Total Hip Replacement
Hip pain is common. It can be caused by a variety of conditions such as wear and tear osteoarthritis, inflammatory arthritis, infection and previous trauma. These causes all result in a debilitating painful joint that is responsible for a significant reduction in quality of life. When arthritis is present the smooth lubricating surface of the joints wear away leaving painful bone on bone articulations. This can be unrelenting and often causes pain throughout the day with restless sleep. The treatment for most arthritic painful hips is joint replacement surgery.
In a Total Hip Replacement the damaged bone and cartilage is removed and replaced with prosthetic components, thereby allowing for smooth joint movement minimising pain. The vast majority of patients who undergo a hip replacement are extremely happy with this procedure and most report a very positive return to their daily activities of life.
The team at Ortho Specialist Centre will organise a personalised treatment plan based on your consultation and examination. The nonsurgical and surgical treatment options will be discussed together with the risks and benefits of each treatment method. This will enable an evidence based approach to your individual tailored condition.
Numerous surgical approaches are possible for performing a Total Hip Replacement. Our Surgeons are trained in the three most common approaches and will apply them to your specific situation. They include the minimally invasive anterior approach that does not require muscles to be cut during the surgery therefore enhancing early recovery and the traditional posterior and lateral approaches.
Our Surgeons regularly attend national and international conferences and training events to keep abreast of the latest surgical techniques and new developments for your surgical application.
Joint replacement surgery has profound results on increasing the quality of life in patients with arthritis.
Shoulder instability is common and affects the younger age group of patients. The shoulder is inherently a vulnerable joint for dislocation as it is a very mobile joint capable of almost 360 degrees of movement. Unfortunately once a shoulder has dislocated, it is common to have repeat episodes of instability. The younger you are at first dislocation the higher the probability of further dislocations.
The first line of treatment is nonsurgical with the use of well trained physiotherapists. Ortho Specialist Centre uses a team of trusted physiotherapists to help rehabilitate the shoulder. Often this is successful however if these options do not relieve the instability, surgery may be required. This may be in the form of arthroscopic keyhole capsular labral repair or open coracoid transfer. These procedures are also known as a Bankart Arthroscopic Stabilisation or Latarjet respectively.
The surgeons at Ortho Specialist Centre will discuss these options with you once a detailed consultation has taken place including reviewing your radiological imaging.
Rotator Cuff Repair
As we age we experience shoulder complaints more often. One of the commonest complaints of pain in the shoulder can be related to rotator cuff tears and bursitis. A rotator cuff tear is a common cause of pain and disability and significantly affects your daily quality of life. The majority of these are caused by degeneration and trauma. The team at Ortho Specialist Centre will determine, via examination and investigations, which one you may have.
The goal of any treatment is to reduce pain and restore function. The standard treatment of shoulder pain is initially non operative. This rehabilitation based method is successful for a large amount of patients. If your symptoms persist than we may recommend surgery if your pain and function does not improve with non-surgical methods. Arthroscopic keyhole surgery is the most minimally invasive method of repair and the procedure Mr Sydenham specialises in. Broadly speaking, this involves reattaching the tendon and creating space for a smooth gliding movement of your shoulder.
After a thorough consultation, the options of non-surgical and surgical treatments, will be presented together with the risks and benefits of each method. This information will be tailored to your individual health needs.
Total Shoulder Replacement
Several conditions can cause shoulder pain and disability, and lead patients to consider shoulder joint replacement surgery.
Similar to hip and knee causes, degenerative joint disease such as osteoarthritis is the most common cause requiring shoulder replacement surgery. Other causes are rheumatoid arthritis, post-traumatic arthritis, and post infection.
A particular cause, known as cuff tear arthropathy, arises from chronic rotator cuff tendon tears. This requires unique specialised surgical management of which the team at Ortho Specialist Centre have done international fellowships in.
During your personalised consultation, we will discuss your treatment methods together with the risks and benefits of each treatment method.
Total Elbow Replacement
Although elbow joint replacement is much less common than shoulder, hip and knee replacement, it is just as successful in relieving joint pain and returning people to activities they enjoy.
Arthritis is the main cause of a painful and stiff elbow joint requiring treatment. However other causes of disability lead patients to consider elbow joint replacement surgery.
Mr Sydenham will discuss these causes and treatments together with the relevant risks and benefits based on your individual healthcare needs.
Elbow arthroscopy is a surgical procedure that allows the surgeon to view the elbow joint utilising a minimally invasive keyhole technique. Arthroscopy is used to diagnose and treat a wide range of elbow problems. Such conditions include removal of inflamed synovial tissue, trimming of damaged articular cartilage, removal of loose fragments of bone or cartilage and treating elbow infections.
Total Knee Replacement
As with other joints in our body, the most common cause of chronic knee pain and disability is arthritis, principally osteoarthritis. Other common causes are rheumatoid and post traumatic arthritis. The smooth cartilage that cushions and lines the articulating surface of the bones of the knee softens and wears away. The bones then rub against one another, resulting in knee pain and stiffness.
A history and examination, followed by x-rays or MRI scans will lead to a discussion about the non-operative and surgical options available. When arthritis is present, key- hole surgery to the knee may not provide long-term benefit.
After a detailed and personalised consultation, the team at Ortho Specialist Centre will discuss your management options and provide you with information and a treatment path. Non-surgical and surgical options will be proposed, discussing the risks and benefits of each treatment.
Once non-surgical treatments have been exhausted then discussion about surgical options will be considered. These include uni-compartmental knee replacement, limb realignment surgery, cartilage restoration and total knee replacement.
Total knee replacement is surgery involved in removing the problematic diseased surfaces of the bone and replacing them with prosthetic components designed to reduce pain and improve function of the knee joint therefore giving back your quality of life that most patients have lost.
Knee arthroscopy is a surgical procedure that allows the surgeon to view the knee joint utilising a minimally invasive keyhole technique. Arthroscopy is used to diagnose and treat a wide range of knee problems. Such conditions include:
Removal or repair of a torn meniscus
Reconstruction of a torn anterior cruciate ligament
Removal of inflamed synovial tissue
Trimming of damaged articular cartilage
Removal of loose fragments of bone or cartilage
Knee sepsis (infection)
Our Ortho Specialist Centre team has vast experience in treating and managing orthopaedic trauma. Our specialist team treats patients of all ages both in private and public hospital settings. We are a unique Orthopaedic group in that we can cover both adult and paediatric patients. Due to the nature of emergencies, our specialist doctors will endeavour to consult the patient within 24 hours of injury and to commence treatment of the fracture.
Paediatric foot and ankle
There are a number of conditions that can effect children’s feet leading to pain and deformity. Congenital Talipes Equinovarus (Clubfoot), flat foot, toe deformities, high arched feet and toe walking are common foot conditions we see in the paediatric orthopaedic clinic. Often these conditions can be treated without surgery but a proportion will require surgical intervention. We will access your child and determine the best management plan for them.
Paediatric Knee Problems
Often problems around the knee occur due to injury during sports. This can lead to injury to the ligaments in the knee, dislocation of the knee cap, damage to the meniscus or damage to the cartilage of the knee. In some instances these conditions can be treated without surgery but often surgery is required for the best outcome.
Knee problems can also occur without injury due to abnormal tracking of the knee cap and rotational abnormalities in the lower limb. In the paediatric population cartilage defects can occur without trauma and lead to knee pain and difficulty with sports. We will access your child clinically and determine the best management plan to determine the source of the pain and the best treatment option for them.
Paediatric Hip Problems
Developmental dysplasia of the hip (DDH) is the most common condition affecting the hips of infants and children. In order for the hip to develop properly the femoral head should be seated in the acetabulum. Clinical examination and ultrasound can detect instability in the hips that requires treatment. If the condition is identified soon after birth, bracing is often successful in treating hip dysplasia. If bracing fails or the condition is identified later in childhood surgery can be required to optimise the hip development.
Perthes Disease is a condition caused by disruption of the blood supply to the head of the femur. The treatment options for this condition are variable and range from activity modification and physiotherapy to surgery to contain the hip. We will access your child clinically and with x-rays to determine the best management plan for them.
Slipped Capital Femoral Epiphysis is a condition where there is a weakness in the growth plate and the ball of the femur slips off the neck of the femur which can lead to disruption of the blood supply. Early surgical treatment of this condition is essential to optimise outcome.
Limb Deformity and Limb Length Discrepancy
The causes of limb deformities and limb length discrepancies can be congenital or secondary to an acquired cause such as trauma to the growth plate or infection. In some instances the degree of deformity is mild and no surgical intervention is
required. In other cases the growth plate can be modulated with surgery to guide the growth of the limb and correct the limb length discrepancy or deformity of the leg. When a child has limited growth remaining or the the deformity is severe more extensive surgery can be required to correct the deformity. We will access your child clinically to determine the cause of the deformity or limb length discrepancy and formulate the best treatment plan for them.
Orthopaedic Problems in Children with Neuromuscular Conditions
Neuromuscular conditions such as cerebral palsy can cause imbalance and weakness of the muscles in the lower and upper limbs. This can lead to orthopaedic problems in the hips, knees, and feet leading to difficulties with walking.
This is a very specialised area of paediatric orthopaedics. We can access your child clinically and determine the best management plan for them. Often a multi disciplinary approach including paediatricians, rehabilitation doctors, neurologists, physiotherapist and occupational therapists are required. Gait analysis may also be required to determine the best orthopaedic interventions. Patients requiring surgical intervention may require referral to the neuromuscular services at the Royal Children’s Hospital to meet their specialist needs.