Todd Schwartz, DO

Products And Services

• Ankle Ligament Reconstruction

  An ankle sprain is a common injury that occurs when the ankle is twisted or turned, and results in torn ligaments within the joint. This injury often causes pain, swelling and bruising, and if it does not heal properly, it may lead to chronic ankle instability or repeated ankle sprains. Ankle ligament reconstruction is a procedure commonly performed on patients experiencing chronic ankle instability and repeated ankles sprains. It is effective in repairing torn ligaments, tightening loosened ligaments and improving the overall stability of the joint. The Ankle Ligament Reconstruction Procedure The ankle ligament reconstruction procedure is performed on an outpatient basis while the patient is sedated under general anesthesia. Different techniques may be used by the surgeon, depending on the condition of the ankle. During the procedure, torn ligaments may be repaired with stitches or sutures, two ligaments may be reattached, or part of a lateral tendon around the ankle may be used to repair the torn ligament. After the procedure is complete, a splint or cast is applied to the ankle. This procedure may take up to 2 hours to perform. Risks of Ankle Ligament Reconstruction As with any surgery, there are possible complications associated with ankle ligament reconstruction which may include: Reaction to anesthesia Nerve damage Infection Bleeding After surgery, blood clots within the veins of the legs may also occur. Recovery from Ankle Ligament Reconstruction After surgery, patients will use crutches for up to two weeks. After this time, they may begin walking in a removable walking boot. Physical therapy is a crucial part of the healing process, and usually begins after about six weeks. Physical therapy treatments focus on improving range of motion without putting excessive strain on the healing tendons. Muscle-strengthening exercises and range of motion exercises may all be used to increase movement and mobility. Most patients fully recover from ankle ligament reconstruction after three to four months, and at that time they can resume all regular activities including running and exercise.

  Link: Ankle Ligament Reconstruction

• Anterior Cruciate Ligament Reconstruction

  The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments in the knee. Running diagonally through the middle of the joint, the ACL works in conjunction with three other ligaments to connect the femur (upper leg bone) to the tibia (the larger of the two lower leg bones). ACL injuries occur most commonly in athletes as a result of direct contact or an awkward fall. About half of ACL injuries are also accompanied by damage to the meniscus, cartilage, bone or other ligaments in the knee, any of which may complicate the repair process. The ACL Reconstruction Procedure ACL reconstruction is usually not performed until several weeks after the injury, when swelling and inflammation have been reduced. In most cases, an ACL repair is necessary because there has been an avulsion of the ligament, which means that not only the ligament, but a piece of bone, has been fractured. Simply reconnecting the torn ends of the ACL will not repair it. The torn ligament has to be completely removed and replaced. Part of another ligament, usually in the knee or hamstring, is used to create a graft for the new ACL. Most commonly, the graft used is an autograft, harvested from patient's own body, such as the tendon of the kneecap (patellar tendon) or one of the hamstring tendons. In other procedures, allograft tissue, taken from another (usually deceased) donor, is used. The graft may be attached with screws or staples before incisions are closed. This procedure is performed under general anesthesia on an outpatient basis. Benefits of Arthroscopic ACL Repair In many cases, this procedure can be performed using arthroscopic techniques, which involve creating a few small incisions in the knee, into which a camera and tiny surgical instruments are inserted. Saline is injected into the knee to allow for more operating space. The surgeon performs the repair while viewing the knee on a video monitor for more precise results. Arthroscopy offers patients a less invasive procedure with less scarring, less pain, less bleeding and a shorter recovery time. Risks of ACL Repair Surgery Although considered a very safe procedure, there are certain risks associated with ACL repair surgery, including graft failure or ineffective surgical results. The risks associated with any surgical procedure, such as infection, blood clots, excessive bleeding, breathing difficulties, and adverse reactions to medication or anesthesia also apply. Recovery from ACL Repair Surgery Following ACL repair surgery, patients can return home after a few hours of medical observation. Patients will likely experience pain, bruising and swelling after surgery, which can be managed through prescription pain medication. Individual recovery varies depending on the type of procedure performed and the condition of the individual patient. Physical therapy begins right after surgery, and normally continues for several months to help patients return to activity with their reconstructed knee. In order to achieve the most effective results from surgery, patients must commit to a long-term rehabilitation program. The ACL surgical repair is typically successful, providing long-term stability of the knee joint. After completion, most patients experience effective pain relief and improved knee function.

  Link: Anterior Cruciate Ligament Reconstruction

• Anterior Hip Arthroplasty

  Traditionally, hip arthroplasty, commonly known as hip replacement, has been performed by accessing the joint through the rear of the leg. Recent advances in technique, however, have made an anterior approach, during which the surgeon accesses the hip joint through the front of the leg, a more desirable option for most patients. An anterior approach offers a number of advantages. Whereas during traditional hip replacement surgery, muscles had to be cut and subsequently reattached, using the anterior approach, these muscles need only be moved aside. Moreover, an anterior hip replacement provides the surgeon with the opportunity to clearly visualize the entire hip socket and to implant a variety of necessary devices. The minimally invasive anterior approach also lowers the risk of dislocation common in other hip replacement procedures. By maintaining the integrity of the muscles and the hip capsule, this procedure also provides the stability to keep leg lengths equal and so avoids the need for leg lengthening. Since less muscle damage takes place, anterior hip replacement often enables the patient to be hospitalized for a shorter period of time and to recover more quickly. In many cases, patients are walking without assistive devices 2 to 3 weeks after the operation. Low impact forms of exercise are recommended immediately after anterior hip replacement, and high-impact activities are typically only prohibited for 3 months. The anterior hip arthroplasty is not equally well-suited to all patients. Patients who are not suitable candidates for anterior hip replacement include: Those with previously implanted devices Extremely muscular individuals Obese patients Whether an anterior approach to hip replacement is a viable option is determined after careful evaluation of the individual patient.

  Link: Anterior Hip Arthroplasty

• Anterior Lumbar Interbody Fusion

  Anterior lumbar interbody fusion (ALIF) is a surgical procedure performed to alleviate persistent lumbar pain, or pain in the lower region of the back. Currently one of the most frequently used spinal fusion techniques, ALIF is performed from the anterior of the spine through the abdomen. Interbody fusion refers to the removal of an intervertebral disc, which is replaced with a bone spacer during the fusion process. This method of anterior incision is chosen when the targeted area of the spine is closer to the front of the body or when the level of instability present is not too great. A major advantage of anterior entry is that a larger implant can be incorporated into the procedure. Reasons for ALIF ALIF is performed to treat nerve compression and its associated pain. Such compression of spinal nerves may occur as a result of: Disc degeneration Abnormal curvatures of scoliosis or kyphosis Fracture of one or more vertebrae Spondylolisthesis, slippage of one vertebra over another Spinal stenosis Spinal instability Patients with persistent low back pain, which often radiates down the leg, may be candidates for ALIF if more conservative treatments, such as rest, non-steroidal anti-inflammatories (NSAIDs), physical therapy and corticosteroid injections, have not been effective in relieving their symptoms. The ALIF Procedure The ALIF procedure is performed under general anesthesia with the patient lying face up on an operating table. The surgeon makes an incision on the side of the abdomen near the affected area. The muscles of the back and the nerves do not need to be moved from this approach. The injured disc and any bone spurs or other debris are removed. A bone graft or some bone morphogenetic protein (BMP), an FDA-approved substance that helps to stimulate bone growth, is then attached to connect the affected discs. Any necessary devices to ensure spinal stability as the vertebrae fuse are also implanted. BMP, discovered in the 1960s, is a protein extract found naturally in the body which can also be created artificially. Its use represents an advancement over previous surgeries, since in assists bone fusion and often eliminates the need for either extracting a bone graft from the patient or using a donor bone graft. Recovery From ALIF Patients usually have a smooth recovery from ALIF. After the procedure, they normally remain in the hospital for 3 to 5 days and are able to resume their activities after 6 to 8 weeks. Patients are advised to avoid bending and stretching for 8 weeks and may be restricted from strenuous exercise for a somewhat longer period, depending on their particular circumstances. Patients have to refrain from driving for as long as they require prescribed pain medication. ALIF carries the same risks as other surgical procedures, including risks of excessive bleeding, damage to adjacent tissue, breathing difficulties and adverse reactions to anesthesia or medications.

  Link: Anterior Lumbar Interbody Fusion

• Arthroscopic Rotator Cuff Repair

  The rotator cuff is the thick band of muscles and associated tendons that cover the top of the upper arm and hold in it place, providing support and stability to the shoulder joint. The rotator cuff also allows for a full range of motion while keeping the ball of the arm bone in the shoulder socket. These tendons can become partially or completely torn as a result of a rotator cuff tear or injury. A rotator cuff tear often occurs as a result of injury or overuse of the muscles over a long period of time. Rotator cuff tears typically involve pain when lifting or lowering the arm, muscle weakness and atrophy, and discomfort at rest, particularly if pressure is placed on the affected shoulder. In most cases, surgery is recommended for tears that cause severe pain or that do not respond to more conservative treatments. Most rotator cuff repair procedures are performed through arthroscopy, which uses a few tiny incisions rather than one large incision. This technique offers patients minimal trauma, less scarring and less damage to the surrounding muscles and tissue. The smaller incisions also result in less pain in the shoulder joint after the surgery. Arthroscopic Rotator Cuff Repair Procedure The purpose of arthroscopic rotator cuff repair is to attach the tendon back to the arm, along with removing any loose fragments from the shoulder area. Arthroscopy is a minimally invasive surgical technique that involves making several small incisions and inserting a fiber-optic device (arthroscope) and tiny surgical instruments to diagnose or treat certain conditions. Connected to a camera that displays images of the internal structure of the shoulder on a computer screen, the arthroscope allows the surgeon to precisely identify, target and treat joint abnormalities. During arthroscopic rotator cuff repair, the patient is sedated under general anesthesia, and several small incisions are made in the shoulder, into which a thin tube and tiny instruments are inserted. The surgeon repairs the tendon through visualization on a television monitor. During the surgery, rotator cuff tears are repaired and any bone spurs are removed. The rotator cuff muscle is stitched back to the bone, which helps the rotator cuff to heal in its proper location. Once the repair is complete, any incisions will be stitched closed and patients will be moved to a recovery room where they will be monitored post-operatively for a few hours. Risks of Arthroscopic Rotator Cuff Repair As with any surgery, there are certain risks involved with arthroscopic rotator cuff repair, which may include: Infection Pain Stiffness Nerve damage Need for repeated surgery These complications are rare and most people experience symptom relief with little to no complications after arthroscopic rotator cuff repair Recovery from Arthroscopic Rotator Cuff Repair After surgery, the arm is immobilized to promote proper healing. A sling may be recommended to keep the arm from moving for the first several weeks post-surgery. Physical therapy often begins shortly after surgery to help restore strength and movement and allow patients to gradually resume their regular activities. It is important for patients to commit to their physical therapy program in order to achieve the most effective surgical results. Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. It is important for patients to commit to their physical therapy program in order to achieve the most effective surgical results. After surgery, physical therapy may be necessary for up to 4 months and full recovery may take up to 6 months. Most patients experience effective pain relief, restoration of function and improved range of motion after their procedure.

  Link: Arthroscopic Rotator Cuff Repair

• Bilateral Total Knee Arthroplasty

  Bilateral knee arthroplasty is the replacement of both knees during the same period of time. This procedure can be simultaneous, with both knees operated on during the same surgery, or staged, with separate surgeries performed on each knee a few days or weeks apart. Bilateral knee arthroplasty is performed on patients disabled by severe arthritis in both knees. While the bilateral procedure is longer and more complex than a single knee arthroplasty, the pain relief after surgery is much greater and the overall rehabilitation time is shorter. There is some debate about whether the simultaneous procedure is preferable to the staged operations and also about whether bilateral arthroplasty is always more beneficial than two widely spaced operations. Advantages of the Simultaneous Bilateral Procedure There are several important advantages to a bilateral total knee arthroplasty, including: Single administration of anesthesia Shorter hospital stay Reduced costs More efficient correction of bilateral bone deformities The great majority of patients who have had the bilateral procedure say that they were pleased with the results and, if given the choice, would choose this method again. Once the immediate postsurgical pain abates, they experience relief in both knees. In addition, they only have to undergo one surgery and one period of rehabilitation. Risks of Simultaneous Bilateral Procedure While total knee arthroplasty is considered a safe operation, it carries the risks of any surgical procedure, including excessive bleeding, blood clots, infection and adverse reaction to medication or anesthesia. The rate of these complications is approximately the same for bilateral or singular operations. For some patients, early rehabilitation may be more difficult after the bilateral surgery since there is not an unaffected leg to use for support. Bilateral total knee arthroplasty is not usually recommended for patients who are over 80 years of age or patients who have serious underlying medical conditions. In these situations, bilateral surgery may present a greater risk since it is a larger, more traumatic event than smaller, more widely spaced procedures. Patients in these categories are at greater risk of developing cardiopulmonary and neurological complications or of requiring blood transfusions.

  Link: Bilateral Total Knee Arthroplasty

• Cervical Percutaneous Discectomy

  Cervical percutaneous discectomy is a procedure that is performed to remove herniated or bulging disc material that is pressing on nerves or the spinal cord. The cervical spine is the portion of the spine that runs through the neck. When the nerves of the cervical spine are compressed, it causes pain and discomfort in the neck that may travel to the shoulder, arm and hand. The goal of a cervical percutaneous discectomy is to decompress the nerves by removing deviated-disc material and disc fragments. It is a minimally invasive procedure that involves making a very small incision and inserting a tiny surgical needle between the vertebrae, into the middle of the disc. Disc material is removed with the guidance of live X-ray imaging, and as a result, painful nerve pressure is relieved. The cervical spine is made up of seven vertebrae stacked on top of one other, each separated by a cushion known as an intervertebral disc. Each disc is composed of an exterior shell of tough cartilage, and a center of softer, more gelatinous material. Through aging, normal wear-and-tear or injury, a disc may bulge between the vertebrae. If a disc herniates (ruptures), it can put pressure on adjacent nerves, causing pain, tingling, numbness and other troubling symptoms. Cervical percutaneous discectomy may be performed to alleviate pain and relieve symptoms in patients with cervical spine disorders such as spondylolisthesis, stenosis and degenerative-disc disease. Candidates for Cervical Percutaneous Discectomy A cervical percutaneous discectomy may be a treatment option for patients with ongoing neck or upper-back pain, or pain that radiates down the arm. This procedure may be an option when more conservative treatment methods such as medication, corticosteroids, physical therapy or chiropractic treatment have failed to resolve symptoms after a period of about 6 weeks. A cervical percutaneous discectomy may also be considered if the patient has experienced chronic and severe pain, and symptoms have interfered with performing regular activities. Benefits of Cervical Percutaneous Discectomy There are many benefits to a cervical percutaneous discectomy. Because it is less- invasive than other types of surgery, there is minimal scarring from the incision, and the ligaments and surrounding discs remain intact. Additional benefits include: Commonly performed as an outpatient procedure Minimal blood loss Retained spinal mobility Carrying less risk than other types of spinal surgery, a cervical percutaneous discectomy also allows for a more rapid recovery. The Cervical Percutaneous Discectomy Procedure A cervical percutaneous discectomy is commonly performed through the front (anterior) of the neck. This is referred to as an anterior cervical discectomy. However, if the herniated discs are affecting the back (posterior) of the spine, the procedure may be performed through the back of the neck in a procedure known as a posterior cervical discectomy. Prior to the procedure, patients are sedated with general anesthesia. A small incision is made, and the skin and soft tissues are separated to expose the bones along the back of the spine. X-ray images are used to guide the movement of the needle and surgical instruments. The disc tissue is then extracted through the needle. When tissue is removed from the herniated discs, pressure on the nerves in the area, and the pain caused by that pressure, are both relieved. The cervical percutaneous discectomy takes about 30 to 45 minutes to perform. Risks of a Cervical Percutaneous Discectomy A cervical percutaneous discectomy is considered a minimally invasive and safe procedure. However, as with all types of surgery, there may be risks which, although rare, include: Reaction to anesthesia Nerve damage Excessive bleeding Infection Failure to remove all targeted disc tissue If all of the disc tissue is not removed, pressure on the nerve and related symptoms may persist. Recovery from a Lumbar Percutaneous Discectomy Patients can usually return home the day of the procedure. Pain medication may be prescribed to control pain during the recovery period. After a cervical percutaneous discectomy, patients should avoid strenuous physical activity and any heavy lifting for several weeks. Physical therapy may be necessary to help the patient regain strength. Most patients can return to work after a week or two; however, those with more more physically demanding occupations may need to wait longer. Most patients experience positive results from a cervical percutaneous discectomy and have significant pain relief, which allows them to resume their normal activities free of pain.

  Link: Cervical Percutaneous Discectomy

• Congenital Foot Deformities

  Babies can be born with foot deformities for a number of reasons. Foot deformities may occur as a result of a genetic defect, birth trauma or developmental or positional abnormalities during gestation. Sometimes, such deformities are hereditary. They may also, in some cases, result from the toxicity to the fetus of certain medications the mother has ingested during pregnancy. While foot deformities may not be painful, they can later affect the child's development and ability to walk and so require prompt treatment. Wherever possible, treatment for congenital foot deformities begins with nonsurgical methods such as manipulation and casting to restore the affected feet to their normal position and hold them in place as they heal. When such treatments are unsuccessful, surgery may be necessary. Some of the most common congenital foot deformities include: Metatarsus adductus, foot points inward Clubfoot, foot points in and down Calcaneovalgus, foot points up and out Vertical talus, flat feet with "rocker bottom" Polydactyly, too many toes Syndactyly, joined or "webbed" toes Overlapping toes Surgery for congenital deformities is often performed during the first year of life, before the baby begins to walk, so that growth and development are not adversely affected. The type of surgery performed depends on the location and severity of the deformity, but can often be done using minimally invasive techniques. In situations where congenital foot deformities are part of a more complex medical disorder, they may be more difficult to treat and be associated with more surgical complications. Fortunately, though, most congenital foot deformities can now be fully corrected and babies born with these conditions most often go on to lead completely normal lives.

  Link: Congenital Foot Deformities

• Hand Surgery

  Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from injury or arthritic disease. Such surgery is usually performed under general anesthesia or local anesthesia with sedation on an outpatient basis. Many hand surgeries may be performed laparoscopically, allowing patients to benefit from smaller incisions, less scarring and bleeding, and shorter recovery times. Hand Surgery Procedures There are several types of surgical procedures performed on the hand. Depending on the type and the extent of the damage, injured tissue may be removed from the joint, tendons and ligaments may be repositioned, a joint may be fused, nerves of tendons may be repaired, or the entire joint may be replaced with a prosthetic. Arthrodesis or Fusion Arthroscopic arthrodesis (fusion) is a surgical procedure used to treat severe cases of degenerative osteoarthritis. This procedure involves fusing the bones of the affected joint in order to manage pain. During arthrodesis, all cartilage is removed from a joint and two or more bones are joined so they do not move. Fusions may be performed with screws, plates or pins or a combination of these materials. While the patient will have somewhat limited movement after arthrodesis, the surgery provides more joint stability and excellent pain relief. Arthroscopy Arthroscopy is a minimally invasive procedure that allows for careful examination and minor repairs of a joint. An arthroscope, a thin tube with a miniature camera attached to it, is inserted through a small incision, allowing the surgeon to view and treat the joint by removing torn cartilage or bone fragments. Osteotomy Osteotomy is a procedure used to remove a section of bone near a damaged joint. This procedure involves involves cutting or repositioning the bone to restore proper alignment and treat osteoarthritis. Synovectomy Synovectomy is a procedure that removes the synovium, or the tissue lining of the joints, to reduce pain and swelling. It is used to treat patients with rheumatoid arthritis and may also be effective at slowing the progression of the disease. Repairing Flexor Tendons Flexor tendons attach the bones of the fingers to the flexor muscles, the muscles that help the fingers to bend. When a flexor tendon is partially torn, the fingers may still bend, but the movement will be painful. There is increased likelihood that the flexor tendon may eventually tear all the way through, resulting in complete inability to move the finger joints. In order for a cut tendon to heal, surgery must be performed. Even with surgery, complete normal function does not normally return. Physical therapy may assist in releasing scar tissue and increasing mobility after surgery. Nerve Injury Repair Hand nerves are delicate and may be damaged not only by cutting, but by pressure or stretching. Injured nerves disrupt transmission of signals between the hand and the brain, causing loss of feeling and muscle dysfunction. In order to repair a nerve, the hand surgeon has to sew the torn ends of the nerve together, a very delicate procedure in which every effort is made to line up nerve fibers precisely. At times, where there is missing nerve tissue, a nerve graft is necessary to re-establish contact between the two ends of the nerve. When a nerve repair operation is performed, the nerve fibers eventually regenerate and function normally, but this may take a long time, sometimes years. When a graft has been done, there may be some permanent loss of feeling in the area from which the nerve graft was taken. During recovery from nerve injury repair, it is common to experience a pins and needle sensation which eventually passes as healing takes place. Risks of Hand Surgery As with any type of surgical procedure, there are certain risks associated with hand surgery, including: Adverse reaction to anesthesia Nerve damage, loss of sensation Blood clots Postsurgical infection Limited range of motion These risks are considered rare, especially when the surgery is performed by a skilled and experienced hand surgeon. Recovery from Hand Surgery After hand surgery for the treatment of arthritis, patients may experience mild to severe pain for which oral medication is typically prescribed. Depending on which surgery has been performed, the hand usually requires immobilization for a few days to a few weeks as it heals. Patients typically require a course of physical therapy in order to restore as much function and range of motion as possible.

  Link: Hand Surgery

• Joint Reconstruction and Replacement

  Because joints are in constant use, they often wear out over time due to overuse or aging. Joint reconstruction or replacement may be required to relieve the resulting pain and restore function. Most joints in the body, including the neck, shoulders, elbows, wrists, hands, hips, knees, ankles and feet, are synovial, permitting movement and articulation. When these joints suffer traumatic injury, or when the cartilage that normally protects them wears away, surgical repair or replacement may be necessary. Reconstruction and Replacement Surgeries Depending on the extent of the damage, there are several surgical options to repair or replace joints, varying in complexity, durability and recovery time. Joint Replacement Surgery Joint replacement is a complicated procedure, usually performed on the hip, shoulder or knee. Prosthetic joints used in the process are made of plastic and/or metal and are designed to move the same way natural joints do. Joint replacements may be cemented or uncemented. Cemented prostheses are often used in older patient whose bones are weaker and who are less active, while uncemented prostheses are used in younger, more active patients. The procedure with the uncemented device takes longer to heal because it requires growth of the patient's bone, but it results in greater mobility. In either case, the artificial joint typically lasts for 10 to 15 years, so the surgery may have to be repeated. In the case of younger patients, it may have to be repeated two or more times. Arthroscopy Arthroscopy is a minimally invasive procedure that is diagnostic as well as reparative. It is performed with a device called an arthroscope which enables the surgeon to magnify, as well as visualize, the site on a video monitor. The arthroscope is inserted through tiny incisions at the site through which the doctor can also make minor adjustments, such as trimming cartilage, removing bone spurs or releasing tight ligaments. Osteotomy Osteotomy is a procedure during which a section of bone is cut in order to realign the damaged joint. This procedure is typically performed on the knee or hip for younger patients who do not want to have joint replacement surgery yet. Resurfacing Surgery Most commonly performed on the hip, resurfacing is helpful to young patient and patients with medical conditions that make a hip replacement inadvisable. During resurfacing, only damaged cartilage is removed and a metal cap is placed over the ball portion of the hip. Although the surgery is less complex than hip replacement, resurfacing does not have as long a track record and so far it appears to be associated with a higher risk of complications. Arthrodesis Arthrodesis, commonly known as joint fusion, is a surgical procedure during which the surgeon uses various wires, pins, screws and plates to position the bones correctly until they fuse. This fusion will prevent painful movement. If there has been significant bone loss, a bone graft may be necessary. The bone to be grafted may be taken from another area of the patient's body, obtained from a donor bank, or may be made of synthetic material. Small Joint Surgery If joints in the hands or feet become so badly damaged that everyday activities are unmanageable, they may be replaced. In such cases, the goal is to restore enough mobility for the patient to resume performing simple tasks like using utensils or putting on shoes. Joint reconstruction and replacement have provided great relief to patients suffering from chronic severe pain. By restoring movement as well, joint surgeries enable patients to lead more active, productive and comfortable lives.

  Link: Joint Reconstruction and Replacement

• Knee Arthroscopy

  Arthroscopy is a minimally invasive procedure that allows doctors to examine tissues inside the knee. During an arthroscopic procedure, a device known as an arthroscope is inserted into a small incision in the knee. Through this tube, a thin fiberoptic light, magnifying lens and tiny video camera are inserted, allowing the doctor to examine the joint in great detail. Arthroscopy may be a diagnostic procedure following a physical examination and imaging tests such as MRI or CT scans or X-rays. It may also be used as a method of treatment to repair small injuries in the knee. Knee Arthroscopy as Treatment Relatively minor knee damage is frequently treated using arthroscopic techniques. Most knee damage results from sports injuries or osteoarthritis. During an arthroscopic procedure, the surgeon may be able to treat: Loose bone or cartilage Meniscal tears Torn ligaments Synovitis (swelling of the joint lining) Misalignment of the patella (knee cap) Inflamed tissue In patients with osteoarthritis of the knee, arthroscopy is also used in the removal of dead tissue, a process known as debridement. Benefits of Knee Arthroscopy Because it is minimally invasive, arthroscopy offers the patient many advantages over traditional, more invasive, surgery. These include: No cutting of muscles or tendons Smaller incisions Less bleeding during surgery Less scarring Shorter recovery time Shorter and more comfortable rehabilitation Candidates for Knee Arthroscopy Knee arthroscopy is quickly becoming the ideal procedure for many conditions affecting the knee. Its minimally invasive advantages allow patients to receive fast and simple pain relief, increased range of motion and restored function, while avoiding or delaying the need for joint replacement surgery. Despite its many advantages, arthroscopy is not appropriate for every patient. Some patients, especially those with knee problems that are in difficult-to-see areas, may benefit more from conventional surgery. The Knee Arthroscopy Procedure Knee arthroscopy is performed on an outpatient basis under local or general anesthesia, depending on the type and severity of the condition, as well as the patient's personal preference. During the procedure, the surgeon inserts the arthroscope into the knee through a tiny incision. This instrument is used to identify any damage or abnormalities within the knee, or to confirm the diagnosis of a previous imaging exam. If damaged areas are detected, they can be repaired during the same procedure by inserting surgical instruments into additional small incisions. Recovery from Knee Arthroscopy After a knee arthroscopy , patients often experience swelling and pain for several days. These symptoms can be controlled by the usual home remedies: resting and elevating the leg, applying ice and taking over-the-counter painkillers. Patients are encouraged to get up and walk around as soon as possible after the procedure, although crutches or a cane may be needed for some period of time. Most patients can usually return to work within a week, but will need to undergo physical therapy in order to restore full range of motion to the joint. Most patients can resume light physical activities after a few weeks, although full recovery from knee arthroscopy may take 12 weeks or longer. Risks of Knee Arthroscopy While knee arthroscopy is considered safe for most patients, there are certain risks associated with any surgical procedure. These risks include: infection, blood clots, accumulation of blood in the knee, nerve damage or adverse reactions to medications or anesthesia. In the great majority of cases, the knee arthroscopy goes smoothly.

  Link: Knee Arthroscopy

• Wrist Arthroscopy

  Arthroscopy is a minimally invasive surgical procedure that can be used both to diagnose and treat a wide range of conditions that affect joints. In the wrist, arthroscopy is used to treat ligaments, tendons and other types of tissue that become damaged as a result of degeneration, trauma, or disease. Wrist pain is a common problem with many possible causes. Sometimes it results from a sprain or fracture due to a fall or other injury, while in other cases it stems from conditions such as arthritis or carpal tunnel syndrome. It is essential, therefore, to obtain the proper diagnosis in order to treat it correctly and effectively. The Wrist Arthroscopy Procedure During the wrist arthroscopy procedure, the wrist is stabilized by being placed on a separate operating table from the one the patient is on. Several tiny incisions are made in the wrist and a thin tube, called an arthroscope, is inserted into the treatment area. The arthroscope is connected to a camera that displays images of the wrist's internal structure on a computer screen, allowing the surgeon to precisely identify and target joint abnormalities. Depending upon what is found, the surgeon, using special small surgical tools, may be able to treat the condition immediately. Reasons for wrist arthroscopy include removing scarred or inflamed tissue, repairing fractures, removing ganglion cysts, and repairing torn ligaments or tendons. Recovery from Wrist Arthroscopy After surgery, the wrist is elevated and bandaged for several days in order to reduce the risk of pain and swelling, and promote proper healing. Patients who undergo arthroscopy experience significantly less bleeding and scarring, and have shorter recovery times, than patients who undergo traditional open surgery.

  Link: Wrist Arthroscopy

• Reconstructive Foot Surgery

  Disorders of the foot develop from a wide range of causes, many of which can be treated with reconstructive foot surgery. Reconstructive surgery can help repair congenital defects, diseases and injuries, often alleviating aesthetic concerns at the same time as it relieves serious medical symptoms and restores normal function. While conservative treatments are frequently the first response to foot disorders, in many cases, reconstructive surgery may be the best available option. Most often, reconstructive foot surgery can be performed outpatient, with minimally invasive techniques, sometimes right in the doctor's office. Reasons for Reconstructive Foot Surgery Reconstructive foot surgery can be used to treat a wide range of foot problems which, while they may result from physical trauma to bone or muscle, may also stem from disorders of various body systems that interfere with circulation, tissue health or locomotion. Patients may require reconstructive foot surgery because of: Hereditary or traumatic deformity Vascular disease Metabolic disorder Tumor Infection Arthritic disease Surgery can involve any part of the foot and may involve skin, tendon, bone, joint, ligament or muscle repair. Screws, pins, wires and plates may be required to help the foot heal and ensure full recovery. Common Types of Reconstructive Foot Surgery The type of surgical procedure performed depends on the type and severity of the problem, but, regardless of type, the surgical goal is to alleviate pain and restore weight-bearing stability, function and normal appearance. Types of reconstructive foot surgery commonly performed include: Hammertoe repair Bunionectomy Endoscopic plantar fascia release Fasciotomy Open ankle fusion Ankle replacement (arthroplasty) Toe or ankle amputation Tumor removal Removal of ganglion cyst Recovery time varies, depending on the specific surgical procedure performed. For most varieties of reconstructive foot surgery, the patient's foot will have to be immobilized with a bandage or cast for a period of several weeks to many months and the patient may require crutches until the foot can bear weight. After surgery, a program of physical therapy will be necessary to assist the patient in regaining full strength and range of motion.

  Link: Reconstructive Foot Surgery

• Ulnar Collateral Ligament Reconstruction

  The ulnar collateral ligament (UCL) is located on the inside of the elbow and connects the bone of the upper arm to a bone in the forearm. The UCL is vital to maintaining elbow stability and function. This ligament may be torn as a result of injury or dislocation of the elbow, or damaged by overuse and repetitive movement and stress. If injuries do not heal properly, the elbow may become loose or unstable. Symptoms of a UCL injury include pain on the inside of the elbow, numbness, tingling, and decreased arm and elbow strength. A UCL injury is more common in athletes, especially baseball players, who use their arm constantly in a throwing motion. Treatment for a UCL injury varies, and initial treatment may include rest, anti-inflammatory medication, and physical therapy. If symptoms persist and do not respond to conservative methods of treatment, surgery to reconstruct or repair the joint, may be necessary. Ulnar collateral ligament reconstruction is a procedure used to repair a torn or damaged UCL ligament. This procedure is commonly referred to as Tommy John surgery, named after the first baseball player to undergo the procedure. The Ulnar Collateral Ligament Reconstruction Procedure This procedure is performed through an incision that is made on the inside of the elbow joint. During the ulnar collateral ligament reconstruction procedure, the surgeon replaces the torn ligament with a tissue graft. In most cases of UCL injury, the ligament can be reconstructed using one of the patient's own tendons, commonly taken from the forearm, hamstring, foot, or knee. Sutures are used to secure the tendon graft in position. When the procedure has been completed, the incision is sutured closed and the elbow is bandaged and placed in a splint. Risks of Ulnar Collateral Ligament Reconstruction As with any surgical procedure, there are risks associated with ulnar collateral ligament reconstruction, which may include: Reaction to anesthesia Infection Nerve or blood vessel damage Some patients may continue to experience chronic pain and instability of the elbow, even after surgery. Recovery and Results The elbow is immobilized for one to two weeks after surgery. After that time, a physical therapy program will help the individual to regain strength, flexibility and range of motion. Full recovery from an ulnar collateral ligament reconstruction may take from 6 to 9 months.

  Link: Ulnar Collateral Ligament Reconstruction

• Elbow Arthroscopy

  Arthroscopy is a type of surgery that uses an arthroscope, a thin fiber optic camera, to visualize an internal area and confirm a diagnosis. If damage or abnormalities are detected during the arthroscopy, repairs can often be made during the same procedure. Arthroscopy is considered an ideal treatment option for many conditions, since it offers smaller incisions, shorter recovery times and less scarring than traditional open surgery. Patients can often return home the same day as their procedure and resume their regular activities in just a few weeks, while experiencing less pain, greater range of motion and restored joint function. Elbow arthroscopy is generally used for simple manipulations of the joint, such as fracture care, debridement and removal of bone fragments. It is also commonly used to confirm and examine abnormalities of the joint to provide a proper diagnosis of any elbow conditions. The Elbow Arthroscopy Procedure During the elbow arthroscopy procedure, the surgeon makes a small incision near the affected area of the elbow and inserts an arthroscope, a long flexible tube with a camera and a tiny light on the end. This device displays magnified images of the inside of the elbow joint on a video monitor for the surgeon to view in real time. During this diagnostic part of the procedure, the elbow is examined for any signs of tearing, damage or degeneration to the ligaments, cartilage and other internal structures. If damage is detected, it can often be repaired during the same procedure by creating a few more small incisions through which tiny surgical instruments are inserted. These instruments allow the surgeon to replace damaged cartilage, join together torn ends, remove loose tissue or realign the joint to minimize pain and inflammation. Once the repair has been performed, the tools and arthroscope are removed and the incisions are sutured closed. A dressing will be applied to the area, which will later be replaced with smaller bandages as the incisions heal. Risks of Elbow Arthroscopy While elbow arthroscopy is considered safer and more efficient than conventional elbow procedures, there are still certain risks associated with any type of surgery. Some of these risks may include: Infection Reaction to anesthesia Nerve or blood vessel damage Tissue damage Prolonged pain Blood clots Patients should discuss these and other risks with their doctor before undergoing elbow arthroscopy. Recovery and Results of Elbow Arthroscopy To reduce the risk of swelling, the elbow is elevated and ice is applied intermittently for 48 hours after the initial surgery. In most cases, the arm will be put into a splint for several days. As healing begins, a physical therapy program will help the individual to regain strength, flexibility and range of motion. Depending on the type of repair that was performed, recovery times may vary, but most patients fully recover from elbow arthroscopy within several months. While arthroscopy offers many advantages over conventional elbow surgery, it may not be appropriate for all patients, especially those with conditions affecting hard-to-visualize areas. In such cases, traditional surgery may be more appropriate.

  Link: Elbow Arthroscopy