Orthopaedic Surgery

 

Orthopaedic Surgery is broadly concerned with conditions/prevention/corrections/disorders involving the musculoskeletal system. Orthopaedic Surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumours, and congenital disorders. 
 
Knee
 
Knee pains can come from a few sources due to injury or chronic wear and tear to the knee joint. Common problems that require medical treatments are : 
 
Persistent Pain
Knee Swelling
Instability of Knee (as in frequent giving way)
Knee Crepitus (painful sounds from the knee)
 
Treatment depends on the severity of the injury, the patient’s physical demands, suitability factors such as age and gender, and is based on a case to case individual evaluation of the pros and cons of the different mode of treatment.
 
Simple treatments can range from physiotherapy, exercise modification, muscle strengthening, topical and oral medication, bracing to finally surgical intervention. Many complex knee surgeries nowadays can be performed through minimally invasive method though certain reconstruction surgeries might still require open techniques.
 
Shoulder
 
The four most common shoulder problems seen :
 
Frozen Shoulder
Impingement Syndrome and Rotator Cuff Tear 
Calcific Tendonitis
Recurrent Dislocation of the Shoulder
 
The Frozen Shoulder being a very common condition is usually treated with physiotherapy to ease the stiffness, oral or injectable medications for inflammation and occasionally surgery for the recalcitrant cases. Treatment for Impingement syndrome and Rotator Cuff involves activity modification, ultrasound and strengthening exercise.
 
For severe cases, surgery is usually needed. Calcific tendonitis can be relieved completely with a Cortisone injection. As for the Dislocation of shoulder, it can now be repaired and stabilised using minimally invasive arthroscopic surgery.
 
Hand & Microsurgery
 
Our upper limb is the most frequently injured part of the body. Some commonly seen conditions at the Hand & Microsurgery Unit are :
 
Injury to the Hand, Wrist, Elbow and Shoulder (Nerve and Tendon Lacerations, Fractures and Joint Injuries)
Nerve Compression Syndrome (Thoracic Outlet Compression Syndrome, Carpal & Cubital Tunnel Syndrome)
Arthritis of the Hand, Wrist and Elbow
Hand conditions in Children including Congenital Differences
Highly specialized Hand and Upper Limb surgical procedures can be done such as finger, wrist and elbow arthroscopy and joint replacements, endoscopic carpal tunnel release, reconstructive microsurgery of nerves and arteries, reconstructive ligament procedures and release contracture of Dupuytren’s disease.
 
Surgery is only the start of recovery. In many cases, therapy and intensive rehabilitation will be necessary to ensure recovery and regain optimal function of the hand.
 
Foot & Ankle
 
On average, we take 4000 to 5000 steps each day. Therefore health problems in the foot and ankle are very common. The most common problems in this area are:
 
Swelling
Sprains and Injuries
Diseases (Rheumatoid Arthritis and Osteoarthritis)
Complex Degenerative Deformities
 
Problems in the foot and ankle could also be an early sign of problems in the vascular or neurological systems. 
A wide range of treatment options can be provided, ranging from the basic treatment using Orthotics (special shoe inserts shaped to the feet), Physiotherapy and Rehabilitation, to advanced techniques using arthroscopic procedures and surgical correction. For example, the treatment of severe bunions is done using scarf osteotomy technique. This procedure involves shaving of the prominent bone, realigning the bones and repair the joint capsule and ligaments.
 
Hip & Spine
 
Hip and back pain is very common and can be caused by numerous diseases or disorders. The most common hip and spine conditions that require treatment are:
 
Hip Injuries & Disorder
 
Strains
Bursitis
Dislocation
Fractures
 
Cervical Spine Disorders
Degenerative disorders such as spondylosis, disc prolapse (‘slipped disc’)
Infections
Trauma
Inflammatory diseases
Tumours or Cancer
Referred pain
Non-specific causes
 
Joint Replacement
 
Replacing a joint can relieve pain and help us move and feel better, enabling us to go about with our daily activities and improve the quality of our lives.
Depending on the severity and extent of injury, the surgery may not remove the whole joint, but will replace with an artificial device or prosthesis and fix the damaged parts. Apart from standard joint replacements, newer techniques using surface replacements and partial replacements are available.
 
When do we need it?
a particular joint is devoid of cartilage
it is difficult and painful to move the joint and the pain becomes so severe that you start avoiding the use of the particular joint
it is so painful that it affects your daily activities
non-surgical procedures or medication no longer works
 
What happens after surgery?
Recovery period varies and range from 6 to 12 weeks which included physiotherapy as part of the rehabilitation treatment.
 
The most common procedures performed by Orthopaedic Surgeons are as follows.
1. Knee arthroscopy and meniscectomy
2. Shoulder arthroscopy and decompression
3. Carpal tunnel release
4. Knee arthroscopy and chondroplasty
5. Removal of support implant
6. Knee arthroscopy and anterior cruciate ligament reconstruction
7. Knee replacement
8. Repair of femoral neck fracture
9. Repair of trochanteric fracture
10. Debridement of skin/muscle/bone/fracture
11. Knee arthroscopy repair of both menisci
12. Hip replacement
13. Shoulder arthroscopy/distal clavicle excision
14. Repair of rotator cuff tendon
15. Repair fracture of radius (bone)/ulna
16. Laminectomy
17. Repair of ankle fracture (bimalleolar type)
18. Shoulder arthroscopy and debridement
19. Lumbar spinal fusion
20. Repair fracture of the distal part of radius
21. Low back intervertebral disc surgery
22. Incise finger tendon sheath
23. Repair of ankle fracture (fibula)
24. Repair of femoral shaft fracture
25. Repair of trochanteric fracture
 
Subspecialties of Orthopaedic Surgery 
 
Hand surgery
Shoulder and elbow surgery
Total joint reconstruction (Arthroplasty)
Paediatric orthopaedics
Foot and ankle surgery
Spine surgery
Musculoskeletal oncology
Surgical sports medicine
Orthopaedic trauma
 
These specialty areas of medicine are not exclusive to orthopaedic surgery. For example, hand surgery is practiced by some plastic surgeons and spine surgery is practiced by most neurosurgeons. Additionally, foot and ankle surgery is practiced by Doctors of Podiatric Medicine.  Some family practice physicians practice sports medicine; however, their scope of practice is non-operative.
 

Our Doctors Specializing In Orthopaedic Surgery

Professor Dr Aaron Lim Boon Keng

MB. Bch BAO (Irel), LMSSA (Lon), Mch Orth (Liv.), FRCS (Edin), AM (Mal)
Specialty: Orthopaedic Surgery
Location : Island Hospital Penang

Kuala Lumpur Sports Medicine Centre

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Specialty: Orthopaedic Surgery
Location : Kuala Lumpur Sports Medicine Centre

Dr Harwant Singh

MD (UKM), FRCS (Edinburgh), MCh Orth (Liverpool), Dip Sports Med (Glasgow), Dip Biomechanics (Strathclyde), PhD (Surgery), FAMM
Specialty: Orthopaedic Surgery, Trauma & Spine Surgery
Location : Pantai Hospital Kuala Lumpur