For elderly patients joint replacement surgery is commonly required to treat damaged joints from wearing out, arthritis or other forms of joint disease including rheumatoid arthritis. In these procedures the damaged joint surface is removed and replaced with artificial surfaces normally made from metal (chromium cobalt alloy, titanium), plastic (high density polyethelene) or ceramic which act as alternate bearing surfaces for the damaged joint. These operations are major procedures which require the patient to be in hospital for several days and followed by a significant period of rehabilitation. The hospital has several ways of approaching the procedure for replacement and the specifics for the procedure will be covered at the time of assessment and booking of surgery. Occasionally blood transfusions are required; if you have some concerns raise this with your surgeon during consultation.

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.

Several small incisions (cuts) are made in the shoulder through which is inserted a small telescopic instrument with a tiny camera attached (arthroscope). The surgeon is then able to remove any bony spurs or inflamed tissue and mend torn tendons of the rotator cuff group.

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.

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 cannot be accessed by other types of surgery.

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.