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.

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.

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. Occasionally blood transfusions are required; if you have some concerns raise this with your surgeon during consultation. For more information about total knee replacement please click here.

The anterior cruciate ligament (ACL) is a strong, stabilising ligament running through the centre of the knee between the femur (thigh bone) and tibia (shin bone). When the ACL is torn, frequently as the result of a sporting injury, arthroscopic surgery known as ACL Reconstruction is performed. The procedure involves replacement of the damaged ligament with tissue grafted from elsewhere, usually the patellar or hamstring tendon. The ends of the grafted tendon are attached to the femur at one end and the tibia at the other using screws or staples. For more information about ACL Reconstruction please click here.

A large number of orthopaedic procedures on joints are performed using an arthroscope, where a fibre optic telescope is used to look inside the joint. Through this type of keyhole surgery, fine instruments can be introduced through small incisions (portals) to allow surgery to be performed without the need for large cuts. This allows many procedures to be performed as a day stay and allows quicker return to normal function of the joint. Arthroscopic surgery is less painful than open surgery and decreases the risk of healing problems. Arthroscopy allows access to parts of the joints which can not be accessed by other types of surgery.

The menisci are two circular strips of cartilage that form a cushioning layer between the ends of the femur (thigh bone) and tibia (shin bone) in the knee joint. Together the medial and lateral menisci, on the inside and outside of the knee, respectively, act as shock absorbers and distribute the weight of the body across the knee joint. The menisci can become torn through injury or damaged from age-related wear and tear and may require surgery. The most common meniscal surgery is partial meniscectomy in which the torn portion of the meniscus is cut away so that the cartilage surface is smooth again. In some cases meniscal repair is carried out, in this case the torn edges of the meniscus are sutured together. Both procedures are performed arthroscopically. For more information please click here for meniscal tears and click here for meniscal transplant surgery.

A pinched nerve in the wrist that causes tingling, numbness and pain in your hand may require surgery to make more room for the nerve. Surgery to relieve carpal tunnel syndrome involves making an incision (cut) from the middle of the palm of your hand to your wrist. Tissue that is pressing on the nerve is then cut to release the pressure. This operation is usually performed under local anaesthetic (the area being treated is numb but you are awake).

In many cases tendons will be lengthened to improve the muscle balance around a joint or tendons will be transferred to give overall better joint function. This occurs in children with neuromuscular conditions but also applies to a number of other conditions. Most of these procedures involve some sort of splintage after the surgery followed by a period of rehabilitation, normally supervised by a physiotherapist.

This procedure is used when osteoarthritic damage to the cartilage on one side of the knee has caused the angle of the knee joint to change so that most of the body's weight is borne by the affected side, adding to the wear on that side. High Tibial Osteotomy involves reshaping and realignment of the bone so that weight becomes more evenly distributed between the inside and outside of the knee, thereby reducing the workload on the damaged side. You will probably have to stay in hospital for several days after surgery followed by up to 6 months rehabilitation. For more information about osteotomy please click here.

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.