Loading...
ADVANCED SURGICAL OPTIONS
SpecializedSurgical Procedures
Explore our comprehensive range of advanced surgical procedures designed to restore function and improve quality of life.
Find Your Procedure
Filter by Category
All Procedures
Showing 18 of 43 procedures
General
LCL Surgery
LCL Surgery Book an Appointment Diagnosis With good physical examination, the Lateral collateral ligament (LCL) injury is relatively easy to identify. However, to establish the extent and grade of injury, further investigations would be helpful. X-ray: X-ray is performed and is useful to rule out any bone injuries. Ligaments are not visible on the X-ray. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the MCL injury. In addition, it helps to assess the condition of the meniscus (cushions in the knee joint), cartilage and other ligaments. Often these structures are also affected and need attention. Treatment First Aid for LCL injuries involves the typical R.I.C.E therapy for the first week. Rest. It is important to minimize walking around. Icepacks. Cold packs 3 to 4 times a day helps reduce the swelling Compression. Crepe bandage is sufficient to help with compression. Elevation. Keeping it elevated on a pillow when resting helps. Conservative Management Isolated LCL injury can be treated with Range of motion (ROM) knee brace in most patients. The angle of bending the knee is adjusted gradually. For the complete healing of the ligaments around 6 to 8 weeks of time is necessary. By 3 weeks, reassessment can help to understand the progress of the healing. PCL + LCL Injury (Postero lateral corner injury) This is a more common type tear in which both LCL and PCL are injured. In patients with multi ligament injury, surgery to reconstruct the posterolateral corner and also PCL ligament is expected to achieve the best outcome. Whether this is performed as 1 stage or 2 stage operation is tailor made to individual’s inury pattern. LCL Surgery LCL reconstruction surgery is a day care surgery in which the torn ligament is replaced by your own spare piece of tissue. This is called auto-graft. Graft material can be obtained from cadaver source (another person), however own tissue is preferred and the healing and take up of the material is better. Hamstring muscle tendon from the inner side of the thigh is used. The two ends of the tendon is fixed to the thigh bone (femur) by using a biocomposite screw or titanium button and midportion to the leg bone (fibula) with a suture anchor made of either PEEK (high grade polymer) or biocomposite material. LCL Rehabilitation Post-surgery, you are allowed to walk with partial weight on the same day evening. You will need the ROM knee brace for upto 3 weeks. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 4 to 6 months before returning back to playing sports on the ground or court.
Learn More
General
LETS – Lateral Extra-articular Tenodesis
LETS – Lateral Extra-articular Tenodesis Book an Appointment Procedure LETS Procedure is often performed in addition to the ACL reconstruction to provide further stability to the knee in the antero-lateral direction. It is not required in every patient undergoing the ACL reconstruction, however a small percentage of people with subtle instability even after the ACL reconstruction may need LETS procedure. This decision often has to be taken by the operating surgeon in the OT. ACL Reconstruction ACL surgery is performed in the standard fashion by using one of the autografts (Hamstrings / Peroneus longus / Quads tendon / Bone Tendon Bone). The ACL graft fixation is either by using the Tightrope Button and Bioscrew or Tightrope Button fixation on both the sides of the ligament. Post the secure fixation of the ACL, joint is assessed clinically on the table for stability using 3 different clinical tests. On examining, if there is subtle laxity in certain angles then we proceed with the LETs procedure. In patients where revision ACL surgery is being performed LETs is done routinely to give extra stability. LETS Procedure LETS or lateral extra-articular tenodesis is an open procedure and not through arthroscopy. A 3 to 4 cm incision over the outer side of the knee is needed. A part of the IT band is separated from the proximal end while leaving its distal attachment to the leg bone intact. The proximal end is then passed under the LCL (Lateral Collateral Ligament) and brought upto just proximal to the bone prominence on the outer side of the knee (Lateral epicondyle) and fixed to the bone by using a suture anchor (PEEK or Bio material based). ACL + LETs Rehabilitation ACL Rehab starts from the day 1. Rehabilitation for ACL + LETs is no different from the standard rehab protocol post ACL Reconstruction alone. Post-surgery, you are allowed to walk on the same day evening. If your meniscus is intact and only ACL reconstruction surgery has been performed, then you are allowed to walk with full weight on the leg. Initial one week you may need the support of a walker. Within a week most people manage to walk without support. Physiotherapy exercises are started early. In the first 6 weeks the focus is mainly on getting the full range of movement and help regain the muscle strength. The whole rehabilitation process will take about 6 to 8 months before returning back to playing sports on the ground or court.
Learn More
General
MCL Surgery
MCL Surgery Book an Appointment Diagnosis With good physical examination, the Medial collateral ligament (MCL) injury is relatively easy to identify. However, to establish the extent and grade of injury, further investigations would be helpful. X-ray X-ray is performed and is useful to rule out any bone injuries. Ligaments are not visible on the X-ray. On occasions we See a small bone fragment pulled (avulsed) out on the inner side of the thigh or leg bone. When found, this represents the MCL ligament injury. This is called Segond fracture. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the MCL injury. In addition, it helps to assess the condition of the meniscus (cushions in the knee joint), cartilage and other ligaments. Often these structures are also affected and need attention. Treatment First Aid for MCL injuries involves the typical R.I.C.E therapy for the first week. Rest: It is important to minimize walking around. Icepacks: Cold packs 3 to 4 times a day helps reduce the swelling Compression: Crepe bandage is sufficient to help with compression. Elevation: Keeping it elevated on a pillow when resting helps. Conservative Management MCL injury can be treated with Range of motion (ROM) knee brace in most patients. The angle of bending the knee is adjusted gradually. For the complete healing of the ligaments around 6 to 8 weeks of time is necessary. By 3 weeks, reassessment can help to understand the progress of the healing. ACL + MCL Injury In patients with multi ligament injury, it is prudent to use ROM knee brace for 3 weeks. If MCL is healing naturally, then can proceed with the ACL reconstruction alone. If poor healing of MCL, then a decision to perform both MCL and ACL reconstruction may need to be taken. Partial MCL Tears or Non-healing MCL tears Body will be trying actively to heal the ligament in the first 4 to 6 months. If satisfactory healing is not taking place in partial tears of MCL, then a PRP (Platelet Rich Plasma) injection can help to stimulate the healing process. MCL Surgery MCL surgery is a day care surgery in which the torn ligament is replaced by your own spare piece of tissue. This is called auto-graft. Graft material can be obtained from cadaver source (another person), however own tissue is preferred and the healing and take up of the material is better. Hamstring muscle tendon from the inner side of the thigh is used. The tendon is fixed to the thigh bone (femur) by using a biocomposite screw or titanium button and back to the leg bone (tibia) with a suture anchor made of either PEEK (high grade polymer) or biocomposite material. MCL Rehabilitation Post-surgery, you are allowed to walk on the same day evening. You will need the ROM knee brace for upto 3 weeks. In patients with MCL surgery alone, can start walking with full weight on the leg from the day one. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 4 to 6 months before returning back to playing sports on the ground or court.
Learn More
General
Meniscal Repair
Meniscal Repair Book an Appointment Diagnosis With good physical examination meniscal (cushions in the knee joint) tear can be identified. However, to establish the extent and grade of injury, further investigations would be helpful. X-ray: X-ray is performed and is useful to rule out any bone injuries. Menisci are not visible on the X-ray. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the meniscus injury. In addition, it helps to assess the condition of the cartilage and ligaments. Often these structures are also affected and may need attention. Treatment First Aid for the acute meniscal injuries involves the typical R.I.C.E therapy for the first week. Rest: It is important to minimize walking around. Icepacks: Cold packs 3 to 4 times a day helps reduce the swelling Compression: Crepe bandage is sufficient to help with compression. Elevation: Keeping it elevated on a pillow when resting helps. Non-surgical Management Meniscal injuries with no pain, locking or catching symptoms, can be observed. Small tears may not need any other active treatment. Meniscal tears in the outer most (red-red) zone of meniscus may self heal over a period of time. However, majority of symptomatic tears may not heal. ACL + Meniscal Injury In patients with ACL and meniscal tear, at the time of ACL reconstruction surgery, meniscus surgery is undertaken as well to help stabilise the knee. Meniscal Surgery Meniscal surgery is an arthroscopic (key hole ) surgery which can by done as a day care procedure. There are various types of surgeries undertaken for the meniscus depending on the type and location of the tear. Meniscal repair Meniscal repair All suture meniscal repair Peek meniscal repair Inside out meniscal repair Outside in meniscal repair Meniscal root repair Meniscal transplantation Partial Meniscectomy (meniscal balancing) - removal of part of the meniscus which is loose and not viable. Meniscal Repair Rehabilitation Post-surgery, you are allowed to walk on the same day evening. In patients with meniscal repair, partial weight bearing on the front of the foot and use of walker or a stick is advised for upto 4 weeks. In patients with partial meniscectomy, full weight bearing on the leg is allowed within first few days as the pain settles. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 4 to 5 months before returning back to playing sports on the ground or court.
Learn More
General
Meniscal Transplant Surgery
Meniscal Transplant Surgery Book an Appointment Diagnosis With good physical examination meniscal (cushions in the knee joint) tear can be identified. However, to establish the extent and grade of injury, further investigations would be helpful. The irreparability of the meniscus will be determined based on the MRI scan evaluation. X-ray: X-ray is performed and is useful to rule out any bone injuries. Menisci are not visible on the X-ray. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the meniscus injury. In addition, it helps to assess the condition of the cartilage and ligaments. Often these structures are also affected and may need attention. Treatment Meniscal Transplant Surgery Meniscal transplant surgery is an arthroscopic (key hole ) surgery. If the bone + meniscus transplant is being undertaken then a mini open cut may be utilised. In patients with irreparable meniscus this surgery is considered. In patients with meniscus and cartilage damage, bone and meniscus transplant is undertaken. The criteria for undergoing this surgery are Young and active patient irreparably damaged meniscus No signs of joint arthritis Patients with previous meniscectomy surgery The availability of the matching sized cadaveric meniscus is mandatory before the surgery is undertaken. During the surgery any remaining parts of the non-viable meniscus is removed. Using special technique, the healthy meniscus is rail-roaded into the joint using sutures and special technique. The meniscus is fixed to the remaining capsule of the joint and the shin bone using special sutures and tightropes and endobutton. Meniscal Transplant Rehabilitation Post-surgery, you are allowed to walk on the same day evening. Partial weight bearing on the front of the foot and use of walker is recommended for upto 4 weeks. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 4 to 5 months before returning back to playing sports on the ground or court.
Learn More
General
Meniscus Root Repair
Meniscus Root Repair Book an Appointment Diagnosis With good physical examination meniscal (cushions in the knee joint) tear can be identified. However, to establish the extent and grade of injury, further investigations would be helpful. X-ray: X-ray is performed and is useful to rule out any bone injuries. Menisci are not visible on the X-ray. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the meniscus injury. In addition, it helps to assess the condition of the cartilage and ligaments. Often these structures are also affected and may need attention. Treatment First Aid for the acute meniscal injuries involves the typical R.I.C.E therapy for the first week. Rest: It is important to minimize walking around in the first week. Icepacks: Cold packs 3 to 4 times a day helps reduce the swelling. Compression: Crepe bandage is sufficient to help with compression. Elevation: Keeping it elevated on a pillow when resting helps. Non-surgical Management Meniscal root tears cannot be managed with non-surgical modes of treatment. Meniscal root repair effectively makes the meniscus completely non-functional. Hence it needs surgery to reattach the meniscal root. ACL + Meniscal In In patients with ACL and meniscal tear, at the time of ACL reconstruction surgery, meniscus surgery is undertaken as well to help stabilise the knee. Meniscal Root Repair Surgery Meniscal root repair surgery is an arthroscopic (key hole ) surgery which can by done as a day care procedure. Firstly the meniscal root tear is identified. A fiberwire stitch is passed through the root. A small bone tunnel is drilled from outside part of the shin bone to the meniscal root footprint area using a special jig. The fiberwires are retrieved out through the bone tunnel. Using a titanium button, the threads are tightened so that the meniscal root gets firmly fixed to the bone. Meniscal Root Repair Rehabilitation Post-surgery, you are allowed to walk on the same day evening. In patients with meniscal root repair, partial weight bearing on the front of the foot and use of walker or a stick is advised for upto 4 weeks. Physiotherapy ROM exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 4 to 5 months before returning back to playing sports on the ground or court.
Learn More
General
MPFL Ligament Surgery
MPFL Ligament Surgery Book an Appointment Diagnosis MPFL or Medial Patello-Femoral ligament injury due to recurrent dislocations of patella is often identifiable clinically by assessing for the pain, tenderness, swelling and Apprehension sign in which one would be extremely apprehensive when doctor tries to bend the knee slowly while trying to put pressure to push patella (knee cap) to the outside. X-ray: X-ray is performed and is useful to rule out any bone injuries, however, ligaments are not visible on the X-ray. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the MPFL injury. In addition, it helps to assess the condition of the meniscus (cushions in the knee joint), cartilage and other ligaments. Often these structures are also affected and need attention. Treatment First Aid for MPFL injuries involves immediate reduction (relocation) of the patella (knee cap) to the place where it belongs to. Further to that R.I.C.E therapy for the first week is invaluable. Rest: It is important to minimize walking around. Icepacks: Cold packs 3 to 4 times a day helps reduce the swelling Compression: Crepe bandage is sufficient to help with compression. Elevation: Keeping it elevated on a pillow when resting helps. Knee Rehabilitation Post MPFL ligament injury, if other restraints of the knee cap are working and if the Apprehension test is negative, then management would be particularly by improving Quads strength, VMO (Vastus medialis obliqus) muscle strength. Physiotherapists play a major role in this as well as improving patellar tracking to prevent further dislocations of the knee cap. MPFL Surgery Surgery is recommended in younger people particularly with recurrrent (repeated) dislocations of the patella. Patellar cartilage loss in addition to MPFL injury warrants the surgery to reconstruct MPFL as well as chondroplasty (regeneration of cartilage). If there are multiple restraints affected, then you may need a bone correcting procedure as well, in addition to the MPFL reconstruction. MPFL surgery is a day care surgery in which the torn ligament is replaced by your own spare piece of tissue. This is called auto-graft. Graft material can be obtained from cadaver source (another person), however own tissue is preferred and the healing and take up of the material is better. Often it would be hamstring muscles tendon from the inner side of the thigh, where the spare muscle tendons are harvested through small keyholes. The graft is fixed using suture anchors and a bio-composite screw. MPFL Rehabilitation Post-surgery, you are allowed to walk on the same day evening using the help of a walker. Within a week most people manage to walk without support. Early mobilistion to get the full range of movement is necessary. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 6 to 8 months before returning back to playing sports on the ground or court.
Learn More
General
PCL Surgery
PCL Surgery Book an Appointment Diagnosis With good physical examination, the PCL or Posterior Cruciate Ligament injury can be identified, however when the knee is acutely swollen and painful, it may be difficult to examine. X-ray: X-ray is performed and is useful to rule out any bone injuries, however, ligaments are not visible on the X-ray. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the PCL injury. In addition, it helps to assess the condition of the meniscus (cushions in the knee joint), cartilage and other ligaments. Often these structures are also affected and need attention. Treatment First Aid for LCL injuries involves the typical R.I.C.E therapy for the first week. Rest. It is important to minimize walking around. Icepacks. Cold packs 3 to 4 times a day helps reduce the swelling Compression. Crepe bandage is sufficient to help with compression. Elevation. Keeping it elevated on a pillow when resting helps. PCL Prehabilitation PCL Prehab exercises can be started once the pain and swelling improve. These help in regaining the knee movements and keep the muscles in a good condition. PCL Surgery Surgery is recommended in people leading an active lifestyle and are physiologically fit. Without surgery, one can manage but will have to limit the activities and be cautious on uneven surfaces to not twist again. PCL surgery is a day care surgery in which the torn ligament is replaced by your own spare piece of tissue. This is called auto-graft. Graft material can be obtained from cadaver source (another person), however own tissue is preferred and the healing and take up of the material is better. The graft material is either the hamstring tendons or peroneal muscle tendon from the side of the lower leg harvested through small cuts. The whole surgery is performed with the help of the camera (arthroscopy) and small cust (keyholes). Usually on one side the graft is fixed with a small titanium button and on the other side with a bio-composite screw. In some instances to increase the thickness of the graft, an all inside technique where both sides small titanium buttons are used. PCL Rehabilitation Post-surgery, you are allowed to walk on the same day evening. If meniscus is intact and only PCL reconstruction surgery has been performed, then you are allowed to walk with full weight on the leg with the support of a walker. Within a week most people manage to walk without support. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole process of rehabilitation will take about 6 to 8 months before returning back to playing sports on the ground or court.
Learn More
General
Pectoralis Muscle Repair
Pectoralis Muscle Repair Book an Appointment Pectoralis Major Muscle covers the whole one side of the chest and inserts on to the inner side of the arm bone (humerus). The tear of the muscle from its insertion is occurs typically when weightlifting – chest press – due to sudden loss of control. It is a rare injury, but causes sudden loss of power and severe pain. Diagnosis Physical examination reveals pain, weakness, change of shape of the chest contour and bruising in and around upper arm and adjacent area of the chest. Ultrasound Scan: Ultrasound scan can help in diagnosing the tear, however the extent and retraction may not be clear on occasions. MRI Scan: MRI Scan helps delineate the Pec tear, the extent of retraction and the status of the surrounding soft tissue. Treatment Pectoralis Major repair Surgery Pectoralis Major muscle repair surgery is a day care surgery. A delto-pectoral cut in the front of the shoulder is utilised to access the tear. Often the clavicular component of the Pectoralis major muscle would be intact and sternal part of that would be torn. The torn muscle is often retracted and hence needs to identified and brought back to approximate it to the pectoral groove in the humerus bone just lateral to the biceps tendon. Before fixing, the bone bed is roughened and multiple small holes with k wire are made to help better healing. Using three set of fiberwires, the muscle tendon is approximated to the bone and fixed using suture anchors. The suture anchors are made up of different materials • PEEK (high grade polymer) • Biocomposite (becomes bone) • Metal (titanium) Pectoralis Major Repair Rehabilitation Post-surgery, you can expect to be in a broad arm pouch supporting your arm. Rehabilitation in the form of gentle passive mobilisation is started early usually by 2nd week. Active ROM exercises are started 4 weeks post-surgery. Strengthening exercises typically start post 6 to 8 weeks. To achieve full functionality including lifting weights, you can expect it to take around 4 to 6 months.
Learn More
Elbow
PRP Injection (Platelet Rich Plasma)
PRP Injection (Platelet Rich Plasma) Book an Appointment PRP or Platelet Rich Plasma injection has been described first in 1970s. However, it has found wider acceptence and evidence in Orthopedic field only in the last 15 years. It now has been an establised treatment in different areas of medicine including Dermatology, General Surgery in addition to Orthopedics. Its treatment value has been equated to that of stem cell therapy in many regards. This is an innovative procedure performed in the clinic as out patient. Indications Tendinopathies Tennis Elbow Achilles tendinopathy (Heel) Patellar tendinopathy (Knee) Rotator Cuff partial tear (Shoulder) Plantar fasciitis Ligament tears (Partial) ACL (Knee) ATFL and CFL (Ankle) TFCC (Wrist) MCL (Knee) Osteoarthritis (Mild to moderate) How is it performed? The preparation for this begins with drawing blood from the patient in the same way as drawing blood for investigations. Blood is carefully collected in the special test tubes and is centrifuged. With this the blood and the plasma get separated. Out of which the lowest layer of plasma, which is rich in platelets is separated. This is then injected to the area of need. Local anaesthesia gel is usually applied to the area prior to the injection. Post injection, you need to avoid taking any NSAID pain killers for 15 days. What to expect post Injection? Post Injection, there may be a mild increase in pain for the first 2 to 3 days. After that the injection pain settles down. Stretching exercises are resumed after 3 days. You can expect improvement in the condition in around 4 to 6 weeks. Another way of doing PRP is by using the blood drawn from the bone marrow (BMAC – bone marrow aspiration concentrate). In certain instances, this is preferred over the standard PRP. However the donor site pain may persist for few weeks.
Learn More
General
Rehabilitation
Rehabilitation Book an Appointment Orthopedic and sports rehabilitation is a multi- disciplinary field involving Physiotherapists, Occupational therapists, Trainers and Doctors working closely to achive the pre-injury level of fitness and mobility for the patient. Prehabilitation For most orthopedic and sports injuries, prehab is a very useful tool to help reduce the swelling, keep the muscles in good shape and condition and improve the range of movements. One of the common surgeries where prehab is used in the ACL Injury. This has been shown to improve the post surgery outcomes and recovery. Wherever possible, the time before surgery is best utilised in prehab. Rehabilitation Rehabilitation has to start early post surgery. Infact, same day physiotherapy inputs has been found to be extremely valuable. Keeping the joints above and below mobile helps a great deal in recovery of the joint on which surgery has been performed. Early muscle activation exercises wherever permissible are important for recovery. For patients with risk of post surgery stiffness, it is important to use Continous passive motion (CPM) machine. First phase of rehabilitation Initial phase of rehabilitation is mainly aimed at regaining the full range of movement of the joint and improving the muscle strength. Second phase of rehabilitation Once this is achieved, the next targets would be to Further improvement of the muscle strength Proprioception (joint and body's ability to sense movement, action, and location) Landing techniques (on jumping and landing, the correct way to land to prevent further injuries) Pliometrics (speed and force to improve the muscle power and function) What symptoms warrant surgery? Functional training specific to the sports involved in. Fourth phase of rehabiliation Return to active sports.
Learn More
General
Revision ACL Reconstruction
Revision ACL Reconstruction Book an Appointment Diagnosis Clinical examination can reveal laxity in patients with ACL retear. However, confirming partial or complete tear by examination can be difficult. Often the knee may not be swollen like it does in primary tear. MRI Scan: MRI Scan is an important investigation, however the MRI images may not always give a clear picture due to artifacts post surgery. A 3 Tesla MRI scan is often better than 1.5 Tesla MRI scan in identifying the ACL retear. In addition, it is important to assess the condition of the meniscus (cushions in the knee joint), cartilage and other ligaments. Treatment ACL Revision Prehabilitation ACL Prehab exercises can be started once the pain and swelling improve. These exercises help in regaining the knee movements and keep the muscles in a good condition. Revision ACL Reconstruction Revision ACL reconstruction is a bigger procedure than the primary ACL surgery. When considering revision surgery, it is important to take the position of the tunnels, bone quality around the tunnels, rest of the joint structures integrity need to be taken into account. Based on these parameters a decision will have to be taken as to whether the surgery will be single stage or two stage procedure. If there is a lot of bone loss, then first stage of the surgery to perform bone grafting and second stage is to do the reconstruction. In patients needing a 2 stage procedure a gap of 3 to 6 months between the 2 procedures is needed for bone healing. Next concern is regarding the type of graft to be chosen for this. As the first surgery may have utilised either hamstrings or patellar tendon (BTB or Bone tendon bone) for graft, the graft material will have to be carefully chosen. The tendon thickness and tendon alone or bone tendon bone graft matters. Usually quadriceps tendon from thigh or the peroneus longus tendon from the leg is utilised for this. Thirdly, additional joint problems such as cartilage loss and / or meniscal tears if present, needs pre planning in terms of type of chondroplasty and meniscal repair techniques for the treatment. Revision ACL Rehabilitation Post-surgery, you are allowed to walk on the next day. If meniscus is intact and only revision ACL reconstruction surgery has been performed, then you are allowed to walk with full weight on the leg. Initial one to three weeks you may need the support of a walker. Within 2 weeks most people manage to walk without support. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 9 to 12 months before returning back to playing sports on the ground or court.
Learn More
General
Rotator Cuff Repair
Rotator Cuff Repair Book an Appointment Rotator Cuff is a group of 4 small muscles which hug the shoulder joint closely and help to fine tune the shoulder movements. The rotator cuff tear can be due to acute injury or due to repetitive strain. A complete tear needs an arthroscopic (keyhole) surgery to repair. Diagnosis Physical examination reveals pain and weakness in certain angle of movement (open can and closed can tests). X-rayX-ray is performed and is useful to assess the type of the acromion (outer projecting edge of the shoulder blade) bone and for signs of arthritis. However, rotator cuff tear is not visible on the X-ray. USG Scan: Ultrasound scan of shoulder has got a role in assessing the state of the rotator cuff muscle. Ultrasound has got certain limitations as it is poor at differentiating between the partial tear and a complete tear of the muscle tendon. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the Rotator cuff tear. It also helps in understanding the condition of the muscle. In addition, it helps to assess the condition of the muscle tendons, rest of the labrum (lip of the socket) and the quality of the biceps tendon. Treatment Partial Tear of Rotator Cuff Management Selected partial tears can be managed with PRP Injection. Complete tears will not respond to this mode of treatment. Rotator Cuff repair Surgery Rotator Cuff repair surgery is a day care surgery. Through arthroscopy (Keyhole), the shoulder joint is assessed and the joint structures are evaluated. The extent of the tear and the quality of the muscle are assessed. The muscle is mobilized to the point of its attachment and then fixed to the bone using fiberwire threads and the suture anchors. The suture anchors are made up of different materials PEEK (high grade polymer) Biocomposite (becomes bone) Metal (titanium) Rotator Cuff Repair Rehabilitation Post-surgery, you can expect to be in a broad arm sling supporting your arm. Rehabilitation in the form of gentle passive mobilisation is started early usually by 2nd week. Active ROM exercises are started usually by 3th week post-surgery. Strengthening exercises typically start post 6 to 8 weeks. To achieve full functionality including lifting objects, you can expect it to take around 4 to 6 months.
Learn More
General
SLAP Repair
SLAP Repair Book an Appointment Overview SLAP (Superior Labrum Anterior to Posterior) tear of shoulder is common in players involved in racquet sports and throwing sports. It is usually due to the bucket handle tear of the long head of the Biceps tendon origin in the shoulder joint. The Shoulder Pain is usually perceived deep in the joint and in the front of the shoulder. This needs a keyhole surgery to repair. Diagnosis A thorough physical examination of the shoulder is required to check for the rotator cuff muscles and stability. Signs checked for assessing the shoulder for SLAP tear are not very specific to the SLAP tear, however can be helpful. X-ray: X-ray is performed and is useful to rule out any bone injuries, however, SLAP tear is not visible on the X-ray. MRI Scan: MRI Scan with contrast is the gold standard investigation to identify the type and extent of the SLAP tear. However, a plain MRI scan is still good enough in picking up these injuries. In addition, it helps to assess the condition of the muscle tendons, rest of the labrum (lip of the socket) and the quality of the biceps tendon. Treatment SLAP repair Surgery SLAP repair surgery is a day care surgery. Through shoulder arthroscopy (key-hole surgery), the joint is assessed and the joint structures are evaluated. Using the probe, the extent of the tear and the quality of the biceps tendon is assessed. In patients with frail biceps tendon, biceps tenotomy (cutting and releasing of the biceps tendon) or biceps tenodesis (reattaching the biceps tendon at a more distal point) procedure may be more appropriate. However, in young patients with intact biceps tendon, the SLAP tear is repaired typically by using one or two suture anchors on the front and back of the biceps tendon attachment. The suture anchors used are made up of different materials PEEK (high grade polymer) Biocomposite (becomes bone) All Sutures Metal (titanium) SLAP Repair Rehabilitation Post-surgery, you can expect to be in a broad arm sling supporting your arm. Gentle passive mobilisation is started early, usually on the day 1 or 2. Abduction (moving the arm outwards and upwards is restricted upto 3 weeks). Usually within 2 weeks, active ROM exercises are started. Strengthening exercises typically start post 6 weeks. To achieve full functionality including lifting objects, you can expect it to take around 4 to 6 months.
Learn More
General
Stem Cell Therapy
Stem Cell Therapy Book an Appointment Non-surgical Treatment Stem cells are the root cells to help grow almost anything in the body again. There is a small cache of these remaining in the bone marrow and other places in the body. These cells have the capacity to grow into daughter cells and create the same tissue again. As body will not be having the right condition to multiply these cells and recreate the tissue, the same process can be stimulated in the laboratory and millions of such cells with specialized function can be created. How does Stem Cell Therapy work? For recreating the new bone or cartilage, the stem cell therapy is very useful in regeneration in conditions such as avascular necrosis (AVN) hip, Cartilage loss (contained defects) in the knees, ankles and hips. A small piece of cartilage with the bone under that is taken from the knee by arthroscopy (keyhole surgery) from an area which is not weight bearing part. Alternatively, bone marrow (blood inside the bone) is aspirated using a needle from the back portion of the pelvic bone. This will be safely labeled and sent to the laboratory. The stem cells are separated and stimulated to grow a specific line of cells in millions. This process takes around 4 to 6 weeks. Then it is transported back to the hospital and through a second procedure, used to either fill the cartilage defects or to regenerate into the bone. Can we use embryonic stem cell from the same family instead? Embryonic cells can grow irregularly and controlling them to differentiate into one single line of cells with single specialization is still something researchers are working on. Embryonic cells can still mount immune response against the host receiving the graft and will necessitate long term use of the immune-suppressant medications for long term. In the long run, the embryonic cells may simply stop working in the host body. There is no validation of these so far. Hence currently, this is not used for the stem cell therapies in orthopedic field. What can I expect post-surgery? Post stem cell therapy, the area may need to be protected from full weight bearing for a period of 2 to 3 weeks. During this period, usually mobility by gentle passive movements is maintained. By 6 weeks most of these should start stabilizing. By 4 to 6 months most people return back to the sporting activities.
Learn More
General
Subacromial Decompression
Subacromial Decompression Book an Appointment Overview Subacromial space is the area below the acromion (roof bone) of the shoulder and the underlying supraspinatus (rotator cuff) muscle. This area contains the subacromial bursa (a fluid filled pouch). This area can be very narrow and obliterated in patients with a flat (Type 2) or down sloping (Type 3) Acromion bone. The thickening of the bursa due to repetitive irritation can also be the cause of pain. Diagnosis Physical examination reveals pain particularly in the terminal range of movements. X-ray: X-ray is performed and is useful to assess the type of the acromion (outer projecting edge of the shoulder blade) bone and for signs of arthritis. Ultrasound Scan: Ultrasound scan of shoulder has got a role in assessing the state of the rotator cuff muscle. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the Rotator cuff tear. It also helps in understanding the condition of the muscle. Treatment Subacromial bursitis and impingement needs an arthroscopic (keyhole) surgery to create space when conservative treatments such as exercises and steroid injection have failed to improve the condition. Arthroscopic Subacromial Decompression Surgery Subacromial decompression surgery is a day care surgery. Through arthroscopy (Keyholes), the shoulder joint is assessed and the joint structures are evaluated. The undersurface of the acromion bone and the joint between acromion and the clavicle (collar bone) is assessed. The beaking part of the acromion bone is shaved off using the bone burr. A smooth undersurface of the acromion bone with enough room for the shoulder joint to move freely is created. The thickened subacromial bursal tissue is removed. The underlying rotator cuff muscle is assessed for its integrity. Subacromial Decompression Rehabilitation Post-surgery, you can expect to be in a broad arm sling supporting your arm. Gentle passive mobilisation is started early as soon as pain is better. Active ROM exercises are started usually by 2nd week post-surgery. Strengthening exercises typically start around 4 weeks post surgery. To achieve full functionality including lifting objects, you can expect it to take around 2 to 3 months. ACL Tear LCL Ligament tear MCL Ligament tear Knee Dislocation (MPFL Ligament Injury) Cartilage tear Patellar Chondromalacia Fracture around the knee joint (Intra-articular fractures) Wear & Tear Patellar tendinopathy Fat Pad Impingement Quads tendinopathy Osteochondritis Dissecans Knee IT Band tightness Loose body
Learn More
Elbow
Tennis Elbow Treatment
Tennis Elbow Treatment Book an Appointment Diagnosis Tennis Elbow or Lateral Epicondylitis is easy to diagnose with clinical examination alone. However, an X-ray would help to rule out any underlying bone condition contributing to the problem. Treatment Exercise based treatment. Tennis Elbow responds well to simple stretching exercise based treatments. Home based or physiotherapy guided exercise regimes work well for majority of patients. Wearing a tennis elbow band in addition, particularly for the hand work may help in preventing further irritation of the tennis elbow. Steroid Injection Steroid injection is a safe and effective treatment for the tennis elbow. However, there is a risk of recurrence with the injection alone. Post injection stretches can minimize the risk of recurrence. PRP (Platelet Rich Plasma) Injection PRP Injection is a safe and effective treatment for tennis elbow. The whole procedure of drawing blood, time to centrifuge and then injection is around 40 minutes of time in the out patients. For the PRP to be effective and average of 4 to 6 weeks of time is required. In some, more than one PRP injection may be required to cure the condition completely. Tennis Elbow Release Surgery In patients with no improvement with all other conservative measures, surgery is considered. This is performed either as an open surgery or arthroscopically (Keyhole). The incision for open surgery is around 3cm long. The tendon is released and debrided (the frail tissue removed). Small puncture holes are made in the bone underneath so that there is some bleeding to that area and healthy tissue can grow to that area. Rehabilitation Post-surgery, the bulky dressing is removed after 4 days. Early mobilization is allowed. Gentle passive stretches for the elbow are started as early as 2 weeks. Strengthening exercises are embarked upon after 4 weeks. One is expected to return to full activity by around 6 weeks post-surgery.
Learn More
Elbow
TFCC Ligament Surgery
TFCC Ligament Surgery Book an Appointment TFCC (Triangular Fibro Cartilage Complex) tear is an injury leading to instability and pain on the ulnar (little finger) side of the wrist. Clinical examination to assess site of pain, movements of the wrist, ulnar head (forearm bone) stability gives enough pointers to diagnose, however the extent of the tear and the condition of the surrounding structures such as tendons wouldn’t be easy to decipher. X-ray: X-ray is performed and is useful to rule out any bone injuries, however, ligaments are not visible on the X-ray. MRI Scan: MRI Scan is the gold standard investigation to identify the type and extent of the TFCC ligament injury. In addition, it helps to assess the condition of the rest of the wrist joint and tendons around the wrist. Treatment Non-surgical Treatment TFCC ligament injuries can be treated with a wrist splint for upto 3 weeks in the first instance. In majority of patients this would be sufficient. If healing well this would be followed by stretching exercises to get the mobility back. In patients with poor healing or no improvement, it becomes necessary to get an MRI Scan done to assess the extent of the injury. Partial TFCC Ligament tears In partial tears which have refused to heal with simple splinting, a PRP (Platelet Rich Plasma) Injection and a plaster cast for 4 weeks is recommended. Here PRP stimulates the healing process and the cast immobilizes so that the ligament can stand a better chance to heal. Complete TFCC Ligament tears Complete TFCC ligament tears need a Arthroscopic TFCC Repair Surgery to heal the tear. This procedure is done either arthroscopically (through camera and small cuts) or as a mini – open surgery. The damaged tissue is debrided (removed) and the edges of the tear are freshened so that it can heal well. Post that, the ligament is reattached to the soft tissues on the sides with stitches. Large tears are repaired with the stitches and the sutures are fixed back to the ulnar bone using small bio-composite suture anchors. Rehabilitation Post-surgery, you can expect to be in a plaster slab upto above the level of elbow for 2 weeks followed by below the level of elbow for another 2 to 4 weeks depending upon the nature of repair undertaken. Once your cast has been removed you need physiotherapy to help regain range of movement first, followed by strength and full function of your wrist.
Learn More
About Our Surgical Procedures
Our orthopedic surgical procedures are designed to address a wide range of musculoskeletal conditions, from sports injuries to degenerative joint diseases. Our experienced surgeons utilize the latest techniques and technology to provide optimal outcomes for our patients.
When considering surgery, we believe in thoroughly educating our patients about their options, potential benefits, risks, and recovery expectations. Each procedure page provides detailed information to help you make informed decisions about your care.
Whether you require minimally invasive arthroscopic surgery or complex joint reconstruction, our team is committed to delivering personalized care and supporting you throughout your surgical journey.