Knee & Hip Surgery
The knees are the strongest joint in the human body, allowing the legs to bend and straighten while carrying almost all of the weight of the individual when they are standing. The knees are a hinge joint, but still have substantial capacity for lateral (side-to-side) motion.
As an active, weight-bearing joint, the knee is a source of pain and problems for many people. This pain may be acute or chronic, and may be a result of injury, overuse or growth. It can stem from the tendons, ligaments, bones, cartilage or any other structure within the knee. Some of the most common knee conditions include:
- Dislocated kneecap
- Meniscal tear
- Ligament injuries
- Patellar tendonitis
The patella, commonly known as the kneecap, helps increase leverage and support within the knee joint. Pain may develop in the patella as a result of overuse or injury, and often causes a fracture. Patella fractures can involve a single crack across the kneecap or a break into several pieces, and usually causes severe pain and swelling.
Surgery may be required for more intense patella fractures, and aims to repair the patella by realigning the fractured ends and holding them in place with pins, screws and wires. Part of the bone may just be removed in smaller fractures. During the healing process, the knee must be kept straight, and patients will often undergo physical therapy to help restore movement to the joint.
The anterior cruciate ligament (ACL) works together with the other ligaments in the knee to connect the femur to the tibia and support the knee joint. A tear in the ACL is one of the most common knee injuries, causing the joint to become unstable and slide forward too much. This injury occurs most often in athletes and causes pain, swelling, tenderness and limited motion.
ACL reconstruction is usually not performed until several weeks after the injury, when swelling and inflammation have been reduced. The torn ligament is completely removed and replaced with a new ACL. Simply reconnecting the torn ends will not repair the ACL. Part of another ligament, usually in the knee or hamstring, is used to create a graft for the new ACL.
The hip is a “ball-and-socket” joint where the “ball” at the top of the thigh bone (femur) fits inside the “socket” of the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip becomes diseased or damaged, the joint can stiffen and be very painful.
While many hip conditions can be treated through conservative methods, surgery is often needed because of the excessive weight placed on the joint while walking, standing and performing other regular activities.
Hip Fracture Repair
A hip fracture involves a break in the top of the femur when the bone angles toward the hip joint. Hip fractures are especially common in older patients and those with osteoporosis. They are usually extremely painful and require surgical repair to relieve pain and restore proper functioning.
During hip fracture surgery, an incision is made over the affected area and the bones are aligned back in place. The bones are often held in place with metal pins, screws, rods or plates while they heal, which may or may not be removed later on. The incision is then closed with sutures or staples. This procedure usually takes two to four hours to perform.
Total Hip Replacement
Hip replacement is usually a last resort treatment for patients with severe hip pain whose daily lives are affected by the pain, including those with arthritis, fractures, bone death or other conditions. In this procedure, the diseased bone and cartilage are replaced with a metal ball and plastic cup.
The artificial joint, called a prosthesis, may be cemented in place, may be cementless, or may be a hybrid of both. The prosthetic devices provide pain relief and restored function for 25 years or longer in most cases.
Most patients who undergo hip surgery achieve successful relief from their condition, including pain relief, restored function and an improvement to their overall quality of life. There are certain risks associated with hip procedures, including infection, nerve damage, blood clots and reactions to anesthesia, but these risks are considered rare and can be further reduced by choosing an experienced and skilled surgeon.