Have you ever had to see an orthopedic surgeon? If you haven’t, chances are that at some point in your life, you will. People are living longer, more active lives. Athletes are training harder and competing against other skilled, strong competitors. And unfortunately, accidents happen. When your activities become limited due to pain, injury, and the general wear and tear on your body, you would be wise to seek the advice and care from a board-certified orthopedic surgeon, who is specialized in the prevention, diagnosis, and treatment of diseases of joints, bones, ligaments, tendons and muscles. Depending on your specific situation, treatment could include physical therapy, medications, injections, bracing, booting or casting, and other treatments. However, in some instances, surgery may be required. So, what are the most commonly performed orthopedic surgeries?
Surgeries for Soft Tissues: Tendons, Ligaments, and Muscles
Muscles are the tissues in your body that create motion. Tendons are tough bands of tissues that connect your muscles to bones so when your muscles move, so do the bones that are connected to them. Ligaments are also tough bands of tissue that connect bones to other bones, so that the bones like those in your leg, can work smoothly and in harmony. Repairing these soft tissues can be delicate, but necessary to restore proper function to your joints and limbs. The following are some of the most common soft tissue surgeries that are performed by orthopedic surgeons.
Knee Arthroscopy is a minimally invasive surgery that allows both diagnosis and treatment during the same procedure. It is performed countless times per year in the United States and around the world. During the procedure, your surgeon would make small incisions and insert a tiny camera attached to instruments, allowing them to see what’s going on inside your knee. While looking at a projection on a screen, your surgeon is able to repair or remove any damaged tissue. This type of procedure has fewer risks and requires less recovery time than more invasive, open procedures. Some examples of injuries that can be diagnosed and treated with arthroscopy include a meniscus tear, torn cartilage, dislocated patella (kneecap), fractured knee bones and torn anterior or posterior cruciate ligaments.
Anterior Cruciate Ligament (ACL) Reconstruction Surgery is necessary when someone has injured this major ligament in the knee. Each year, more than 100,000 ACL reconstruction surgeries take place in the US.
The ACL is one of two ligaments that cross the middle of the knee, connecting the thighbone to the shinbone. It helps to strengthen and stabilize the knee. Most of these injuries occur during physical activities, like those involved in sports or fitness activities that put extra stress on the knee. Movements such as jumps, sudden stops and/or redirection, places an individual at greater risk of injuring their ACL. Your surgeon can repair this type of injury by removing the torn tissue and using another tendon from your body, or from a deceased donor, to replace it.
Rotator Cuff Repair Surgery, another very common orthopedic procedure, may be necessary to repair one of the tendons in the shoulder. Four muscles and their tendons make up the rotator cuff, which strengthens, protects and stabilizes the shoulder. If you fall on your shoulder or move your shoulder too quickly and with too much force, you will be at risk of tearing one of these tendons. Rotator Cuff tears are also often the result of a wearing down of the tendon that occurs slowly over time. Signs of a rotator cuff injury include pain and not being able to raise your arms over your head. The severity of the tear will determine what type of surgery will need to be performed, but generally, the tendon will need to be reattached to the top of the large bone in your upper arm. With smaller tears, tendons may only need to be trimmed. Depending on the type and severity of the injury, your surgeon may need to perform an “open” procedure with larger incisions to repair the damage, or arthroscopy, if less invasive surgery is warranted.
Surgeries Involving Joint Replacement
Joint replacements are performed on people who have painful joints, usually due to osteoarthritis. A joint in the human body is the point where two bones connect. Most joints facilitate movement (shoulder, hip, knee), however, the stress we place on these joints over the years, and through injury, can cause them to wear down. Osteoarthritis, also known as degenerative joint disease, is the wearing down of the cartilage (or cushioning) in the joints, resulting in changes in the bone, loss of function and pain. There are many ways to treat arthritis, including medications, physical therapy, and injections, however, as the arthritis increases in severity, it may become necessary to replace the damaged joint surgically. The most common total joint replacement procedures in the United States are total knee replacements (about 600,000 a year) and total hip replacements (over 300,000 a year). Whichever joint is being replaced, the procedure usually results in relief of pain and improved strength and mobility.
Hip Replacement Surgery involves removing a damaged hip joint and replacing it with an artificial joint usually made of plastic and metal. The hip is what’s called a “ball and socket” joint. The thighbone has a rounded top, which fits nicely into a round socket in a healthy hip. During this procedure, your surgeon would first make an incision, and then remove the round part of the top of the thighbone and attach the artificial “ball” to the bone. Next, they would clean the surface of the hipbone of any damaged tissue and attach an artificial “socket”. Once the ball is placed in the socket, your muscles hold the joint together and the incision is closed. Some of these surgeries used to require a large incision, although now a minimally invasive procedure is typically performed, and a smaller incision is used. These minimally invasive surgeries mean less tissue is disturbed, and that typically means less pain, faster healing and shorter recovery times for the patient.
Shoulder Replacement Surgery, while not done in as great a number as hip and knee replacement, is still a common orthopedic surgery. The surgery is performed by first making an incision and then by removing the “ball” shaped top of the upper arm bone and replacing it with a metal ball. (In a Partial Shoulder Replacement, this is the only part of the joint that is replaced.) Next, the damaged tissue in the “socket” is cleaned and a plastic artificial socket is attached. The new shoulder is then held in place by the rotator cuff tendons. If the rotator cuff is also injured, your surgeon may perform a Reverse Shoulder Replacement, where the artificial ball is actually attached to your shoulder bones and the socket is attached to the top of the arm bone.
Knee Replacement Surgery is different than shoulders or hips because the knee is a “hinge joint”, not a ball and socket joint. During a knee replacement, your surgeon will replace the bottom end of your thighbone with a metal shell that is a cap covering the end of the bone. Next, the top portion of the bone of your lower leg will be replaced with a plastic and metal surface as well. A plastic button may also be placed under the kneecap.
Knee replacement surgery has come a long way and is now typically done using a minimally invasive technique that includes a smaller incision. In these cases, patients healing time is usually lessened and they are able to walk and get back to normal activities faster than with traditional surgery. There are also knee replacements available using custom-fit implants that are created using a 3D model of your knee from a CT scan, and knee replacements that can be done using robotic Makoplasty technology. There are even knee implants available today that are just for the unique size and shape of the knee in a woman versus a man.
Hand and Wrist Surgeries
Carpal Tunnel Syndrome is a common condition that affects the hand and wrist. It occurs when the median nerve in the wrist is compressed. Carpal Tunnel Syndrome develops when the tissues and tendons in the Carpal Tunnel swell and make the area within the tunnel smaller. This can result in pain, numbness, and tingling of the thumb, index, middle, and half of the ring finger. When other treatments fail to relieve symptoms or the condition becomes worse, your surgeon can perform a simple Carpal Tunnel Release Surgery. During this procedure, your surgeon makes an incision in the Transverse Carpal Ligament to open the tunnel and make it larger. By doing so, the pressure is taken off of the median nerve. This should eliminate the symptoms. The procedure is short and only takes a matter of minutes. It can be done using an open technique or endoscopically.
Trigger Finger Release is a common procedure that can be used to release a finger that is locked or caught in a bent position. Trigger finger occurs when the tendons in the thumb and fingers do not glide smoothly, causing the tendons to catch or get stuck when the fingers or thumb bend. It can also cause pain, discomfort, and swelling. Trigger Finger is more common among women than men and can develop more frequently in people with certain medical conditions, such as diabetes, rheumatoid arthritis, autoimmune disease, and gout. If other treatments fail, your surgeon can perform a procedure to cut or loosen the affected tendon pulley, so that you will be able to straighten your finger again. The procedure is simple and short and is usually curative.
Orthopedic surgeons such as Dr. Brett Gilbert are highly skilled physicians who can treat the injury, reduce pain and improve function to your bones, ligaments, muscles, tendons, and joints. In addition to the surgeries listed above, other common orthopedic procedures include ankle repairs, spinal surgeries, joint fusions, and fracture repairs.
If you are suffering from injury, or experiencing pain or problems with mobility, our friendly team is here to help. To seek the expert advice of Dr. Brett Gilbert, or to address your unique concerns, contact us today by calling us at (919) 788-8797 or request an appointment online, and work to start living pain-free once again.