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Nicholas deGiorgio-Miller - Upper Limb, Hand, Hip & Knee Orthopaedic Surgeon

Private Service, Orthopaedics

Description

Nick deGiorgio-Miller is a New Zealand trained Orthopaedic Surgeon with interests in surgery of the:

He works at Wairarapa Hospital and Selina Sutherland Hospital, Masterton.

 
What is Orthopaedics?
This is an area that deals with conditions of the musculoskeletal system (disorders of bones and joints of the limbs and spine). The specialty covers a range of different types of conditions starting with congenital (conditions which children are born with) through to degenerative (conditions relating to the wearing out of joints). The field of orthopaedics covers trauma where bones are broken or injuries are sustained to limbs.
Other conditions that sit under the spectrum of orthopaedics are metabolic conditions, neurological and inflammatory conditions.

Consultants

How do I access this service?

Referral

Referral Expectations

You need to bring to your appointment with you:

1.       Any letters or reports from your doctor or hospital.
2.       Any X-Rays, CT or MRI films and reports.
3.       All medicines you are taking including herbal and natural remedies.
4.       Your pharmaceutical entitlement card.
5.       Your ACC number, if you have one.

Fees and Charges Categorisation

Fees apply

Fees and Charges Description

Nick is a Southern Cross Affiliated Provider and NIB First Choice member

Procedures / Treatments

Hand & Wrist Surgery

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.

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.

Joint Replacement

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 polyethylene) 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.

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 polyethylene) 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

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.

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.
Arthroscopy (keyhole surgery)

Many 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.

Many 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.
Soft Tissue (muscles, tendons and ligaments)

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.

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.
Total 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. 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.

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.

Anterior Cruciate Ligament (ACL) Reconstruction

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.

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.

Rotator Cuff Repair

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.

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.

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.

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.

Parking

Free patient parking is provided at Selina Sutherland Hospital

Contact Details

Blair Street
Lansdowne
Masterton
Wellington 5810

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Street Address

Blair Street
Lansdowne
Masterton
Wellington 5810

Postal Address

PO Box 747
Masterton 5840

This page was last updated at 11:35AM on June 12, 2024. This information is reviewed and edited by Nicholas deGiorgio-Miller - Upper Limb, Hand, Hip & Knee Orthopaedic Surgeon.