Shoulder –
Arthroscopic Rotator Cuff Repair & Acromioplasty,
Arthroscopic Bankart & SLAP Reconstruction,
Arthroscopic frozen shoulder release, AC Joint recon
Total Shoulder Replacement incl. Delta Reverse Replacement
Hand/ Wrist-
Carpal Tunnel, DeQuervain's, Dupuytren's,
Finger Joint and Carpal Bone Replacement,
Total Wrist Replacement, Wrist Arthroscopy
Knee -
Arthroscopy, ACL reconstruction, Meniscus Repair,
Cartilage Grafting, Partial & Total Knee Replacement
Upper Limb -
Elbow Arthroscopy & Replacement, Ligament Reconstruction, Upper Limb Fractures
More Information:
| ALL-ARTHROSCOPIC | CUFF TEAR ARTHRITIS |
CARPAL (WRIST BONE) REPLACEMENT |
‘ALL-ARTHROSCOPIC’ ROTATOR CUFF REPAIR
Arthroscopy = Joint surgery through small keyhole incisions.
Arthroscopy has been one of the major advancements in Orthopaedic Surgery and advanced the knowledge and skills
of shoulder surgery over the past decade. Now the vast majority of elective shoulder surgery can be performed arthroscopically,
with significant advantages to the patient and surgeon.
However the skills and equipment are completely different to traditional open surgery.
Advantages
1. Better results
a. 940 (arthro) v 712(mini open) at 12 months Arthro v Mini-open Canada multicentre pilot study 2006
2. Less pain, surgery can be done as day procedure.
3. Less swelling and bruising making rehab easier
4. Can treat co-existant conditions at the same time through keyholes
a. Labral tears
b. Impingement
c. AC joint arthritis
5. Low re-rupture rates 11% La Fosse (2009)
a. 5% Medium(Sugaya 2007), 22% Large (Huisman 2007)
b. 40-90% in mini-open (Galatz 2007)
6. No “ugly” scars
7. Low infection rate
a. 1.9% in mini-open (JSES 2002)
CONTRAINDICATIONS
• Lack of surgeon familiarity with arthroscopic repair techniques
• Low-demand patients with functional rotator cuff tears
• Patients who require pain relief only
• Patient unwillingness to comply with the rigorous postoperative rehabilitation program
• Severe rotator cuff tear (rotator cuff arthropathy)
Frequently Asked Questions
Will I have therapy post op?
Yes. Initially 2-3 times per week then less often. Exercises must be done at home too
How long do I have to wear the sling?
4-6 weeks. Longer when in an uncontrolled environment
?When can I go back to work?
This is highly variable depending on what you do
For desk jobs it could be as early as a couple days
Labor jobs with lifting, 4-6 months
REHAB
Start passive range of motion at 1 week
Sling for 4-6 weeks
Start active range of motion when sling comes off
Start strengthening at 8-12 weeks
No sports, lifting for 4-6 months
Reverse Shoulder Replacement
Centre of Rotation increased so that deltoid acts on elevation
1992-1998 Delta 3
91% survived 10yrs(Guery 2006)
120-130 elevation
Most patients have tended to be >70 Delta Extend
Since 2007
Early Results in Europe Excellent
CARPAL(WRIST BONE) REPLACEMENT
Pyrocarbon Implants
What is pyrocarbon?
Biocompatable smooth layer of treated carbon/graphite substrate
Developed from nuclear industry technology
Can be used for heart valves/ joint replacement
Low risk of breakdown compared with traditional materials
Trapezium arthritis (Base of Thumb)
Very common place to get early arthritis
Replacement maintains thumb length and strength
Proximal scaphoid
Fracures
Non-union
Other sites
Capitate resurfacing
Distal Ulna
Radial head
Finger joints