Problems with the appearance or function of the hand can be the result of injury, birth defects or degenerative conditions. Transplantation Fingers or hands that have been accidentally cut off can be reattached by very detailed surgery that is performed under a microscope (microsurgery) and involves reconnecting tendons, blood vessels and nerves. Arthritis Arthritis is a condition in which a joint and the surrounding tissue become swollen and painful. If surgery is necessary, it may involve replacement of the joint with an artificial joint or removal or repair of swollen or damaged tissue. Birth Abnormalities Surgery may sometimes be required for hand abnormalities that are present at birth such as too many or too few fingers, webbed fingers or joints that won’t bend. Carpal Tunnel Syndrome 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. This operation is usually performed under local anaesthetic (the area being treated is numb but you are awake). Injuries Damage to tendons, nerves, joints and bones in the hand may require surgical repair. In some cases, tissue may be transferred from a healthy part of your body to the injured site (grafting). Dupuytren’s Contracture This condition occurs when there is abnormal thickening of the deep tissue between the palm of your hand and your fingers. This thickening occurs very gradually and will start to make your fingers curl toward your palm. If this condition gets to the stage where it significantly limits your hand function, surgery may be recommended. This usually involves removal of the thickened tissue, allowing you to straighten your fingers again.

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.

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.

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.

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 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.

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.

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.

Carpal Tunnel Syndrome is caused by a pinched nerve in the wrist that causes tingling, numbness and pain in your hand. 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 condition occurs when there is abnormal thickening of the deep tissue between the palm of your hand and your fingers. This thickening occurs very gradually and will start to make your fingers curl toward your palm. If this condition gets to the stage where it significantly limits your hand function, surgery may be recommended. This usually involves removal of the thickened tissue, allowing you to straighten your fingers again.

Elbow surgery is an operation that helps fix problems in the elbow, like injuries or wear and tear from arthritis. Surgery might be: Arthroscopic: less invasive surgery. The surgeon makes small cuts and uses a tiny camera to see inside the elbow. They can then fix or take out the damaged parts. Open: for more complicated problems, the surgeon makes a larger cut to get a better look and fix the damaged parts directly. Joint Replacement: when the elbow joint is badly damaged, the surgeon might remove the damaged areas and replace them with parts made of special materials.

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.

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.

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 on the following link for meniscal tears and for meniscal transplant surgery.

An incision (cut) is made on the front of the knee to allow the surgeon access to the knee joint. The damaged and painful areas of the thigh bone (femur) and lower leg bone (tibia), including the knee joint, are removed and replaced with metal and plastic parts.

Knee surgery is an operation that helps fix problems in your knee, like an injury, arthritis, a torn ligament, or damaged cartilage. Surgery might be: Arthroscopic: less invasive surgery. The surgeon makes small cuts and uses a tiny camera to see inside the knee. They can then fix or take out the damaged parts. Open: for more complicated problems, the surgeon makes a larger cut to get a better look and fix the damaged parts directly. Joint Replacement: when the knee is badly damaged, the surgeon might remove the damaged areas and replace them with parts made of special materials.

Otherwise known as degenerative arthritis. OA 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 www.arthritis.org.nz

Revision joint replacement is the repair or replacement of an existing joint replacement.

This surgery involves making several small incisions (cuts) on the shoulder through which is inserted a small telescopic instrument with a tiny camera attached (arthroscope). This allows the surgeon to look inside the shoulder, identify problems and, in some cases, make repairs to damaged tissue.

An incision (cut) is made in the shoulder to allow the surgeon access to the shoulder joint. The diseased and damaged parts of the shoulder joint are removed and replaced with smooth, artificial metal ‘ball’ and plastic ‘socket’ parts.

Shoulder surgery is an operation that helps fix problems in your shoulder, like torn muscles or tendons or wear and tear from arthritis. Surgery might be: Arthroscopic: less invasive surgery. The surgeon makes small cuts and uses a tiny camera to see inside the shoulder. They can then fix or take out the damaged parts. Open: for more complicated problems, the surgeon makes a larger cut to get a better look and fix the damaged parts directly. Joint Replacement: when the shoulder is badly damaged, the surgeon might remove the damaged areas and replace them with parts made of special materials.

An incision (cut) is made over the damaged tendon. The damaged ends of the tendon are sewn together and, if necessary, reattached to surrounding tissue.

Service types: Hand and wrist surgery.

Service types: Knee replacement.