Otherwise known as degenerative arthritis, osteoarthritis occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older. You can get it at any age and are more likely to if you have previously injured a joint, or are overweight. The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well. The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience. Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see http://www.hughblackley.co.nz/arthritis.htm

For elderly patients joint replacement surgery is commonly required to replace joints that have been worn out by arthritis. Serious injury or long term illness may also damage joints so that they require replacement. In these procedures the damaged or diseased joint surface is removed and replaced with artificial surfaces normally made from metal (chromium cobalt alloy, titanium) and plastic surfaces (high density polyethylene and ceramic) which act as replacement surfaces for the damaged joint. Joints commonly replaced are the ankle, hip and knee. These operations are major procedures which require the patient to be in hospital for several days then followed by a significant period of rehabilitation. Occasionally blood transfusions are required. Hip Replacement An incision (cut) is made on the side of the thigh to allow the surgeon access to the hip joint. The diseased and damaged parts of the hip joint are removed and replaced with smooth, artificial metal ‘ball’ and plastic ‘socket’ parts. Click on the link for more information about hip surgery. Knee Replacement This is a surgical procedure performed on a knee joint that has become painful and/or impaired because of disease, injury or wear and tear. In total knee replacement, artificial materials (metal and plastic) are used to replace the following damaged surfaces within the knee joint: the end of the thigh bone (femur) the end of the shin bone (tibia) the back of the kneecap (patella) This operation is a major procedure which requires you to be in hospital for several days and will be followed by a significant period of rehabilitation. Click on the link for more information about knee surgery.

Often orthopaedic procedures on joints can be performed using arthroscopy, where a fibre optic telescope (arthroscope) is used to look inside the joint. Through this type of keyhole surgery, fine instruments can be introduced through small incisions or cuts (portals) to allow surgery to be performed. Arthroscopy is typically performed on ankle, hip, knee and shoulder (including rotator cuff repair) joints. Arthroscopy has the following advantages over open (large incisions) surgery: many procedures can be performed as day-stay surgery allows quicker return to normal function of the joint is less painful than open surgery decreases the risk of healing problems allows access to parts of the joints which cannot be accessed by other types of surgery. Knee Arthroscopy Several small incisions (cuts) are made on the knee through which is inserted a small telescopic instrument with a tiny camera attached (arthroscope). This allows the surgeon to look inside the joint, identify problems and, in some cases, make repairs to damaged tissue. Click on the link for more information about knee arthroscopy. Ankle Arthroscopy Two or three small incisions (cuts) are made in the ankle and a small telescopic instrument with a tiny camera attached (arthroscope) is inserted. This allows the surgeon to look inside the joint, identify problems and, in some cases, operate. Tiny instruments can be passed through the arthroscope to remove bony spurs, damaged cartilage or inflamed tissue. Click on the link for more information about ankle arthroscopy.

Tendons can be lengthened to improve the muscle balance around a joint or they can be transferred to give overall better joint function. This typically occurs in children with neuromuscular conditions but also applies to a number of other conditions. Tendons that have been damaged by injury can be repaired by sewing the damaged ends together and, if necessary, reattached to the surrounding tissue. Most of these procedures involve some sort of splintage after the surgery followed by a period of rehabilitation, normally supervised by a physiotherapist. Click here for information about Achilles tendon injuries.

Orthopaedic deformities can be congenital or acquired as the result of injury, infection or tumour. Resulting in crooked limbs or discrepancies in limb length, such deformities can affect appearance and function and can often cause significant pain. Osteotomy is the division of a crooked or bent bone to improve alignment of the limb. These procedures normally involve some form of internal fixation, such as rods or plates, or external fixation which involves external wires and pins to hold the bone. The type of procedure for fixation will be explained when the surgery is planned. Some of the more common orthopaedic deformities are: Intoeing Bow Legs (Genu Varum) Club Foot (Talipes) Developmental Dislocation of the Hip Bunions Limb Length Discrepancy