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The ACL or the anterior cruciate ligament are the tough tissue bands that connect the thigh bone to the shin bone
Bodyinjurysurgery

ACL Injuries: Minimally Invasive Surgery

by allurewellness
written by allurewellness

The ACL or the anterior cruciate ligament are the tough tissue bands that connect the thigh bone to the shin bone.

The anterior cruciate ligament runs through the knee diagonally and works by giving the joint in the knee the much needed stability.

It also helps control the back-and-forth movement of the lower leg.

Oftentimes, knee injuries occur when playing physically demanding sports like skiing, squash, football, and tennis.

Up to 40 percent of known sports injuries can be traced to ACL injuries.

In cases where damage is extensive, minimally invasive surgery might be recommended.

Tears in the ACL often happen when the lower leg and the knee are twisted or when the lower leg is extended too much.

Other likely causes of ACL injuries include:

  • Incorrect landings (from jumps)
  • Collisions (from football tackles)
  • Drastic stops
  • Sudden changes in direction

When the ACL is torn, there is a tendency for the knee to become highly unstable.

Losing its full motion range is also possible.

When is surgery needed?

For ACL tears that are minor, conservative and noninvasive treatment options will most often suffice

For ACL tears that are minor, conservative and noninvasive treatment options will most often suffice.

However, if there are multiple tears, immediate surgical intervention is the most likely option to help ensure the knee is stabilized.

Surgery is also often carried out before too much inflammation can occur and cause permanent damage to the joint.

Stitching alone will not be enough to repair ACL tears.

Tissue graft (from the patient or a cadaver) will be required to provide support and facilitate ligament growth.

Fortunately, it is a lot easier for orthopedic surgeons nowadays to gauge the severity of the injury.

When immediate repairs are deemed necessary, a minimally invasive surgery called arthroscopy is performed.

The procedure is carried out under general anesthesia.

The surgeon will also need to make several tiny incisions in the knee.

In order to clean the joint, fluid will be injected.

A fiber optic camera will then be inserted so it can provide detailed images on the television monitor.

The detailed images will help the orthopedic surgeon clearly see the joint parts and determine the steps necessary for the repair.

Years prior, surgeries of the knee are often classified as open surgery and will often entail at least a week-long stay in the hospital.

Several months will also be required for full recovery to take place.

Fortunately, patients can perform day-to-day routines more quickly with procedures that are minimally invasive.

Knee arthroscopy is also carried out to:

  • Trim the pieces of the broken cartilage
  • Remove or repair the cartilage that works as cushion in the meniscus (the space situated between the knee bones)
  • Repair the bone fractures found in the knee
  • Repair the lining of the knee or the synovium
  • Remove the fluid-filled sac that can manifest in the back of the knee (Baker’s cyst)

Preparations

Before the surgery, the following will most likely be suggested:

  • Discussing bleeding disorders or other medical conditions with the surgeon.
  • Taking a blood sample just in case a transfusion of blood will be necessary.
  • Letting the doctor know if you have colds, fever, herpes breakout, flu or other conditions that might cause rescheduling of the surgery.
  • Taking ibuprofen (Advil, Motrin), Iopidogrel (Plavix), naproxen (Aleve, Naprosyn), and other blood thinners should be stopped.

On the day of the procedure, the following will most likely be recommended:

  • Eating and drinking after midnight should be avoided especially if general anesthesia will be administered.
  • Should be in the hospital on the time scheduled.
  • Taking medications provided with only a small water sip.

After the surgery, patients can expect the following:

  • They will be asked to go home after only a few hours.
  • They will have to use crutches when necessary.
  • Since the procedure is minimally invasive, recovery will be faster. However, in some instances, the complexity of the repair and the severity of the condition may affect the length of the recovery.

If you are a candidate for minimally invasive surgery for an ACL injury, get expert help from the able specialists at www.bjios.sg now.

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In essence, microsurgery is surgery performed on very small structures
Bodysurgery

Microsurgery: Basic Principles

by allurewellness
written by allurewellness

In essence, microsurgery is surgery performed on very small structures (i.e. nerves and the blood vessels).

Specialized instruments under a microscope are also used for the procedure.

Microsurgery makes use of techniques like blood vessel repair and organ transplantation.

The aforementioned techniques have been used since the twentieth century’s early part.

Microsurgery techniques have also been utilized by several surgical specialties.

For instance:

Ophthalmologists (eye doctors)

Performs microsurgery to remove cataracts, carry out corneal transplants, and treat glaucoma and other eye conditions.

Otolaryngologists (ear, nose, and throat doctors)

Uses microsurgeries when working on the small and delicate structures of the inner ear or when carrying out work on the vocal chords.

Gynecologists and urologists

Reverses tubal ligations and vasectomies using microsurgery principles.

Plastic surgeons

Reconstructs damaged or disfigured skin, tissues, and muscles using microsurgical techniques.

Other specialties

Performs microsurgery to replant or reattach amputated body parts to replace a new one (for instance, a lost or damaged thumb is replaced with a great toe).

Equipment Used in Microsurgery

The key functions of microsurgical equipment include magnifying the operating field and providing instrumentation

The key functions of microsurgical equipment include magnifying the operating field and providing instrumentation.

The equipment used are designed to make precise maneuvering feasible and to make operating on barely visible structures possible.

Essential instruments used in microsurgery include microsurgical instruments, micro suture materials, and the microscope.

Microscope

Microscope that is used in microsurgery is either mounted on the ceiling or on the floor.

It also comes designed with a moveable arm so manipulating its position becomes relatively easier.

A set of lenses and a high-intensity light source are used to view the surgical site.

A video camera is used so other members of the surgical team can view the surgical site on a display screen.

Ideally, a five to forty times (5–40x) magnification is used in microsurgical procedures.

Instruments

Compared to traditional surgical instruments, those used in microsurgery have distinct differences.

Aside from its capability to delicately manipulate barely visible structures, microsurgical instruments also come with handles that are large enough so handling them comfortably and securely is possible.

Instruments often utilized in microsurgery include:

  • Needle holders (for suturing)
  • Forceps
  • Vessel dilators
  • Standard surgical tools
  • Scissors
  • Irrigators

Suture Materials

In microsurgery, suturing or stitching is carried out utilizing needles and threads that are specialized.

The diameter or gauge of the threads can vary in size.

When choosing the apt thread to be used, the procedure that will be performed as well as the tissue that needs to be sutured will be taken into account.

In most cases, threads with 9–0 to 12–0 gauges are used in microsurgery.

Suture threads can also be non-absorbable or absorbable.

They can also be made from natural materials or synthetic ones.

The type used will depend on the procedure as well as the tissue that needs suturing.

Suture needles come in diverse sizes and shapes.

They also have different point types.

Generally, however, the needles often used are less than 0.15 mm in diameter.

Training

Surgeons will have to undergo extensive training and practice before they perform microsurgery.

Know-how on basic anatomy and surgical techniques will also be required.

Surgeons will also be taught how to hold the instruments properly, how to lessen hand tremors, ways to maintain proper posture when performing microsurgical procedures and maintaining visual contact when using the microscope, among other things.

A set of essential techniques have to be mastered by the surgeon as they are often utilized in microsurgery.

These basic techniques include nerve grafting and repair, vessel repair, and vein grafting.

When already very proficient in the basic skills needed for microsurgery, more advanced techniques will be taught, including treating specific conditions.

For more information about microsurgery and if it is the right option for you, check www.bjios.sg right now.

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The procedure performed to remove bone cancers and soft tissue in the limbs is called limb salvage surgery
Bodysurgery

Limb Salvage Surgery: Who Needs It?

by allurewellness
written by allurewellness

The procedure performed to remove bone cancers and soft tissue in the limbs is called limb salvage surgery.

The procedure is also otherwise known as limb-sparing surgery.

Limb salvage surgery is done in order to avoid amputation.

Goals

Some of the primary goals of limb salvage surgery include:

  • Avoiding amputation
  • Removal of cancer
  • Preservation of appearance
  • Maintaining the greatest possible degree of function

While often carried out in tumors and bone sarcomas, limb salvage surgery is also an option in soft tissue sarcomas affecting the extremities.

Nowadays, the procedure has become the ideal alternative to amputation.

It has also become the recommended treatment option for cancers that spread slowly (from the limb to other body parts), or those cancers that have not spread to the soft tissues yet.

Years prior, the usual treatment route of those patients with cancer in the limbs is amputation of the extremity affected.

Fortunately, nowadays, patients no longer have to lose their limbs in order to treat the cancer.

This development can be credited to numerous factors—survival rate of patients treated using chemotherapy, advanced imaging methods (CT scans and MR), and remarkable improvements in surgical techniques both resection and reconstruction, to name a few.

In recent years, limb salvage surgery has also become one of the recommended option for patients with chronic bone and degenerative conditions like rheumatoid arthritis.

Likewise, it has also become one of the treatment options for those patients that are considered candidates for diabetic limb amputation and those with chronic and acute limb wounds.

Diagnosis

Before your doctor will decide if limb salvage surgery is apt, the following key factors are taken into consideration:

  • Type of cancer
  • Its size
  • Its location
  • The cancer’s progression
  • Age of the patient
  • Overall health of the patient

When recommended, doctors will make sure the patient understands the likely outcome of the surgery.

While proven effective, there is still that possibility that the implant will fail and additional surgery might be required.

In some cases, amputation might become an option.

Physical and occupation therapists can also help patients who are candidates for limb salvage surgery.

Preparation for the surgery may include introduction of exercises that can help strengthen the muscles and ambulation (walking).

ROM or range of motion exercises patients would need to do after the operation will also be taught.

Procedure

Limb-sparing surgery involves not just removing the cancer but also at least an inch of the healthy tissue surrounding it.

Chemotherapy, radiation, or in some cases, a combination of both might be recommended to shrink the tumor before the procedure is performed.

Limb salvage surgery has 3 stages:

  • The cancer as well as a margin of healthy tissue is removed.
  • Bone graft is performed or prosthesis is implanted when necessary.
  • Wound is closed by transferring soft tissue or muscle from other parts of the body.

Surgical Techniques

Soft Tissue Sarcomas

Nowadays, a staggering 80 percent of cases of soft tissue sarcomas affecting the extremities are treated through limb salvage surgery.

The procedure entails removing the limb nodes, tumor, and the tissues where the cancer has spread.

An inch of the healthy tissue surrounding the tumor will also be removed.

For cases of soft tissue sarcomas that has spread to the lungs, the procedure will involve removing the original tumor, shrinking the lung tumor through chemotherapy or radiation, and surgically removing the lung tumor.

Bone Tumors

Treating low grade bone tumor and its components, doctors will remove the malignant lesion alongside a cuff of the healthy tissue.

Aftercare

Generally, patients will have to remain in the hospital for 5 to 10 days after the procedure.

Sensation and blood flow of the extremity affected will be monitored.

The hospital stay is also required to help ensure the patient does not develop any life-threatening complications like pneumonia, deep-vein thrombosis, and pulmonary embolism.

Know more about limb salvage surgery and what it can do for you by visiting www.bjios.sg.

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While now a common procedure, years ago, joint replacement was once considered high-tech
Bodyinjurysurgery

Hip and Knee Replacement: When is it Necessary?

by allurewellness
written by allurewellness

While now a common procedure, years ago, joint replacement was once considered high-tech.

In the United States alone, surgeons perform the procedure more than a million times each year.

The staggering figure can be attributed to the enhanced mobility and pain relief only hip and knee replacement surgeries can offer.

Undoubtedly, for the right candidates, hip and knee replacement can be a life altering procedure.

However, surgery is not always the treatment option for those who are suffering from hip or knee pain.

Knee Replacement

Oftentimes, the most likely candidates for knee replacement surgery are those patients who are suffering from osteoarthritis

Oftentimes, the most likely candidates for knee replacement surgery are those patients who are suffering from osteoarthritis.

Understandably, the condition is common in the knees as it bears the weight of the body.

The procedure will be the treatment option resorted to only after all other conventional alternatives have been exhausted.

Just like many major surgical procedures, knee replacement also has certain risks.

Some of the risks include but are not limited to the following:

  • Heart attacks
  • Stroke
  • Infection
  • Nerve damage
  • Blood clots (in the lungs or leg veins)

The surgery will be performed by an orthopedic surgeon.

Prior to the surgery, physical examination will be performed to assess the stability, strength, and the range of motion of the knee.

Hip Replacement

In essence, hip replacement is the surgical procedure carried out to remove the hip joint’s damaged parts.

If all other conventional treatment alternatives have proved futile, hip replacement surgery becomes the likely option.

Patients with severe osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis are often likely candidates for the procedure.

Extent of the hip replacement however will be based on the severity of the joint damage.

For those individuals with hip fractures due to osteoporosis, hip replacement is also the likely treatment option.

Oftentimes, the most common reason for the procedure can be attributed to damage brought about by arthritis.

Also known as total hip arthroplasty, hip replacement surgery is often considered the best treatment approach when pain has become so severe and it already interferes with the patient’s day-to-day routine.

Preparation

For individuals who are candidates for hip or knee replacement, asking the right questions is deemed an integral part of the preparation.

If you are a candidate for joint replacement, the following questions should make it to your list:

Is surgery the best treatment alternative available for my case?

  • Do I have other treatment choices?
  • After the surgery, how far can I walk without experiencing any pain?
  • Is surgery the best option for someone my age?
  • Can I still participate in any sports (i.e. golf, tennis, swimming, etc.) that I enjoy?

What can I do to help ensure the procedure is a resounding success?

  • Will I be taught muscle strengthening exercises?
  • Is it recommended that I lose weight before the procedure?
  • Will it be necessary to learn how to utilize crutches/walker before the surgery?

What home preparations do I need to do?

  • Do I have to do any rearranging?
  • What are some of the effective ways I can ensure safety at home?
  • How much is the extent of help I will be needing?

What are the potential risks and complications of the procedure?

  • Will blood transfusion be necessary before or after?
  • What can I do to help minimize the risks?
  • Which medical conditions (i.e. heart disease, diabetes, high blood pressure, etc.) have to be monitored?

What is the procedure like?

  • How long will the surgery last?
  • How soon after the procedure can I commence with my routine activities?
  • How long will the hospital stay be?

What preparations am I expected to do the night before the procedure?

  • When do I stop eating or drinking?
  • What are the essentials I need to bring?
  • Are there medications I am supposed to take prior to the procedure?

Joint replacement is not the ideal treatment option for everyone. To know if it is appropriate for your case, visit www.bjios.sg right away.

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bunion is the term given to the bony bump that develops at the big toe’s base
Bodysurgery

Bunion Surgery: What are the Benefits

by allurewellness
written by allurewellness

In essence, bunion is the term given to the bony bump that develops at the big toe’s base.

Wearing of footwear that is too small or narrow is considered one of the most common culprits of the painful condition.

There are more cases of bunions in women than in men.

When the condition does not respond to noninvasive treatments, surgery might be recommended to correct the deformity.

Removal of the bunions is sometimes referred to as bunionectomy, hallux valgus (Latin term for “foot deformity”) removal, or bunions surgery.

Bunion Surgery

To help alleviate the pain brought about by bunion, some wear shoes that are larger than their feet size.

Others find comfort when wearing protected pads.

Unfortunately, there will be instances when even making significant lifestyle adjustments won’t be able to improve the condition.

In similar scenarios, bunions surgery might become the best treatment option.

Some cases that might require bunion surgery can include the following:

  • Patient experiences severe pain. The pain and discomfort can make the performance of daily routine and activities extra challenging.
  • Patient can no longer walk without experiencing pain.
  • The big toe is still swollen and painful even after proper rest and medication.
  • Straightening or bending the toe is no longer possible.

For patients who are possible candidates for bunion surgery, discussing the condition as well as the procedure with the doctor is highly recommended.

A discussion with the doctor is important so both parties can decide on the kind of surgery to be performed to correct the condition.

To accurately diagnose the condition, an X-ray of the affected foot might be recommended.

While unknown to many, there are more than 100 different types of bunion removal procedures that can remove the bunion and realign the big toe.

However, oftentimes, the kind of bunion removal surgery will depend on the progression as well as the size of the bunion.

Preparation

Before the surgery, it will be likely that patients will be asked to undergo a few tests to assess their overall health status.

A cardiogram (to check heart function), X-ray of the lungs, blood and urine tests might also be suggested to check for other possible underlying conditions.

Patients taking blood thinning and other medications will most likely be asked to refrain from doing so at least a few days before the scheduled surgery.

After the surgery, patients are often already allowed to go home once the anesthesia has worn off.

Fasting might also be recommended but it will be determined based on the starting time of the scheduled procedure so it would be best to check with your doctor on this.

As a general rule of thumb, it would be best to ask for a list of dos and don’ts and make sure you strictly adhere to them so likely complications that will arise can be avoided.

Procedure

In most cases, general anesthesia will not be required during bunion removal surgery

In most cases, general anesthesia will not be required during bunion removal surgery.

Oftentimes however, a local anesthetic known as ankle block will be given.

It works by numbing the area situated below the knee.

The surgeon will proceed with the bunion removal and other necessary repairs once the knee is numb.

While there are several types of bunion removal surgeries, the following are three of the most common:

Osteotomy

The joint of the big toe is cut and realigned.

Exostectomy

No alignment is done but removal of the bunion is performed.

Arthrodesis

Metal plates or screws are used to replace the damaged joint and to correct the deformity.

Patient will be taken to the recovery room right after the surgery.

The blood pressure and heart rate will also be monitored while waiting for the anesthesia to wear off.

Fortunately, in most cases, patients can already go home after a couple of hours or so.

Recovery

Recovery from the surgery will usually take 6 to 8 weeks.

However, it will take at least 4 to 6 months for full recovery to take place.

Patients will have to wear a surgical boot or a cast for at least 2 weeks after the procedure.

For more information about bunion and the procedure appropriate for your case, visit www.bjios.sg now.

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Bodysurgery

Trigger Finger Surgery Recovery

by allurewellness
written by allurewellness

In essence, the painful condition characterized by locking of the thumb or fingers when bent is called trigger finger.

When the tendons become inflamed, trigger finger occurs.

The tough tissue bands that connect the muscles and the bones is called tendons.

The synovium (lubricating membrane surrounding the joint) makes the easy gliding of the tendon through the sheath possible.

When there is inflammation and swelling of the tendon, it can pop or snap when the affected finger is bent.

Depending on the severity of the condition, treatment options can range from noninvasive options to trigger finger surgery.

Cause

The condition can be attributed to repeated as well as forceful use of the thumb or the finger.

Rheumatoid arthritis, diabetes, and gout, can also trigger the development of trigger finger.

Grasping a power tool for long periods can also result to the condition.

Industrial workers, farmers, and musicians are prone to developing trigger finger since they often perform repeated finger and thumb movements.

Trigger finger is more common among women.

People who are 40 to 60 years old are also more prone to developing the condition.

Symptoms

Soreness of the thumb base or the affected finger is often the first telltale sign of trigger finger.

Painful clicking or snapping is also noticed when bending or straightening the finger.

The catching sensation will often get worse when the affected finger and resting.

It will also often loose up when moved.

Diagnosis

In most cases, a physical examination of the hand and the fingers would be enough.

In some instances, the finger can swell and a hump over the joint situated in the palm will develop.

The finger affected can also become very stiff and painful and can get locked in a bent position.

X-rays and lab tests are often not needed in order to diagnose the condition.

Treatment Options

In most cases, those with trigger finger will be asked to rest the affected finger or thumb.

To ensure there is no joint movement, a splint may be recommended.

If symptoms will persist however, medications like ibuprofen or naproxen will be prescribed to help fight the inflammation.

Steroid injection into the tendon sheath is yet another treatment option available at one’s disposal.

However, if the condition will not respond to any of the conservative treatment options, trigger finger surgery will be the likely treatment alternative.

Recovery

While not true in all cases, the following is the typical scenario for those recovering from trigger finger surgery:

While the hand can already be used at least a day after the surgery, numbness would still be noticeable at 8 to 24 hours after.

Dressing will be kept dry for at least 5 days.

Wetting the hand will be allowed 7 days after the procedure.

Predicting when the patients can return to their normal activities will be based on several key factors like the exact procedure carried out and how active the patient is, among others.

In majority of the cases however, patients can already drive a day after the surgery and can use their hands to type a couple of days after.

Others can already participate in sports like tennis after 1 to 3 weeks while doing manual labor is possible after 3 to 4 weeks.

Patients will be given instructions post-surgery like exercising the affected finger, changing the bandage, and cleaning the wound.

Instructions must be adhered to strictly in order to ensure complications and infections are avoided.

Following the instructions given can also help ensure recovery will be quicker.

While recovery can be a case to case basis, typically, it can take several weeks.

If finger contractures develop however, recovery can take a while longer.

For expert help and guidance on the management and treatment of trigger finger, please visit www.bjios.sg.

 

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