What is Ankle Fusion Surgery

Ankle fusion operation, also known as ankle arthrodesis, is a surgical procedure conducted to close the joint space by joining the bones that make up the ankle joint.

Your ankle joint is an articulation of three bones. These three bones are known as the tibia, fibula, and the talus. During ankle fusion operation, the cartilage covering the bony surface of the ankle joint is scraped off. The diseased part of the bones is also trimmed.

Next, the newly exposed bony surface of the tibia and the talus are placed in close contact. Additionally, they are compressed using screws. New bone formation takes place in and around the joint resulting infusion of the bones into a single bone.

Candidates for Ankle Fusion Surgery

Ankle fusion operation is recommended for patients experiencing unbearable pain during the ankle movement. The pain may result because of the following reasons:

• Joint wear and tear
• Rheumatoid arthritis
• Post-traumatic arthritis
• Infection in or around the joint
• Neuromuscular disease
• Failure of previous non-surgical treatment

Not all patients with the aforementioned conditions are always suitable for ankle fusion. Patients with the following characteristics are not suggested to undergo this surgery:

• Insufficient quantity and quality of bone
• Severe deformity in the leg
• Vascular diseases that prevent proper healing

Anterior cruciate ligament (ACL) reconstruction refers to the replacement of the damaged ACL with a tissue to facilitate normal functioning of the knee. ACL is a major stabilizing ligament in the knee, which connects the femur to the tibia. ACL helps provide proper movement of the tibia. ACL also facilitates pivoting or sudden change in the direction of the leg, preventing the damage to the knee.

Damage to the ACL Surgery 

The ACL can be injured in different ways, thus warranting a need for ACL repair. The following scenarios may damage the ACL:

• Collision with a football
• Slowing down while running
• Landing incorrectly after a jump
• Twisting of the knee and the foot in opposite direction

Initial Treatment for Anterior Cruciate Ligament Tear

The ACL may not require surgery when the knee is stable when the ligament is not torn completely, or even when you don’t have to strain your knees by active sports. The alternate treatment in such a situation is “RICE” – Rest, Ice, Compression, and Elevation.

Physiotherapy, exercise, and braces for legs can help provide support to the knee. Exercises such as swimming, running in a straight line, and playing golf can be preferred by active individuals if they do not wish to return to an active sports life.

The spinal cord is a linear arrangement of many small bones known as vertebrae. These vertebrae consist of spaces between them known as intervertebral spaces. They are filled with cartilaginous structures that provide a cushioning effect to the vertebrae and support the movement of the spine. These cartilaginous structures are called Intervertebral discs.

Any pathology of the intervertebral discs such as disc herniation (slipping of the disc from between the vertebrae), ruptured disc, or degenerative disc disease may cause severe back pain due to nerve impingement, indicating the need for either partial or total disc replacement. In partial disc replacement surgery, only a portion of the cartilaginous disc is replaced by the artificial disc, while the total disc is replaced in the total disc replacement surgery.

Cervical disc degeneration and disc rupture may cause chronic neck pain radiating towards the arm.  Thoracic disc degeneration may cause chronic upper/ mid back pain while lumbar disc degeneration may cause chronic lower back pain.

Conditions that indicate the need for a disc replacement surgery:

• Discitis (Inflammation of the intervertebral disc)
• Scoliosis (abnormal spinal curve laterally)
• Herniated disc in back (slipping of the cartilaginous disc into surrounding tissue)
• Disc degeneration and disc rupture (infection of the intervertebral disc causing its degeneration.

Arthroscopy is a minimally invasive procedure used for the diagnosis and treatment of conditions related to the joints. It is performed with the help of a special instrument called an arthroscope. It comes with an attached video camera and a light. What is observed by the camera is recorded and can be viewed by the surgeon on a television monitor.

Arthroscopic knee surgery is an alternative to total knee replacement and other forms of knee replacement surgery. During the knee arthroscopic surgery, small incisions are made to insert an arthroscope and other surgical tools to correct a defect in or around the knee joint. Total knee replacement, on the other hand, refers to complete removal and replacement of the diseased joint with a prosthetic implant.

When is knee arthroscopy required?

Knee arthroscopy is conducted for the diagnosis and treatment of the following conditions:

• Inflammation of the knee
• Injuries such as :
  
  
  • Fractures
  • Ligament tear
  • Tendon damage
  • Torn meniscus
  • Misalignment of kneecap
  • Bakers cyst
  • Meniscus tear
  • Loose fragments of bone or cartilage

Kyphoplasty is also known as balloon kyphoplasty. It is a minimally-invasive surgical procedure that can repair spinal fractures caused by cancer, osteoporosis, or benign lesions. It is not used for spinal stenosis treatment.

Kyphoplasty procedure is designed to relieve the intense pain caused by vertebral compression fractures, to stabilize the bone or to bring back some or all of the lost vertebral body height due to the compression fracture. Kyphoplasty or balloon kyphoplasty is a superb replacement of the typical conventional therapies such as analgesic use, bed rest, and bracing. It is a quick remedy for severe pain due to vertebral compression. It eliminates the pain almost immediately and the risk of complications during kyphoplasty is low. However, it is not intended for the treatment of arthritis or intervertebral disc disease. Kyphoplasty is different from discectomy, which is conducted in case of a herniated disc. Discectomy completely removes the damaged or herniated disc from the vertebrae of the patient.

Laminectomy and vertebroplasty are two other procedures that follow different techniques for stabilizing fractures. Laminectomy works by removing the lamina to create space, vertebroplasty works by injecting cement into the broken or cracked spine. For the same reason, vertebroplasty cost is different from kyphoplasty cost.

Who is the best candidate for kyphoplasty?

Kyphoplasty is typically suggested in case of:

• Severe pain that cannot be controlled by pain-relieving medications
• Severe functional restraints such as inability to walk or stand
• Fractures resulting in loss of height and alignment
• Multiple fractures in spine
• Fractures with radical collapse
• Fractures located at the thoracolumbar junction
• Spondylolisthesis, that is, displacement of one vertebra over another

Meniscectomy is a type of meniscus tear treatment in which a part of the meniscus is removed. This is done when an individual suffers from a type of a knee injury called meniscus tear. The surgical decision to remove all of or a part of the meniscus is taken based on the overall health, age, activity level, and the nature of injury of the patient.

This meniscus treatment is performed by a team of orthopaedic surgeons. The doctor is likely to advise this surgery if they think that it is the best available treatment for you, depending on the exact location of the tear, its pattern, and size.

There are different types of a meniscus tear. A small meniscus tear usually requires no surgery and heals on its own through home treatment. A moderate to larger tear in the red zone of the meniscus is best treated with the help of a meniscectomy surgery. A tear in the white zone of the meniscus, on the other hand, is not treated with the help of meniscectomy surgery because there are fewer chances of healing.

The meniscus is a rubbery ligament between the shinbone and the thighbone. Meniscus tear takes place when there is a solid contorting movement of the knee, especially when the knee is bent while the foot is firmly placed on the ground. It is one of the most common knee injuries among sportsperson who play football, cricket, and tennis, and people who perform high-impact activities.

 A few people may suffer from meniscus tear due to ligament of knee degeneration that takes place with age due to several factors.

 Pain, swelling and tightness may increase over several days if you have a meniscus tear. You may not be able to straighten your knee, and it may lock in position. It may be problematic for you to put weight on your leg or even walk normally like before.

 Minor meniscus tears can heal by itself if there is a good blood supply to the area. However, some tears require arthroscopic surgery to fix the tear. It is important to rest and let the ligament heal. Ice packs and physical therapy helps with the recovery of a meniscus tear.

Different Approaches to Meniscus Repair Surgery

 Only 10 percent of meniscus tears can heal by itself if there is an appropriate blood supply.

Most of the surgeries are arthroscopic surgeries in which a special device is used to view inside the knee and see the torn meniscus. There are different procedures, however, that can be conducted to repair or fix the meniscus and these include the following:

• Meniscectomy: It can be partial meniscectomy or complete, that is, the torn meniscus can be partially removed or completely. It can be done as an open surgery or arthroscopic surgery.
• Meniscal Repair: It can be performed open or arthroscopically and the preservation of the meniscus involved three aspects:
  • Repair of the torn meniscus
  • Non-surgical treatment of asymptomatic meniscal pathologies
  • Partial meniscectomy and resection

• Meniscal Regeneration: Meniscal transplantation (MAT) can be performed to restore the meniscus. In this case, a graft is usually taken from the hamstring muscle to reproduce the meniscus.

Microdiscectomy is also known as microdecompression or cervical microdiscectomy. It is one of the most commonly performed spine surgery procedures.

Microdiscectomy or cervical microdiscectomy is preferred for patients with a lumbar herniated disc. The main goal of a discectomy is to relieve the pressure on a spinal nerve root by removing the material causing the pain. Traditionally, this purpose was solved by an open technique called lumbar discectomy surgery, which involves making a large incision to cut some of the back muscles, leading to a slow and painful recovery. Nowadays, an advanced form of surgery called microdiscectomy can achieve the same goal that too with the help of a small incision and fewer injury to back muscles. As a result, the recovery takes less time and is less painful.  A special microscope is used in microdiscectomy to view the disc and nerves. The larger view allows the surgeon to make a smaller incision, causing less damage to the surrounding tissues.

When is microdiscectomy needed?

Sciatica is a condition caused by compression of the spinal nerve, which generally results in chronic pain in the legs of the patients. This compression of the spinal nerve is frequently the result of a herniated lumbar disc.  As a herniagrows, the damaged tissue extends into the spinal column and pushes on the nerves. This condition causes the nerves to send pain signals to the brain and the brain interprets the pain source to be coming from the legs.

Most commonly, sciatica heals naturally or with the help of medication in a few weeks. But, if sciatica lasts more than 12 weeks after taking oral medicines, patients may benefit from discectomy. Discectomy is also used for the treatment of spondylosis and lumbar spinal stenosis. While spondylosis occurs due to degenerative osteoarthritis of the vertebrae, lumbar spinal stenosis occurs due to narrowing of the spinal canal leading to nerve compression. The latter may also warrant the need for a spinal stenosis surgery.