Do I Need Surgery?

Hip Replacement

The indications for surgery are:

  • Pain (groin pain) that is constant,may wake the patient up at night (despite taking pain medications)
  • Functional Limitations :difficulty walking, stair climbing, difficulty putting shoes and socks on, difficulty getting in and out of car/public transport
  • Stiffness; in a very small proportion of patients stiffness alone may be an indication for surgery especially when there is functional disability
  • Failed non-surgical treatment: painful hip and functional limitation despite a course of physiotherapy, pain medications and activity modifications
  • X-ray changes – indicative of arthrosis with the above symptoms

2 or more of the above with Xray features are strong indications for surgery.

It is important to consult an orthopaedic surgeon early.

Hip Resurfacing

The indications for Hip Resurfacing:

  • Young, active patients preferably males under 70 years of age with good bone quality
  • Young patients who have arthritis but want to pursue a very active life style involving Jumping, Running and sports.
  • Adequate bone density as measured by a bone density scan
  • In cases of Avascular necrosis, Less than or equal to 1/3 of femoral head involved
  • We do not recommend younger females to undergo hip resurfacings

Hip Arthroscopy

Indications for hip arthroscopy include:

  • Cam type Femoroacetabular impingement: (Femoroacetabular Impingement (FAI)
  • Pincer type lesions
  • AcetabularLabral tears
  • Snapping Hip
  • Hip joint Infection
  • Ligamentumteres injuries
  • Iliopsoas bursitis
  • Cartilage Lesions
  • Removal of loose bodies
  • Extra articular pathology

Patients are carefully selected for surgery after appropriate radiological imaging and discussion with the orthopaedic surgeon.

Knee Arthroscopy

This is can be done for both diagnosing and treating a condition and may vary from patient to patient.

Indications are:

  • Treating Meniscal Tears (trimming, repairing or replacement)
  • Diagnosing and treating ACL and PCL Injuries
  • Cartilage defects or injuries (Abrasion/mosaicplasty, Autologous cartilage implanting)
  • Removal of loose bodies
  • Lateral release for maltracking knee cap
  • Synovectomy in cases of rheumatoid, PVNS, Synovial chondromatosis
  • Joint washout in case of infection
  • Arthroscopic assessment before partial knee replacement

Meniscal Repair

Indications for Meniscal Repair

  • Peripheral tears (red-red zone) tears – that are less than 3-5 mm from the periphery
  • Unstable tears that are more than 7-10 mm
  • Single , mobile vertical, longitudinal tears of the meniscus in the outer third
  • (Tears > 3cm when repaired may not heal)
  • (Transverse tears even in the outer third may not heal)
  • (Meniscal tears in the presence of ACL tears have a higher rate of re-tear)

An MRI scan is required before any surgery can be planned and treatment results can vary from patient to patient.

Meniscal Replacement

Indications are:

  • Young, active patients with minimal arthritis who have complete loss of a meniscus
  • Patients should have good alignment of the knee joint
  • Patients should have a stable knee

Total Knee Replacement

Indications for surgery are:

  • Pain: Painful knee that is not responding to pain medications, may wake patients up at night
  • Functional Limitations:Reduced walking distance, difficulty climbing stairs, difficulty bending knees/squatting due to arthritis affecting normal daily activities.
  • Failed Non-Surgical treatment: painful knees and functional limitation despite physiotherapy/hydrotherapy, pain medications and weight loss or activity modifications
  • X-ray changes: arthritic knee

2 or more of the above features with Xrays changes may be an indication for surgery.

Partial Knee Replacement

Indications for surgery are:

  • Arthritis Isolated to one compartment of the knee (medial or lateral)
  • Good arc range of motion of >90 degrees
  • <15 degrees of varus or valgus deformity
  • Stable knee joint with no evidence or inflammatory arthritis

This may vary from patient to patient and should be discussed with an orthopaedic surgeon.

ACL Reconstruction

Indications for Surgery:

  • Young patients who have an ACL tear with knee instability (giving way)
  • Athletes who have an ACL tear where they perform cutting, pivoting and jumping
  • Patients who have recurrent symptoms of instability (giving way) after atleast 3-6 months of non surgical treatment and rehabilitation

It is important that patients undergoing surgery are willing to complete the postoperative rehabilitation program.