ACL reconstruction is surgery to replace the anterior cruciate (KROO-she-ate) ligament (ACL) — one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops and changes in direction — such as basketball, soccer, football and volleyball.
A torn ACL can't be successfully sewn back together, so the ligament is replaced with a piece of tendon from another part of your leg or from a deceased donor. This surgery is usually performed through small incisions around your knee joint. A narrow, fiber-optic viewing scope is used to guide the placement of the ACL graft.
Why It’s Done: Reasons behind - ACL Reconstruction
Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone (femur) to your shinbone (tibia) and helps stabilize your knee joint.
Most ACL injuries happen during sports and fitness activities. The ligament may tear when you slow down suddenly to change direction or pivot with your foot firmly planted, twisting or overextending your knee.
But not everyone who tears an ACL requires ACL reconstruction. Sedentary people who forgo sports that involve a lot of quick stops and changes in direction usually recover well with conservative treatments and physical therapy.
Your doctor may recommend ACL reconstruction if:
- You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
- More than one ligament or the cartilage in your knee is injured
- You're young and active
- The injury is causing your knee to buckle during everyday activities, such as stair climbing
- Knee pain, stiffness or weakness
- Poor healing of the graft
- Failure to achieve symptom relief
Successful ACL reconstruction paired with rigorous rehabilitation can restore the stability and function to your knee. Within the first few weeks after surgery, you should strive to regain knee range of motion equal to that of your opposite side. Athletes often can return to their sports after six to 12 months.
Condition - Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints. There are over 100 different forms of arthritis. The most common form, osteoarthritis (degenerative joint disease), is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases.
Signs & Symptoms
The most common symptoms of arthritis are:
- Joint pain
- Joint swelling
- Redness of skin around a joint
- Stiffness, especially in the morning
- Limited movement
Its major causes are:
- Infection, usually by bacteria or virus
- Broken bone
- An autoimmune disease
- General “wear and tear” on joints
Arthritis in initial stages can be managed by medications. Anti-inflammatory drugs often suppress the pain and limit swelling. Once the joint cartilage has been damaged to an extent that any attempt to use it is very painful and X-rays confirm the severe destruction, surgical options need to be considered.
Surgery should be advised after a thorough general check-up of the patient. And peri-operative care is highly co-ordinate between surgeon, anesthetist, physician, physiotherapist or any other specialty depending on patient’s health status.
Various Surgical interventions are available for arthritis depending on the severity of patient's condition and the doctor's assessment. These include:
A telescope is inserted into the knee and products of wear and tear are removed.
High Tibial Osteotomy
The shin bone (tibia) is cut at the upper end and realigned to distribute the loads in a knee which is only partially arthritic.
Total Knee Replacement
Total knee replacement or 'Arthroplasty' is relining of the joint (bone end surfaces) with artificial parts called Prostheses. This has a new design called High Flexion Knees permitting near complete range of movement.
Unicondylar Knee Replacement
In some patients only one half of the knee joint is worn out. In these situations only one side of the knee is replaced. It can be done in specific conditions, which only the surgeon can judge and advice. Unicondylar Knee Replacement is comparatively economical and since the operation is less extensive, the post-operative recovery is faster.
Total Hip Replacement
There are two major types of Total Hip Replacements: a cemented prosthesis and an un-cemented prosthesis. Both are widely used.
Patients must give a detailed account of their medical history to the Surgeon as it may have a bearing on their operation and its result.
Condition - Back Pain
It is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine. Back pain may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. The potential sources and causes of back pain include:
- Spinal disc herniation
- Degenerative disc disease
- Lumbar spinal stenosis
- Inflammatory disease
- Medications - Short term usage, medications prove effective
- Exercises - Primarily back strengthening exercises under the guidance of a certified trainer, but always started once acute pain is controlled
- Surgery - Highly specialised orthopaedic surgeons, rheumatologists and physiotherapists use computer assisted orthopaedic surgery techniques which are as follows:
- Joint Replacement Surgeries - The joint replacement team provides state-of-the-art surgical care employing up-to-date techniques for the treatment.
- Spine Surgery - Our dedicated spine clinic offers conservative and operative management for a wide range of spinal disorders, making use of state-of-the-art equipment like operating microscopes, computer-navigation, etc.
- Traumatic Orthopaedic Management - We are equipped with:
- Three-dimensional digitised fluoroscopic intra-operative imaging, coupled with professional software support services
- Multi-functional multi-optional fracture tables (permitting minimal incision technique fixation for all possible fractures)
- The latest orthopaedic implant and instrumentation, including biodegradable implants
Condition - Clubfoot
Clubfoot is a condition when the foot turns inward and downward. It is congenital condition which means it is present at birth. Clubfoot is the most common congenital disorder of the legs. It can range from mild and flexible to severe and rigid.
Signs and Symptoms
Its symptoms are:
- Abnormal physical appearance of the foot
- Calf muscle and foot may small than normal
Although its cause is now known, it is believed that the condition may be passed down through families in some cases. Risk factors include a family history of the disorder and being male. The condition occurs in about 1 out of every 1,000 live births.
Treatment may include setting the foot into its correct position using a cast. The treatment for this condition should be done as early as possible. Gentle stretching and recasting will be done every week to improve the position of the foot. Generally, five to 10 casts are needed. The final cast will stay in place for 3 weeks. After the foot is in the correct position, the child will wear a special brace nearly full time for 3 months. Then, the child will wear the brace at night and during naps for up to 3 years.
Condition - Osteoarthritis
Osteoarthritis is a kind of arthritis which is defined as a joint inflammation that results from cartilage degeneration. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints. Osteoarthritis commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees.
Signs and Symptoms
Common symptoms of osteoarthritis are:
- Joint pain
- Stiffness in joints
- Loss of flexibility
- Grating sensation
- Bone spurs
Osteoarthritis is not an outcome of a disease as it is primarily caused due to the natural aging of the joint. Other causes are:
- Family history
- Being overweight
- Fractures or other joint injuries
- Playing sports that involve direct impact on the joint
The truth is that osteoarthritis can't be cured. Physiotherapy and Rehabilitation is a central element of treatment in inpatient and outpatient settings for various arthritis related conditions. Physiotherapy and Rehabilitation at Max Healthcare is directed towards maximizing functional abilities and mobility in order to increase your independence.
Condition - Spinal Fractures and Paralysis
Spinal fractures are different than a broken arm or leg. A fracture or dislocation of a vertebra can cause bone fragments to pinch and damage the spinal nerves or spinal cord. Most spinal fractures occur from car accidents, falls, gunshot, or sports injuries.
Injuries can range from relatively mild ligament and muscle strains, to fractures and dislocations of the bony vertebrae, to debilitating spinal cord damage. Depending on how severe an injury is, one may experience pain, difficulty walking, or be unable to move arms or legs (paralysis). Many fractures heal with conservative treatment; however severe fractures may require surgery to realign the bones.
Spinal fractures are emergencies that need expert management. Paralysis is a dreaded complication of these injuries. Care of spinal injured persons requires a full spectrum of psychologist, physiotherapists, occupational therapist, social workers and vocational counselors to optimise recovery.
At Max Institute of Orthopaedics and Joint Replacement Surgery, the diagnostic workup is already in place comprising of:
- Digital x-rays and ultrasound
- We have state-of-the-art operation theatres available round the clock for the stabilization
- Dedicated team of spine surgeons is available for providing modern care
- State of the art physiotherapy department is available for the rehabilitation
Condition - Spondylitis
Spondylitis is one of the most common causes of back and neck pain and is essentially the result of an inflammation of the vertebral joints. The problem with detecting the condition is that it develops silently and comes to prominence once the condition has fully developed.
Pain in spondylitis is usually concentrated around the cervical region of the neck, shoulder and lower spine with the instances and stings of pain flowing further downwards. There are three main types of spondylitis:
- Cervical spondylitis - which affects the cervical spine, causing the pain to spread towards the back of the neck
- Lumbar spondylitis – which causes the pain in the lumbar region
- Ankylosing spondylitis - which is primarily a disease that affects the sacroiliac joints, causing stiffness in the lower back, hips, knees and chest
A comprehensive treatment plan includes medication and exercise that can help in maintaining a normal upright posture and spinal mobility minimize the impact of hip and other joint manifestations, and reduce pain and stiffness.
A full treatment plan includes the following:
Stretching exercises and spinal exercise can improve mobility and posture and minimize the long-term impact.
Your doctor will prescribe the best medication option which will usually vary from case to case. Following are the medication categories:
- Non-steroidal anti-inflammatory drugs
- Corticosteroid injections
- Oral corticosteroids
- Tumor necrosis factor inhibitors
Total hip, shoulder or knee replacement are options for restoring mobility in those joints when they have become severely damaged. Corrective spinal surgery has become a safer prospect since the advent of magnetic resonance imaging and may be necessary if your spine fuses into a severely bent position.