Treatments & Procedures
What is Achilles tendon insertion repair?
Achilles tendon insertion repair is a surgery that helps with wear and tear on the Achilles tendon at the point where it joins the heel bone.
What is it for?
Insertional Achilles Tendinosis occurs where the Achilles tendon attaches to the heel bone. Tendinosis develops when the tendon is damaged, causing pain, limited mobility and problems wearing shoes.
Am I a candidate?
After a full medical history, physical exam and certain tests, you and your physician will discuss if you are a candidate for surgery. Nonoperative treatments are attempted first. Some health conditions or medications may prevent you from having this type of surgery.
What does Achilles tendon insertion repair involve?
In many cases, this repair can be done through arthroscopy, which is a minimally invasive procedure using a tiny camera and small instruments that can operate without large incisions. The damaged part of the tendon can be removed, leaving the rest of the tendon attached to the heal bone. In some patients, a large amount of tendon may be damaged.
What is recovery like?
Healing may take six to 12 weeks. Depending on the type of injury and its location, your physician may prescribe some gentle movement exercises, and/ or some bracing to guide or limit movement. Patients may also need physical therapy to restore as much functionality as possible.
What is Achilles tendon repair?
Achilles tendon repair is a surgery that repairs the Achilles tendon, the largest tendon in the body. Tendons connect muscles to bones, so when the muscle contracts, the tendon moves the bone.
What is it for?
The Achilles tendon must be functioning for a person to walk. Achilles tendon repair may be needed to restore motion and reduce pain.
Am I a candidate?
After a full medical history, physical exam and certain tests, you and your physician will discuss if you are a candidate for surgery. Some health conditions or medications may prevent you from having this type of surgery.
What does Achilles tendon repair involve?
In many cases, this repair can be done through arthroscopy, which is a minimally invasive procedure using a tiny camera and small instruments that can operate without large incisions. Usually the repair simply involves stitching the ends of the damaged tendon together.
Achilles tendon repair typically occurs in an outpatient setting, which means there is no overnight hospital stay.
What is recovery like?
Healing may take six to 12 weeks. Depending on the type of injury and its location, physician may prescribe some gentle movement exercises, and/or some bracing to guide or limit movement. Patients may also need physical therapy to restore as much functionality as possible.
What is Advanced Reconstruction?
Advanced shoulder reconstruction, sometimes called reverse total shoulder replacement, reverses the position of the ball and socket to allow a different muscle group to move the arm. This process is used in specific arthritis and rotator cuff tears that would not benefit from traditional replacement anatomy.
What is it for?
Advanced shoulder reconstruction is for patients with a large rotator cuff tear and joint inflammation, those who had an unsuccessful traditional shoulder replacement, severe pain and problems moving the arms from the side to over the head, and those who did not respond to other treatments.
Am I a candidate?
After a full medical history, physical exam, and certain tests, you and your physician will discuss if you are a candidate for surgery. Some health conditions or medications may prevent you from having this type of surgery.
What does the treatment or procedure involve?
Advanced shoulder reconstruction requires opening the shoulder joint and removing the damaged parts of the bones. A ball is attached to the shoulder, and a cup is attached to the top of the upper arm, making a new joint. This is performed through general anesthesia.
What is recovery like?
Following surgery, the shoulder will be in a sling for several weeks, usually between four and six weeks. Your physician will also prescribe some exercises to do at home as you begin to heal. When the sling is removed, physical therapy will increase to include more range of motion and other exercises. It is usually three to four months before the shoulder is totally healed.
What is anterior cruciate ligament (ACL) reconstruction?
The ACL is one of the four main ligaments within the knee that connect the lower legs bones to the upper leg bone through the knee joint. The ACL runs diagonally in the middle of the knee to provide stability as the knee twists and moves. When the tendon is severely injured, it cannot be sewn back together, so a tendon from another part of the body or a donor ligament is used to rebuild the ACL.
What is it for?
ACL injuries most commonly occur during sports that involve sudden stops and changes in direction — such as basketball, soccer, football and volleyball. Other injuries like falls or car accidents can cause severe damage as well.
Am I a candidate?
After a full medical history, physical exam and certain tests, you and your physician will discuss if you are a candidate for surgery. Some health conditions or medications may prevent you from having this type of surgery.
What does ACL reconstruction involve?
ACL surgery is usually performed through arthroscopy that uses a tiny camera and instruments inserted through small incisions around the joint. This minimally invasive approach means that there may be fewer complications from bleeding and infection.
ACL reconstruction requires a graft, or piece of tendon from another part of the body or a cadaver donor. The graft is attached to the damaged ACL so that, as it heals, it makes a more stable connection between the lower and upper leg bones.
What is recovery like?
After surgery, you will probably need to keep your knee in a brace for three or four weeks. Your physician will also prescribe some exercises to do at home as you begin to heal. As healing progresses, you will do more physical therapy to include more range of motion and other exercises. Full recovery may take several months. Athletes can usually resume sports within six to 12 months.
Arthroscopic ankle surgery is used to diagnose and treat a number of ankle joint conditions.
With the arthroscopic approach, small incisions are made that allow the doctor to insert a high-powered fiber optic camera and surgical instruments into the ankle area. As the doctor watches a monitor linked to the camera, he or she can address the specific needs inside the ankle joint.
Arthroscopic surgery can treat conditions like acute ankle sprains and repetitive ankle injuries caused by chronic instability, vascular problems, genetic predisposition, degeneration, and metabolic abnormalities; anterior ankle impingement (also known as “athlete’s ankle” or “footballer’s ankle”); anterolateral ankle impingement; posterior ankle impingement; synovitis; loose bodies; arthrofibrosis; infection; ankle fractures; and unexplained ankle symptoms.
Advantages of ankle arthroscopy include minimal scarring, reduced pain and bleeding, and lower chance of infection than open surgery.
Arthroscopic elbow surgery is used to diagnose and treat a number of elbow joint conditions.
With the arthroscopic approach, small incisions are made that allow the doctor to insert a high-powered fiber optic camera and surgical instruments into the elbow area. As the doctor watches a monitor linked to the camera, he or she can address the specific needs inside the elbow joint.
Common arthroscopic procedures include removal of loose bodies; release of scar tissue; and treatment of osteoarthritis and rheumatoid arthritis. Advantages of elbow arthroscopy include minimal scarring, reduced pain and bleeding and lower chance of infection than open surgery.
Arthroscopic knee surgery is used to diagnose and treat a number of knee joint conditions.
With the arthroscopic approach, small incisions are made that allow the doctor to insert a high-powered fiber optic camera and surgical instruments into the knee area. As the doctor watches a monitor linked to the camera, he or she can address the specific needs inside the knee joint.
This type of knee surgery is used for conditions like torn meniscus, torn or damaged anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), swollen or damaged lining of the joint, misaligned kneecap, small pieces of broken cartilage in the knee joint, removal of Baker’s cyst, and some fractures of the bones of the knee.
Advantages of knee arthroscopy include minimal scarring, reduced pain and bleeding, and lower chance of infection than open surgery.
Arthroscopy is a specialized surgical procedure that orthopaedic surgeons use to visualize, diagnose and treat problems inside a joint.
After a thorough medical history, physical examination, and X-rays or other imaging, a doctor may recommend arthroscopy. The procedure involves making small incisions around the joint and inserting a small, high-powered fiber optic camera and thin instruments. The camera is hooked to a monitor where the doctor can see exactly what is happening in the joint. Originally, arthroscopy was used just for visualization, but as engineering developed smaller, well-controlled instruments, repair procedures can be performed.
Six joints are most frequently analyzed with arthroscopy: knee, shoulder, elbow, ankle, hip, and wrist. Reasons for arthroscopy include inflammation, or acute or chronic injury. Benefits of arthroscopy include reduced scarring, swelling and pain. In some cases, like rotator cuff surgery, a doctor may combine arthroscopic surgery and traditional open surgery.
Arthroscopy is followed by a period of rest, icing the area and pain management. In most cases some type of physical therapy or rehabilitation is prescribed to increase strength and functionality of the affected joint.
Bones fracture, or break, in a number of different ways. In general, bones are somewhat flexible, but a force may crack or break the bone. Extreme force from things like an automobile crash or a gunshot may shatter the bone.
Common types of fractures include: stable fracture, where the broken ends of the bone line up and are only slightly out of place; an open, compound fracture, where the skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture; a transverse fracture, which has a horizontal fracture line; an oblique fracture, which has an angled pattern; and a comminuted fracture, when the bone shatters into three or more pieces. Fractures usually cause fairly severe pain. Other symptoms of a broken bone include swelling and tenderness, bruising, and a deformed appearance.
Broken bones need medical attention to heal properly. Without proper treatment, a fracture can cause a number of additional medical problems. For diagnosis, a doctor will use physical examination and x-rays or other imaging.
Fracture treatment depends on the location and severity of the injury. Traction, a gentle, pulling action, may be used to align a broken bone. External fixation is a surgical procedure that attaches pins and screws to an external support bar. Internal fixation with open reduction uses rods, screws and plates to hold together pieces of the bone together.
A plaster or fiberglass cast is a common fracture treatment. A functional cast or brace may be used to allow some movement of unaffected nearby joints.
Knee surgery is used to diagnose and treat a number of knee joint conditions. With the arthroscopic approach, small incisions are made that allow the doctor to insert a high-powered fiber optic camera and surgical instruments into the knee area. As the doctor watches a monitor linked to the camera, he or she can address the specific needs inside the knee joint.
This type of knee surgery is used for conditions like torn meniscus, torn or damaged anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), swollen or damaged lining of the joint, misaligned kneecap, small pieces of broken cartilage in the knee joint, removal of Baker’s cyst, and some fractures of the bones of the knee.
Advantages of knee arthroscopy include minimal scarring, reduced pain and bleeding, and lower chance of infection than open surgery.
Limb lengthening and reconstruction techniques can be used to lengthen and/ or straighten bone segments. Damaged or misshapen bones may be the result of a congenital problem that the patient has had from birth or in response to a traumatic injury or serious disease.
The limb lengthening and correction process works on the principle of distraction osteogenesis. The bone is carefully cut during surgery and then very gradually distracted (pulled apart), leading to new bone formation. In this way, bone segments can be lengthened up to double the original bone length.
Adults and children with arm or leg length difference, bone or joint problems from birth deformities, growth plate fractures, trauma-related bone issues, deformities from serious infections or tumors, or dwarfism or congenital short stature may all be good candidates for bone lengthening.
There are several approaches to bone lengthening surgery, including both external and internal mechanisms. Determining which procedure is right for you will include review of age, general overall health, support at home and other factors.
Patients who have undergone surgery to remove a tumor, have a failed healing of a fracture, or have suffered an injury to an extremity from trauma or war may be good candidates for limb reconstruction. Patients with serious cancers may also need limb reconstructive surgery at the same time as surgery to remove tumors.
Reconstruction may require using the patient’s own bone, a bone transplant from a donor and, if necessary, a specialized modular joint replacement.
The bone is stabilized using metal plates, rods and screws. Both external and internal stabilization methods may be used. Determining which procedure is right for you will include review of age, general overall health, support at home and other factors.
Depending on the reason behind the limb reconstruction, several specialists may be involved including an orthopaedic surgeon, a vascular surgeon and a plastic surgeon that specializes in microvascular surgery and muscle transfer. In some cases, more than one surgery is required.
Reverse shoulder replacement surgery is necessary in some cases because of anatomy issues or in patients with completely torn rotator cuffs with severe arm weakness, severe arthritis and rotator cuff tearing, and those who had a previous shoulder replacement that failed.
In reverse total shoulder replacement, the socket and ball prosthetics are switched. That means the ball is attached to the shoulder bone and a socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.
There are several different kinds of shoulder joint prostheses available. Most are made with metal and plastic and are attached with a special type of bone cement or a “press fit” into healthy bone.
Many types of shoulder and elbow problems require clinical care by a physician or other health care professional. Common shoulder problems include sprains, strains, dislocations, separations, tendonitis, bursitis, torn rotator cuffs and frozen shoulder. Common elbow injuries include cubital tunnel syndrome, lateral epicondylitis (Tennis Elbow) and medial epicondylitis (Golfer’s or Baseball Elbow). Depending on the nature of the problem, nonsurgical methods of treatment often are recommended before surgery is considered. However, in some instances, delaying the surgical repair of a shoulder or elbow can increase the likelihood that the problem will be more difficult to treat later.
Shoulder replacement surgery is a less common joint replacement than knee or hip surgeries, but the goals are the same: reduce pain and increase mobility and use. During the surgery, all or part of the shoulder joint can be replaced, depending on the patient’s diagnosis and condition.
There are several different kinds of shoulder joint prostheses available. Most are made with metal and plastic and are attached with a special type of bone cement or a “press fit” into healthy bone.
Various kinds of arthritis, shoulder injury and facture, regular wear and tear with age, and long-term effects of serious rotator cuff tears all may require shoulder replacement.
Spine surgery is one treatment option for neck or back pain that can be considered if the pain has not diminished after several months of non-surgical treatment, if your pain does not respond to narcotic medications, or if you are unable to complete basic daily activities. There are a number of surgery options available, ranging from minimally invasive procedures (e.g. microdiscectomy for a herniated disc) that allow for a quick recovery, to other types of surgery (e.g. a posterolateral fusion for degenerative disc disease) which are more extensive and have a much longer recovery time. Your Palm Beach Health Network Physician Groups doctor will help you understand your surgery options so you can better decide on a course of action.
