Book an Appointment
Emergency: 022-61305005
I want to find
My Health Records

Corrective Spine Osteotomy

Management Team

Corrective Spine Osteotomy

Overview

Corrective spine osteotomy is a complex surgical procedure that usually involves the removal of a part of the spine (vertebra) for spinal deformity correction.

Afflicted individuals show abnormal spine curvature. In many cases, the condition can be cosmetically bothersome even if there are no apparent symptoms. However, in a few patients, abnormal spine curvature can cause back pain and may even lead to nerve compression. This can affect the limbs and may even cause bowel and bladder complications.

Although rare, spine deformities, such as scoliosis (the sideward deviation of the spine) and exaggerated kyphosis (the increased front-to-back curve of the spine) may require specialised surgical management through corrective spine osteotomy. 

This complex procedure for spinal deformity correction or scoliosis treatment is carried out by an expert team, including a spine surgeon, anaesthetist, physician, and physiotherapist. It requires a highly skilled surgical team with extensive experience to achieve favourable outcomes.

Preoperative preparation

  • Clinical examination to assess the magnitude of the deformity, identify its causes, and confirm any nerve involvement.
  • Spine radiograph (X-ray) to identify the apex of the deformity and its magnitude and assess any bony abnormalities.
  • Subsequent magnetic resonance imaging (MRI) of the spine may be required to assess the neural tissue.
  • Further investigations specific to each patient.

Surgery

  • Administration of general anaesthesia.
  • Spinal realignment by the surgeon by carefully removing or reshaping the parts of the spine to correct the abnormal curve.
  • Placement of metal rods, screws, or plates to stabilise the spine in its new, corrected position.
  • Incision closure and surgery completion.

Postoperative care

Post-surgery rehabilitation is crucial for achieving favourable surgical outcomes. Various postoperative measures include:

  • Medications to control pain and discomfort after surgery.
  • Keeping the surgical site clean and dry with regular dressing changes to prevent infection.
  • Physical therapy to regain strength, mobility, and improve recovery.
  • Avoiding heavy lifting or strenuous activity for several weeks or months depending on the surgeon’s advice.
  • Regular follow-up visits to the surgeon to monitor healing, assess complications, and track progress.

Corrective spine osteotomy is a complex procedure with potential risks, such as:

  • Infection
  • Nerve damage
  • Blood loss
  • Hardware failure
  • Non-union or malunion
  • Postoperative pain
  • Blood clots

Full recovery can take several months with patients usually resuming light activities within 3–6 months. Physical therapy plays a critical role in regaining strength and mobility. Many patients experience lasting results with the spine remaining stable and properly aligned. However, long-term outcomes depend on the severity of the deformity, the success of the surgery, and patient adherence to postoperative rehabilitation.

Although corrective spine osteotomy is a complex procedure, for many patients, it results in improved alignment, pain relief, and enhanced quality of life.

Filter Alphabet

Hip Replacement

Management Team

Hip Replacement

Overview

Hip replacement or hip arthroplasty is a surgical method in which an artificial joint is inserted as a replacement for a damaged or diseased hip joint. Such artificial joints are usually made of materials like metal, polyethylene, or ceramics. The procedure is carried out in order to relieve pain, restore functionality, and ultimately improve the quality of life for patients.

Hip replacement surgeries are usually indicated for conditions like:

  • Severe osteoarthritis (OA): a common condition involving cartilage breakdown and pain.
  • Rheumatoid arthritis (RA): a type of autoimmune condition that causes hip joint inflammation and damage.
  • Post-traumatic arthritis: this occurs due to a hip injury or fracture.
  • Avascular necrosis: reduced blood flow to the hip bone resulting in bone death and joint damage.

Non-surgical treatment methods include:

  • Physical therapy: The mobility and strength of the supporting muscles can be enhanced using targeted exercises.
  • Medications: Pain-relieving and anti-inflammatory drugs may be recommended to alleviate symptoms.
  • Weight management: Helps reduce strain on the joints.
  • Injections: Corticosteroids or hyaluronic acid to relieve pain and inflammation.

Preoperative Preparation:

  • Evaluation: Comprehensive assessment of overall health.
  • Anaesthesia Planning: Determining the most suitable anaesthesia approach.
  • Rehabilitation Planning: Preparing for post-surgery rehabilitation.

Surgical Procedure:

  • The surgeon removes damaged portions of the hip joint, replacing them with an artificial implant.
  • Typically performed under general or regional anaesthesia, this procedure takes about 1–2 hours.

Postoperative Care:

  • Rehabilitation: Physical therapy begins right after surgery to restore strength, mobility, and function.
  • Pain Management: Medications and techniques to control post-operative pain and swelling.
  • Lifestyle Adjustments: Activity recommendations, use of assistive devices, and joint care guidance to support faster recovery and prevent complications.

Long-Term Management:

  • Regular Follow-Ups: Routine check-ups with the orthopaedic surgeon to monitor the hip implant and joint health.
  • Physical Therapy: Ongoing therapy to maintain flexibility and muscle strength, aiding long-term recovery.

  • Infection  
  • Blood clots  
  • Tissue or nerve damage  
  • Fractures in the surrounding bone
  • Loosening and/or dislocation of the implant
  • Alterations in leg length

Generally, hip replacement surgeries are associated with excellent patient outcomes. They greatly enhance the quality of life of most patients, markedly decreasing hip pain and enhancing hip mobility. Successful outcomes rely on thorough preoperative planning, surgical expertise, adherence to rehab protocols, and ongoing joint care. Often, complete recovery requires 3–4 months; of course, this duration varies from patient to patient. Surgeons recommend that patients avoid high-impact activities (jumping or running); nevertheless, low-impact activities, such as walking, swimming, and driving, are advised as forms of physical therapy. Usually, hip replacements can last for several years.

Filter Alphabet

Lumbar Discectomy

Management Team

Lumbar Discectomy

Overview

Lumbar discectomy is a surgical procedure done for the lumbar spine, wherein a part of the herniated intervertebral disc is removed to relieve pressure symptoms over the nerve root.

  • Sciatica, slip disc, herniated nucleus pulposus (HNP), and disc prolapse are all synonyms for similar conditions. 
  • Heavy weightlifting, heavy labour activities, clumsy sitting position, poor posture, obesity, and rarely trauma can cause a part of the intervertebral disc to degenerate and prolapse out of its place, exerting undue pressure over the nerve root and causing pain.
  • Patients complain of lower back pain, which goes down to either of the buttocks, thigh, calf, and legs.

An orthopaedic spine surgeon or a neurosurgeon can perform this procedure.

Preoperative preparation

  • A thorough clinical examination is essential to establish a clinico-radiological correlation.
  • Although sciatica is most commonly caused by herniated discs, other pathologies may mimic sciatica and need to be ruled out by clinical examination.
  • A spine X-ray may be performed to demonstrate lumbar list (sideward bending of the spine) and lordosis (reduced curvature), as well as instability. However, not all patients demonstrate these findings on an X-ray.
  • A subsequent spinal magnetic resonance imaging (MRI) might be needed to assess the status of the neural tissue. Further investigations would vary according to each patient.

Surgery

  • This procedure is usually carried out by an expert team including a spine surgeon, an anaesthetist, a physician, and a physiotherapist.
  • Microdiscectomy, which uses small incisions and causes less tissue trauma, is commonly carried out to relieve symptoms post-surgery.
  • Physiotherapy is essential to improve the mobility and overall surgical outcome.
Filter Alphabet

Laminectomy

Management Team

Laminectomy

Overview

Laminectomy is a surgical procedure done on the spine to manage stenosis (narrowing) of the spinal canal. The lamina is the bone of the spinal vertebra that lies behind it. Laminectomy is the removal of the lamina bone.

  • This procedure is indicated in patients who present with spinal stenosis (narrowing of the spinal cord) and nerve compression.
  • Sometimes laminectomy may be combined along with other spinal procedures, such as fixation to enhance the surgical outcome.

This procedure is performed by an orthopaedic spine surgeon or neurosurgeon. It is done from the back of the patient. After adequate exposure of the spine, the bone is removed with special instruments. This opens up the spinal canal and the neural elements are relieved of compression.

Preoperative preparation

  • Spine X-ray to reveal the spinal curvature.
  • Dynamic X-ray (by bending forwards and backwards) may be required to rule out any abnormal motion of the spine.
  • A subsequent spinal magnetic resonance imaging (MRI) might be needed to check the status of the neural structures. Further investigations would vary according to each patient.

  • This relatively simple procedure of the spine is carried out under general anaesthesia.
  • Patients experience relief of symptoms after surgery.
  • Analgesics are administered to relieve surgical site pain.
  • Rehabilitation involves physiotherapy exercises to increase the overall strength, confidence, mobility, and overall physical performance of the patient.
Filter Alphabet
L

Knee Joint Arthroplasty

Management Team

Knee Joint Arthroplasty

Overview

Knee joint arthroplasty, commonly known as knee replacement surgery, is a surgical procedure to replace a damaged or diseased knee joint with an artificial joint. This procedure is typically performed to relieve pain and restore function in people with severe knee arthritis or other knee joint issues.

Knee joint arthroplasty involves removing the damaged cartilage and bone from the knee joint and replacing them with an artificial joint. There are two main types of knee arthroplasty:

  • Total knee arthroplasty (TKA): It involves replacing all compartments of the knee joint.
  • Partial knee arthroplasty (PKA): It involves replacing only the damaged part of the knee joint, leaving the healthy parts intact.

  • Severe and persistent knee pain that does not improve with rest or medication.
  • Knee joint stiffness or reduced range of motion, especially in the morning or after sitting for long periods.
  • Persistent swelling in the knee.
  • Trouble with walking, climbing stairs, or performing daily activities.
  • Weakness or instability in the knee joint.

  • Ageing (> 50 years of age), arthritis, and joint wear and tear.
  • Obesity that stresses the knee joint.
  • Previous knee injuries.
  • Family history of arthritis or joint problems.
  • Jobs or activities that stress the knees.

  • Severe primary osteoarthritis, which leads to the breakdown of cartilage and causes pain and stiffness.
  • Rheumatoid arthritis or other inflammatory arthritis types with knee involvement.
  • Secondary arthritis, which develops after an injury or infection of the knee.

Diagnosis is made by a knee specialist who will perform various examinations to confirm the need for knee joint arthroplasty:

  • Physical examination by assessing knee pain, swelling, range of motion, and functional limitations.
  • Medical history review to discuss symptoms, their duration, previous treatments, and overall health.
  • Investigations such as:
    • X-rays: To evaluate the extent of joint damage, bone alignment, and overall joint structure.
    • Magnetic resonance imaging (MRI) or computed tomography (CT) scan: To assess the soft tissues around the knee and provide detailed information about cartilage and bone damage.
    • Blood tests: To rule out infections or other conditions that might affect the surgery or recovery.

Non-surgical treatment

These include physical therapy, medications (analgesics and anti-inflammatory drugs), weight management, and injections like corticosteroids or hyaluronic acid to reduce pain and inflammation.

Surgical treatment

  • Conventional partial knee replacement or total knee replacement surgery
  • Navigation-assisted knee surgery
  • Robotic-assisted surgery: It is more precise and requires fewer bone cuts (Bone preserving). It is associated with fewer complications, faster recovery, and good functional outcomes.

Pre-surgical evaluation

These include assessing overall health, preparing for anaesthesia, and planning post-surgery rehabilitation.

During surgery

The surgeon will remove the damaged parts of the knee joint and replace them with an artificial implant. The procedure typically lasts 1–2 hours.

Post-surgery measures

  • Rehabilitation: Post-surgery physical therapy is crucial to regain strength, mobility, and function in the knee. This often begins immediately after surgery.
  • Pain management: It includes medications and ice therapy to manage pain and swelling.
  • Lifestyle modifications: It is necessary to follow recommendations for activity levels and joint care to ensure optimal recovery and prevent complications.
  • Ongoing physical therapy is the key for continuously improving strength and flexibility.

After the surgery, patients are suggested to undergo basic or advanced physiotherapy. However, returning to daily activities should be discussed with the orthopaedic expert for further injury prevention and rapid recovery.

Knee joint arthroplasty can significantly improve the quality of life by reducing pain and restoring mobility. However, it requires careful planning and commitment to rehabilitation for the best outcomes.

Filter Alphabet
K

Knee Arthroscopy

Management Team

Knee Arthroscopy

Overview

Knee arthroscopy is a minimally invasive surgery used to diagnose and treat knee injuries. It involves making small incisions to insert a camera (arthroscope) and tiny surgical tools into the knee joint. The camera provides real-time images of the knee's interior, helping the surgeon diagnose and address issues with cartilage, ligaments, and other soft tissues.

Knee arthroscopy procedures are recommended:

  • When knee pain persists despite nonsurgical treatments like rest, ice, non-steroidal anti-inflammatory drug (NSAID) therapy, and physical therapy.
  • To examine injuries related to ligaments, tendons, and cartilage.
  • To treat conditions, such as bursitis and synovitis.

Preoperative planning

Before the procedure, patients may need to stop certain medications and fast. Anaesthesia options include local, regional, or general.

Surgery

During the procedure, the knee is cleaned and secured, a small incision is made, and the arthroscope is inserted. The surgeon uses the camera’s images to guide the repair of damaged tissues, remove inflamed or damaged material, and close the incisions with stitches or bandages.

Postoperative care

Most arthroscopies are outpatient procedures that take about an hour. After the surgery, patients may need crutches, pain medication, and rest with their knees elevated. Following recovery, physical therapy can help regain strength and mobility. Patients are suggested to undergo advanced physiotherapy regimens. However, recovery times vary, and returning to strenuous activities should be discussed with the healthcare provider for injury prevention and rapid recovery.

Knee arthroscopy generally offers a quicker recovery and less pain compared to traditional surgery. However, the possible risks include:

  • Bleeding
  • Infection
  • Blood clots
  • Knee stiffness
  • Swelling

Please contact your healthcare provider if you experience severe pain, bleeding, or signs of infection.

Filter Alphabet
K

Elbow Replacement

Management Team

Elbow Replacement

Overview

Elbow replacement is an elbow surgery that involves replacing the diseased bones of the elbow joint with new metallic implants (similar to those used to replace hip/knee and shoulder joints).

Elbow replacement is indicated for patients with:  

  • Severe forms of arthritis
  • Intra-articular (involving the joint) fractures
  • Elbow instability
  • Elbow bone tumour

Preoperative planning

  • Preoperative examinations to assess general condition
  • Preoperative fitness assessment by the anaesthetist

Surgery

  • The procedure is usually performed under general anaesthesia and can be combined with a regional block.
  • A long incision is made at the back of the elbow joint to expose the muscles and bones (distal humerus and proximal ulna).
  • The affected parts of the bones are removed and replaced with new metallic implants that are fixed to the bone using bone cement and ligaments around the elbow.
  • A pressure dressing is applied to the wound.

Postoperative care

The patient is asked to gradually mobilise the joint based on their healing progress. Physical therapy and rehabilitation are necessary to restore functionality.

  • Infection during the early or late phase
  • Wound healing complications
  • Nerve injury
  • Implant-related issues, such as loosening
Filter Alphabet
E

Arthroscopy

Management Team

Arthroscopy

Overview

Arthroscopy is a minimally invasive procedure, commonly used to diagnose joint disorders and plan treatments accordingly. A small incision is first made at the joint location; through this incision, a narrow tube with a fibre-optic camera is inserted. This enables the surgeon to clearly view the region inside the joint on a high-definition monitor. This technique makes it feasible for orthopaedic doctors to diagnose and treat joint disorders using minimal incisions and small surgical tools.

Arthroscopy is deemed useful when X-rays or other imaging tests do not provide conclusive results. It is commonly performed on joints such as the wrist, elbow, shoulder, hip, ankle, knee, and ankle joints and is commonly recommended in one or more of the following cases:

  • When the presence of loose bone fragments is noted
  • When cartilages and/or joints are damaged or torn
  • When the joint linings are inflamed
  • When the presence of scarring within joints is noted

Preoperative preparation

Preparation steps may vary depending on the joint being treated, but typically include:

  • Avoiding certain medications
  • Fasting before the procedure
  • Arranging for transportation home
  • Wearing comfortable, loose clothing

Surgery

The procedure generally follows these steps:

  • Changing into a hospital gown
  • Receiving a sedative through intravenous route
  • Administering local, regional, or general anaesthesia based on the condition.
  • Positioning the patient for optimal joint access
  • Injecting sterile fluid into the joint for enhanced visibility
  • Making small incisions for the camera and instruments
  • Incision closure through stitches or adhesive tape

Post-operative care

Arthroscopy usually lasts around an hour. After the procedure, post-operative care includes:

  • Medications for pain management and inflammation control
  • R.I.C.E. (rest, ice, compression, elevation)
  • Application of splints, slings, or crutches
  • Physical therapy along with rehabilitation exercises

Arthroscopy is generally safe, but a few possible complications might include:

  • Tissue or nerve damage
  • Infection
  • Blood clots

Recovery often allows for light activities and desk work within a few days, driving in 1–3 weeks, while more strenuous activities like heavy lifting, running, and high-impact sports may be resumed few weeks later. Regular follow-ups are vital to monitor the progress and resolve any concerns.

The most effective preventive measure is maintaining a healthy lifestyle, including the consumption of a balanced, nutritious diet, regular exercise, and weight/obesity management; these can significantly reduce the risk of arthritis, especially in weight-bearing joints. Avoiding smoking and excessive alcohol use also plays a crucial role, as these habits can exacerbate inflammation and contribute to arthritis progression. Promoting awareness and encouraging early intervention are essential steps to improve the quality of life for those at risk. Finally, osteoarthritis care and gout management can help mitigate the exacerbation of symptoms in arthritis patients.

If in need, please approach a doctor 

If you experience joint pain, stiffness, or swelling, it is important to consult a healthcare provider, such as a primary care physician or rheumatologist, who can assess your symptoms and may refer you to specialists for targeted treatment.

Filter Alphabet
A

Trigger Finger

Management Team

Trigger Finger

Overview

Trigger finger is a common condition affecting single or multiple fingers or the thumb. The tunnel present at the base of the finger/thumb is thickened, leading to an improper sling of the tendon. The affected finger/thumb mimics the trigger of a gun when an attempt is made to straighten it.

Most of the patients are healthy adults with no underlying cause. However, some risk factors include:

  • Female sex.
  • Diabetes and rheumatoid arthritis.
  • Gripping activities.

  • The primary complaint is clicking or stiffness at the base of the affected finger/thumb, which is more pronounced during early morning or after a period of rest.
  • The patient typically complains of pain at the base of the finger (A1 Pulley) during the initial stages, while fixed locking or even weakness of the affected finger or thumb can occur in the advanced stage of the disease.

  • Physical examination.
  • X-rays to rule out arthritis.
  • Ultrasonography to see the condition of the affected tendon pulley.
  • Magnetic resonance imaging (MRI) to assess any causes for the swelling/compression.

Non-surgical treatment

  • Splinting the finger/thumb in a straight position, especially during the nighttime can be tried in initial cases with some response.
  • Activities like gripping should be avoided in some cases.
  • Physiotherapy may be beneficial in relieving the pressure around the pulley. Additionally, anti-inflammatory medications may provide temporary relief in the initial stages.
  • Around 50%–60% of the patients respond well to local steroid injections around the A1 pulley to reduce the inflammatory process. A maximum of 2 such injections can be tried.

Surgical treatment

  • Surgery:
    • The procedure can be performed under local or regional anaesthesia depending on the medical condition, pain threshold, and disease stage.
    • Open surgery involves an incision of around 2 cm at the base of the finger/thumb and releasing the A1 pulley completely, which is usually seen as a tight constricting band.
  • After surgery:
    • A sterile dressing is applied after the surgery and the patient is asked to do the finger movements as early as possible.
    • Complete recovery can take up to 2–3 weeks.
Filter Alphabet
T

Tennis Elbow

Management Team

Tennis Elbow

Overview

Tennis elbow is a condition in which the tendons attached to the outer part of the elbow are inflamed. It is also known as lateral epicondylitis because the inflamed tendons are attached to the lateral epicondyle.

Although the cause for this condition is unclear, risk factors include:

  • Repeated elbow overuse and movements, such as those during screwing, typing, or knitting.
  • History of diabetes, thyroid disorders, or conditions like rheumatoid arthritis.

  • Pain on the outer aspect of the elbow, especially while doing activities like twisting and lifting heavy weights.
  • Sometimes the patients present with radiating pain down to the forearm, wrist, or weakness.

  • Physical examination through tests, such as Cozen’s test.
  • X-rays to rule out fractures, bony spurs, or even calcifications.
  • Ultrasonography to assess the integrity of the extensor origin muscles (present on the outer part of the bone).
  • Magnetic resonance imaging for additional information.

Non-surgical treatment

  • Lifestyle modifications, including avoiding activities like lifting heavy weights and twisting movements at the elbow.
  • Specific sports injury treatment
  • Applying ice packs on the affected area to reduce the inflammation (swelling) and pain to a larger extent.
  • Splints and strapping using commercially available braces help reduce the strain on the extensor compartment muscles and promote the healing process. The use of straps, especially while playing sports, can reduce pain.
  • Stretching and strengthening exercises to strengthen the whole muscle-tendon unit, including the elbow and wrist joints.
  • Local injections (such as steroids) and platelet-rich plasma can alleviate the pain and promote regeneration at the tendon site.

Surgical treatment

  • Surgery:
    • Mini-open surgery: This involves making a 3–4 cm incision over the outer aspect of the elbow joint and excising the unhealthy tissue, followed by repairing the tendons (most commonly Extensor Carpi Radialis Brevis).
    • Arthroscopy: This is a new modality that helps in addressing the pathology with 2–3 small incisions releasing the pressure on the tendons and excising the unhealthy tissue.
  • After surgery:
    • Wound care for 2 weeks and maintaining the arm in a sling.
    • Based on the type of repair/release done, the rehabilitation usually starts 2 weeks after surgery.
    • Complete recovery is expected by the end of 2–3 months.
Filter Alphabet
T
Subscribe to Bottom to top