KNEE ARTHROSCOPY
Knee arthroscopy is a surgical procedure that allows observation of the knee joint through small incisions made through the skin. Arthroscopy is used to diagnose and treat a wide range of knee problems.
This technique uses specially designed video cameras and small lenses (1.9 mm to 4 mm), along with small-caliber instruments that can be inserted into the joints without damaging them (forceps, scissors, etc.).
The advantages of arthroscopy include rapid recovery due to less aggressive surgery, less pain, faster functional recovery, and shorter hospital or outpatient stays.
The number of procedures that can be performed using arthroscopy is increasing, offering significant advantages over traditional (open) surgery.
Knee arthroscopy can now repair and treat cartilage problems, meniscal injuries, ligament reconstruction, loose body removal, synovial or joint tissue cleansing, and other procedures.
The advantages of the endoscopic technique over traditional surgery include faster patient recovery and less postoperative discomfort, as it is a less invasive procedure.
To achieve full joint recovery after arthroscopy, it is advisable for the patient to perform rehabilitation exercises that will aid tissue healing and a full recovery.
Most common indications for knee arthroscopy:
- Ligament injuries
- Meniscus injuries
- Articular cartilage injuries
- Chronic synovitis
- Joint stiffness
- Fractures
- Bursitis
- Intra-articular loose bodies.
Knee arthroscopy can be performed under local-regional or general anesthesia. The complication rate after arthroscopic surgery is generally very low. If complications do occur, they are generally minor and easily treated. Possible postoperative problems with knee arthroscopy include knee stiffness and local discomfort. Like all surgeries, there is a risk of thrombosis and infection (lower than with other types of procedures).
MINIMALLY INVASIVE HIP REPLACEMENT SURGERY
Minimally invasive anterior hip replacement surgery represents a major advance in the treatment of patients with hip osteoarthritis.
Because it uses an anterior approach, the surgeon accesses between the muscles without damaging them and respecting the body’s anatomical features. This allows for a much faster recovery than with conventional procedures, while minimizing pain, incision size, and hospital stay.
Anterior hip replacement surgery is a minimally invasive technique with no limitations regarding the indications for its use.
This technique is very innovative for athletes, as they will be able to continue their physical activity without movement restrictions after the procedure (although they will have to avoid contact sports), and also for obese patients, as fat accumulation in the groin is less than in the posterior region.
The approach is performed anteriorly, using a “bikini” incision that will be hidden under clothing, causing minimal aesthetic impact on the patient’s life.
Conventional hip surgery (performed posteriorly, i.e., through the gluteus) involves detaching (removing) the muscles to implant the hip prosthesis, requiring subsequent reconstruction of the muscles. However, with this technique, the surgeon accesses between the muscles without damaging them, respecting the body’s anatomical elements.
In the medium term, the hip prosthesis’s dislocation potential is reduced to virtually zero, and the patient is allowed any type of movement from the first postoperative day.
UPPER EXTREMITY
Hand and upper limb pathologies, due to their complexity and specificity, require in-depth knowledge and special dedication. Thanks to new technologies, great advances have been made in both the diagnosis and treatment of these injuries.
The training and experience of our specialists in microsurgery and upper limb surgery, as well as in arthroscopy, allow them to effectively treat:
- Fractures: hand, wrist, forearm, elbow, arm, and shoulder
- Complications of upper and lower limb fractures, such as malunion, pseudoarthrosis, osteomyelitis, and joint stiffness.
- Amputations and complex injuries, primarily of the hand
- Acute and chronic tendon injuries
- Acute and chronic peripheral nerve injuries
- Rheumatic hand, elbow, and shoulder
- Brachial plexus and sciatic nerve pathology
- Peripheral compressive neuropathies (primarily CTS and ulnar canal)
- Dupuytren’s disease
- Degenerative arthritic conditions such as rhizarthrosis, TTS osteoarthritis, etc.
- Peripheral paralysis
- Loss of substance in severe extremity trauma, employing a full range of surgical skills.
BONE:
- Internal, external, and mixed osteosynthesis of fractures.
- Osteotomies: simple and complex distal radius, ulnar shortening
- Arthrodeses: total wrist, partial (radiocarpal and intercarpal), metacarpophalangeal, interphalangeal, etc.
- Arthroplasties
MICROSURGICAL:
- Vascularized bone grafts
- Microvascular suturing
- Nerve suturing
- Skin coverage (pedicle and free flaps on upper and lower limbs)
SOFT TISSUE:
- Acute tendon repair (flexors and extensors)
- Tendon reconstruction: chronic tendon injuries
- Acute ligament repair
- Chronic ligament reconstruction (MCP, scapholunate ligament, etc.)
- Fasciotomy, fasciectomy, and dermofasciectomy (Dupuytren’s disease)
- Tendon transfers (paralytic hand, peripheral neuropathies, etc.)
- Release of nerve compression syndromes (CTS, ulnar syndrome in the olecranon-epithelial groove, PES, tarsal tunnel syndrome, etc.)
FOOT AND ANKLE
The Foot and Ankle Unit practices the latest techniques in orthopedic medicine and surgery, based on minimally invasive surgical techniques, such as percutaneous surgery or arthroscopy, and more complex and advanced techniques that allow for the correction of more severe deformities.
Percutaneous surgery is primarily used to correct one of the most common foot deformities, such as bunions or hallux valgus, hammertoes, and other toe problems that can be very limiting for the patient.
Furthermore, arthroscopy allows for ligament repair in chronic ankle sprains (instability), the treatment of tendonitis through tendoscopies or endoscopic calcaneoplasty, tendon transfers, and the treatment of foot paralysis.
Complex Foot and Ankle Deformities and Ankle Prostheses
Our experts also specialize in the treatment of complex deformities and osteoarthritis of the foot and ankle through osteotomies and tendon transfers or the use of ankle prostheses, avoiding arthrodesis (joint fixation) as much as possible. The team has extensive experience in the implantation of ankle prostheses and the use of circular fixators (hexapods), which, through computer-assisted calculations, allow for the correction of a large number of severe ankle and foot deformities.
Foot or ankle injuries are one of the most common reasons for visits to the trauma department and commonly occur during sports activities, leisure activities, work-related tasks, or home projects.
The most common pathology is an ankle sprain, which is also one of the main reasons for seeking emergency care. Although its initial treatment should be conservative, with rehabilitation and physical therapy, in some cases, the progression to chronicity (poorly healed sprain) may require surgical intervention to resolve the problem.
Traumatic injuries also include Achilles tendon ruptures, ankle fractures, and fractures of foot bones such as the calcaneus.
Finally, we must mention sports-related pathologies of the foot and ankle, in which we have extensive experience treating high-level athletes. Arthroscopic and minimally invasive surgery allows for faster recoveries and more effective treatment of injuries sustained during sports.
Most common foot and ankle injuries
Bone injuries:
- Ankle fractures
- Calcaneus fractures
- Talus and cuboid fractures
- Talus and cuboid fractures
- Fractures of the ankle • Metatarsal fractures
- Jones fracture or fifth metatarsal tail fracture
- Sesamoiditis
- Freiberg’s disease
- Ankle osteoarthritis
Soft tissue injuries and foot deformities:
- Plantar fasciitis or heel spur
- Morton’s neuroma
- Tendinitis and tendinosis (Achilles tendinopathy, posterior tibial tendonitis, and peroneal tendinopathy)
- Metatarsalgia
- Bursitis
- Flat feet
- Feet cavus varus
- Müller-Weiss disease
- Bunion (hallux valgus)
- Hallux rigidus (big toe osteoarthritis)
- Foot and ankle paralysis
- Posterior tibial neuropathy or tarsal canal
- Sinus tarsi syndrome (tarsal sinus)
- Tarsal coalitions (tarsal bars)
In addition to the after-effects of nerve injuries and neurological diseases.
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