cartilage can tear when a sudden force acts to twist the knee. This condition is called a meniscus tear and can be treated either conservatively or surgically depending on the injury.
- Femoral Neuropathy: When the femoral nerve of the leg is affected by conditions like diabetes, arthritis, etc. it leads to the debilitation of the nerve. This can weaken the knees and lead to knee buckling.
- Plica Syndrome: Plica syndrome is an inflammation of the medial plica (abnormal band of tissue in the knee) which causes knee pain and buckling.
Shoulder
Arthritis
Shoulder arthritis is the wear out of the cartilage inside the shoulder joint. Manifesting as shoulder pain, stiffness in the shoulder and reduced range of movement of the shoulder, it can be treated by non-invasive as well as invasive techniques. Non-invasive methods include physical therapy, icing the area, and medications.
Fracture
The scapula, the clavicle, and the humerus are the bones that make up the shoulder. Any of these can sustain a break. While they all cause shoulder pain with swelling and reduced range of shoulder movement, they also have signs unique to each of them. X-rays, CT scans, and MRIs are used to diagnose the condition. Icing the area, physiotherapy, medicines and arm slings (to immobilize the area) might help. Surgery may be needed in some type of fractures only.
Shoulder Dislocation and Instability
The shoulder joint detaches from the socket, and as a result the shoulder becomes unstable. While genetic predisposition is a cause, other causes include injury and overuse. Frequent dislocations increase instability. Patients are advised to refrain from activities that might cause dislocation along with icing and pain medications. Surgery is necessary for recurrent dislocations.
Frozen Shoulder
Medically called adhesive capsulitis, frozen shoulder is the result of the connective tissue around the shoulder thickening and reducing movement. Diabetics and people whose shoulder movement is restricted (eg. Following injury) are more prone to frozen shoulder. Physiotherapy helps along with injections to alleviate pain. In very rare cases, surgery might be needed.
Rotator Cuff Tears
The rotator cuff refers to the muscles and tendons that play a key role in connecting the upper arm with the shoulder. Symptoms of rotator cuff tear are pain at night time and pain even when the shoulder is at rest. Carrying and lifting things might also cause pain. Performing the same motion repeatedly is a common cause of rotator cuff tear. Falls, injuries, etc. are other possible causes.
Other Painful Conditions
- Bursitis: The bursa (the sacs filled with fluid) around the shoulder that aid in movement get inflamed and cause shoulder pain.
Elbow
Fractures
The ulna is one of the bones in the forearm. The tip of the ulna (near the elbow) ends in the olecranon, which protrudes slightly and is unprotected by muscles and soft tissue. Hence, this part is susceptible to fractures and breaks/cracks relatively easily with a blow. Olecranon fracture can be treated with splint or surgery depending on the severity.
Dislocation
The radius, the ulna and the humerus form the elbow joint. When these three bones get displaced from the joint, it is called an elbow dislocation. Fall on an outstretched hand usually is the cause. Painful and visible to the naked eye, complete elbow dislocations are quite easy to diagnose. Partial dislocations will need a physical examination and diagnostic tests for confirmation.
Arthritis
Arthritis in the elbow could be osteoarthritis or rheumatoid arthritis. With osteoarthritis, reduction in the cushioning cartilage around the elbow joint causes the elbow bones to rub against each other. Injuries and overuse are the common causes.
Rheumatoid arthritis is an autoimmune condition wherein the body joints are attacked by the body’s own immune system. When both elbows are affected, rheumatoid arthritis is the usual cause.
Tennis Elbow, Golfer’s Elbow
Racquet sports like tennis, badminton, etc., which require a tight grip and swinging movement can exert a lot of pressure on the tendons on the outer part of the elbow. This condition is called a tennis elbow and it might cause pain while lifting objects, fisting the hand, raising the hand, etc. Golfer’s elbow is alike tennis elbow, except in this the tendons in the inner part of the elbow are affected. These can occur even in a person who does not play sports or games. Physical examination with imaging tests help confirm the conditions.
Other Painful Conditions
- Cubital Tunnel Syndrome: Constriction of the ulnar nerve in the elbow can cause pain, loss of sensation and weakness in the elbow.
- Ruptured Biceps Tendon: The biceps has tendons at both its ends with one tendon attaching to the shoulder and the other tendon attaching to the elbow. A trauma to the tendon can cause it to tear partially or completely resulting in a ruptured biceps tendon.
Hand and Wrist
Fractures
The bones of the hand and wrist may break due to road accidents, a bad fall, high-impact sports, etc. When the patient is already suffering from osteoporosis, the probability of sustaining a fracture is more. Immediate treatment is of importance as the bones might not heal properly otherwise. The symptoms include pain in the hand, swelling, and in some cases the hand is visibly deformed. A physical examination along with an x-ray is done for diagnosis. Surgery will be done under anaesthesia to realign the bones.
Arthritis
When arthritis affects the hand, performing daily activities might become difficult. Symptoms include pain which increases with hand movement. The pain is also more on waking up in the morning. As arthritis progresses, the pain also increases. X-rays, blood tests at times, are done for diagnosis. The condition’s severity as assessed on tests will determine the treatment. Treatment can be invasive or non-invasive. There are various surgical treatments too which can be done depending on individual conditions and joints involved.
Carpal Tunnel Syndrome
The median nerve runs through the arm, through the carpal tunnel in the wrist till the fingers. When this median nerve is compressed, the hands might experience a tingling sensation, or they might completely lack sensation. This is called the carpal tunnel syndrome, and it has many possible causes that range from diabetes and pregnancy to rheumatoid arthritis. What begins as a tingling sensation may aggravate to pain and the inability to hold objects properly. Early treatment is important for recovery. Treatment options include immobilizing the hand, performing stretching exercises, pain medication, and surgery as the last resort.
Trigger Finger
When bending the finger, the finger gets locked in bent position and straightens with an audible snap accompanied by pain. This is called trigger finger. Overuse of the fingers and hand, performing the same movement repeatedly and inflammation of the tendons can result in trigger finger. Pain on getting up in the mornings, pain while gripping objects and straightening fingers are the other symptoms. There are no specific tools to diagnose this condition; a physical examination is what will help the doctor in diagnosis. Rest, immobilization, physiotherapy, and pain medications will help treat the condition. Surgery when done for unresponsive individuals gives dramatic relief.
Other Painful Conditions
- Cubital Tunnel Syndrome: When the ulnar nerve is pinched, cubital tunnel syndrome might result. When the elbow is subjected to a lot of weight, this condition manifests. Surgical and non-surgical treatment options are available.
Musculoskeletal Tumors
Benign Tumours of the Bone
Just like in other parts of the body, tumours can form in the bones and muscles too. These tumours can be benign or malignant.
Benign tumours occur in any age. The tumour may be felt as a lump and may also be accompanied by pain. Sometimes, its presence is discovered accidentally while taking an x-ray for a fracture. The fracture may have been a result of the tumour’s growth. It is best to surgically remove the tumour.
Bone Metastasis
In bone metastasis, cancer from other parts of the body spreads to the bones. The cancer does not originate in the bone. When the cancer affects the bones, it can form small holes in the bone. As a result, the bone gets weakened. This is called osteolysis, and the possibility of fracture increases when bones are thus affected. Radiotherapy, chemotherapy, pain management and surgery are the treatment options.
Others
Pelvic and Acetabular Fractures
Usually sustained in an accident or because of a fall from height, pelvic and acetabular fractures require prompt treatment. For senior citizens though, even a relatively insignificant fall can result in this fracture if their bones are already weak. The complicated anatomy of the pelvis makes this a challenging condition to treat. The pelvis holds up the upper body, and the acetabulum refers to the part of the pelvis that connects to the femur. These fractures usually are accompanied by injury to the surrounding tissues and nerves. The surgeon will decide on a surgical or non-surgical option depending on individual conditions.
Bone Infection (Osteomyelitis)
When the bone is infected, either as a result of infection spreading from far away tissue or by infection originating in the bone itself, the condition is called osteomyelitis. In the latter case, a wound or open injury might expose the bone to germs and result in the condition. Fever with pain and inflammation at the site of infection are the usual symptoms. Smokers and diabetics are at an increased risk of contracting this condition, and hence they should take care to avoid cuts in feet, which may lead to osteomyelitis.
Geriatric Orthopaedics – Fragility Fracture
When a fracture is sustained by a fall from standing height or less, this is usually because the bones are already weak. This kind of fracture is called a fragility fracture and is common among older citizens. With a fragility fracture, surgical intervention is recommended so that the patient can regain mobility as quickly as possible. Quick recovery is all the more important as in some cases immobility can lead to various complications. Post-surgery, methods to prevent future fractures need to be implemented.
Periarticular Fractures
Fractures that occur in or in close proximity to a joint are called periarticular fractures. Extreme pain and inability to move are characteristic of these fractures. Treatment is complicated because of the anatomical nature of these fractures. Though they can occur anywhere in the body, parts of the leg are more common sites for these fractures. Since they are close to the joints, accurate treatment is necessary.
Periprosthetic Fractures
In a periprosthetic fracture, the bone breaks or cracks near the implant that has been placed already. These types of fractures are becoming increasingly common these days. They might be caused by weak bones, bone infection, and pressure on the bone. Women are more at risk than men.
Post-Surgical Problem Fractures (Malunion and Non-union)
In a malunion, the bone heals after a fracture, but its positioning is not right. As a result, the limb may seem twisted/ bent or reduced in length. When pain persists after fracture treatment, malunion is a possible cause. Surgical intervention may be required to correct it.
Non-union refers to the fractured part’s inability to mend. Even for months after the fracture, healing does not take place. For a fracture to heal well, it needs to be held in proper position with adequate blood supply. When blood supply is not enough, non-union can result.
Orthobiologics
Orthobiologics are substances that are found in the human body that promote healing. So, surgeons make use of these to enhance the healing process. Bone grafts, stem cells, platelet rich plasma, etc. are all examples of orthobiologics.