Orthopaedic surgery

Waiting times:

Endoprostheses of large joints (hip, knee, shoulder) 13-14 měsíců.
Arthroscopy and "minor" surgical procedures (anterior cruciate ligament replacements, corrective surgery on the hands and feet, including hallux valgus) 2-4 weeks depending on the number of patients.
Note: Minor surgery - surgery that is less invasive for the patient and usually requires a shorter hospital stay, 1-4 days.

Arthroscopic surgery

These are medical and diagnostic joint surgeries performed using an arthroscope. The image is transmitted to the screen using light cables. The surgery itself is carried out with special instruments, when the joint is filled with saline by a pump.
The most frequently operated joint is the knee, followed by the shoulder, less frequently the kneecap and elbow. These surgeries are very gentle, allow quick rehabilitation and recovery, and require a very short hospital stay. The cosmetic effect is also significant - only two small wounds on the front of the knee joint.
Operations are performed in a modern surgery room equipped with an arthroscopic tower. We have special arthroscopic devices such as shaver (miniature milling machine) and Vulcan (high frequency coagulation).

Arthroscopic surgery on the knee joint

Meniscus treatment

The most common arthroscopic procedure - a relatively uncomplicated surgery where the damaged part of the meniscus is either removed (partial menisectomy) or the torn meniscus is sewn back together with absorbable sutures.
The patient is discharged home the next day. After the menisectomy, the limb can be loaded according to the tolerance and immediate rehabilitation is started. In case of meniscus suture, the postoperative regime is slow due to the possibility of meniscus retear, 4-6 weeks of rigid brace, then careful rehabilitation, weight bearing, i.e. walking on the operated limb is possible immediately. In the long term it is better to preserve the meniscus. Anesthesia is spinal or general. Complications are rare.

Anterior cruciate ligament surgery

Anterior cruciate ligament tears are among the most common sports injuries. The ligament is most commonly torn during rotational and uncoordinated movement. It is accompanied by pain, often a cracking feeling in the joint, limitation of mobility and early onset of swelling of the joint.
Early treatment consists first of rest, puncture of the hemarthrosis (blood in the joint), icing, bracing. If there is any diagnostic uncertainty or suspicion of concomitant meniscus damage, early arthroscopy is indicated. Suturing of the ligament showed poor results, so this method was abandoned. 4 weeks or more after the injury, ligament resurfacing, i.e. ligament reconstruction with a graft, can be performed. This is taken either from the patellar ligament (ligament under the patella) or from the hamstring (tendon on the inside of the knee), depending on the level of future sporting activity, occupation and gender. A graft can also be ordered from a tissue bank. We use a number of special and mostly absorbable implants to anchor the graft.
After surgery, immediate rehabilitation with RHB is initiated, walking and stepping according to pain tolerance, the orthotics is indicated only in some cases. Hospitalization lasts 3-4 days. Rehabilitation and strain is gradual and long term. Full sports activity is possible in 5-6 months.
Non-operative treatment consists of strengthening the thigh muscles (mainly the posterior muscle group), electrostimulation and physical therapy. A special orthotics is used for sports.

Treatment of damaged cartilage

Damaged cartilage is one of the most common arthroscopic findings. In indicated cases, we cover the defect by cartilage transfer with a so-called mosaic reconstruction. Other times, a so-called cartilage debridement is performed, i.e. removal (alignment) of the damaged cartilage. For larger defects, chondrocyte from a tissue bank can be grown.

Other arthroscopic knee procedures

Removal of loose objects (joint mice), treatment of symptomatic plicas, assessment of arthritic knee involvement with regard to further surgery, treatment of intra-articular fractures, removal of swollen joint lining and its collection for histological examination.

Arthroscopic surgery on the shoulder

The method is similar to the knee joint. Usually the surgery is performed under general anaesthesia. A special traction device is used to make the joint clear. The most common procedures are the stabilization for recurrent luxations, treatment of cartilage, removal of swollen joint lining, treatment for the so-called impingement syndrome by acromioplasty, suturing of torn tendons of the rotator cuff.

Arthroscopic shoulder stabilization

In repeated dislocations of the shoulder, the joint capsule and ligaments that hold the head in the socket must be reconstructed. Previously, these surgeries were performed open, but today they are almost always performed arthroscopically. We use a variety of absorbable and titanium implants to suture or resurface the damaged structures. After surgery, the limb is fixed with a orthotics for 4-6 weeks. The patient is discharged home the day after surgery.

Acromyoplasty

As a result of joint degeneration or traumatic damage to the tendons and ligaments of the shoulder, the space between the knob and the humerus is narrowed. When lifting the arm, the knob is then impacted (impingement) into the upper arm, which is accompanied by pain. When the conservative treatment is no longer possible, a surgical solution consisting in the removal of the lower part of the humerus is indicated. Today, these surgeries are performed more arthroscopically using a special bone cutter. After this operation, immediate rehabilitation is started, but it must be taken into account that the rehabilitation of the shoulder is always longer term.

Rotator cuff sutures

Tendon damage in the brachial plexus area of the upper limb is one of the common causes of shoulder pain. Mostly the tendon of the supraspinatus muscle, which is part of the so-called rotator cuff, is torn. In indicated cases, suturing is necessary. The operation can be performed openly and, more recently, arthroscopically using special instruments. After this surgery, fixation with a orthotics for 3-6 weeks is necessary, followed by rehabilitation, which is usually longer.