ORTHOPAEDIC SURGERY
Combining cutting-edge technology with compassionate, personalised care
Fit4Surgery Program
There is significant evidence in support of optimising your health prior to orthopaedic surgery. At OSSEM we start by recommending:
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Medical conditions such as diabetes, hypertension and asthma are addressed and treatments optimised.
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Speak to us about psychological support. With additional training in Focused Psychological Strategies, we can coach you individually or link you with a psychologist.
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Getting your nutrition right before your orthopaedic surgery is very important for the healing process. Losing weight if you need to will also help your recovery. Dr. Lynne Reid will work with you to meet your goals.
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Lifestyle modifications including cutting down on alcohol consumption, stopping smoking and undertaking regular physical exercise in the run up to your orthopaedic
These interventions directly impact the outcomes of your surgery and can benefit everyone in every age group. Studies suggest up to a 50% reduction in postoperative complications, a reduced readmission rate and maintained positive lifestyle changes.
For you this could be a reduced length of stay or avoidance of complications such as infections, blood clots or heart or respiratory problems. Your journey will be smoother if you are optimised before you start. The recommended best practice is individualised treatment for every patient and 6 weeks before surgery is the optimum time frame.
Total Knee Replacement
What is it?
The knee is the body's largest joint, cushioned by articular cartilage. As cartilage breaks down, bones become exposed, forming osteophytes. Soft tissues around the joint can become inflamed, causing stiffness and pain. This leads to muscle weakening and further joint damage, with obesity worsening osteoarthritis, especially in women. Speak to one of our OSSEM doctors about our Fit4Surgery Program and in particular weight loss prior to surgery if you would like some help with this.
What does surgery involve?
Total knee replacement, or total knee arthroplasty, is a surgical procedure in which parts of the knee joint are replaced with artificial parts (prostheses). A/Prof. Reid has been performing knee replacement surgery for over a decade.
After surgery
After your surgery it is important to get out of bed and mobilise (initially under supervision by the physiotherapist and nursing staff) to reduce complications and promote healing. Delay in mobilisation can increase the chances of developing post-operative complications, so we are keen to get you moving quite quickly. After discharge, we will see in our consulting rooms for follow up at 2 weeks where A/Prof. Reid will examine you and our nurse will review your wound.
Rehabilitation
You can expect to walk with assistance the day after surgery using walking aids and will be able to shower with a waterproof dressing. Swimming will depend on full wound healing, to be discussed at your 6-week check-up. Most patients can walk unaided and drive by 6 weeks, once pain management allows for safe emergency stops. Cycling is encouraged for rehabilitation, starting on a stationary bike around week 4 and progressing to outdoor cycling by 8 weeks, depending on your recovery.
Tibial Tubercle Osteotomy (TTO)
What is it?
Tibial Tubercle Osteotomy (TTO) is a surgery to improve patella alignment by adjusting the patellar tendon’s insertion on the tibia. It treats patellofemoral instability and maltracking, reducing instability and arthritis symptoms. TTO is effective for patients without bone-on-bone osteoarthritis and can be combined with ligament reconstruction or cartilage repair. Although it doesn't cure arthritis, it significantly reduces knee pain by alleviating pressure on the patella.
What does surgery involve?
You will be admitted to the hospital on the day of your surgery, which will be performed under either general or spinal anaesthesia. The procedure begins with the insertion of a small camera (arthroscope) into the knee joint to inspect for and treat any damage to the cartilage.
A small incision will then be made at the front of the knee. A 7 cm section of the tibial tubercle (the bony attachment of the patellar ligament) will be repositioned and secured with two screws, allowing it to heal in its new location. The procedure moves the tibial tubercle either medially (toward the inner side) or distally (further down the tibia), depending on your condition.
After surgery
After surgery, you will wake up with a brace on your leg to keep it straight, which you must wear whenever you're up and about. You can remove it while sleeping. You will also be given crutches and can only place limited weight on your leg for the first six weeks, using two crutches to support yourself, placing just your leg’s weight on the ground for balance. Most patients go home within 1–2 days once pain is controlled, with time in the hospital also allowing for early physiotherapy and crutch training. From week three, you will gradually reduce your pain medication, especially before physiotherapy and bedtime. Most patients stop needing pain relief after six weeks.
Rehabilitation
Your first post-operative visit will be with your surgeon at 2 weeks. This appointment is critical for checking your incision healing and range of motion as well as to answer any questions you may have. You will then follow-up with your surgeon 6 weeks after surgery, 12 weeks after surgery, 6 months after surgery, and one year after surgery. X-rays will be ordered at each visit up until the 3-month mark to ensure that the TTO is healing. At one-year post-op you will discuss with your surgeon your return to higher level activity.
Meniscal Tear Surgery
What is it?
The meniscus is a C-shaped piece of cartilage that acts as a cushion between the thigh and shin bones, and tears often occur due to sudden twisting or heavy pressure on the knee. Meniscal tear surgery is a procedure performed to repair or remove damaged cartilage in the knee.
What does surgery involve?
Surgery may involve either repairing the torn tissue or removing the damaged section in a process called a meniscectomy. This type of knee surgery is done arthroscopically which is minimally invasive keyhole surgery.
A tourniquet is inflated around your thigh to maintain a bloodless field during the surgery. Typically, two small incisions are made during a knee arthroscopy. One incision for the arthroscope and one for the surgical instruments to treat the knee damage. The keyhole technique usually allows for a more rapid recovery than open techniques as well as shorter recovery times following surgery. The meniscal tear will be either repaired or trimmed depending on the location of the tear in the meniscus. Generally, tears in the zone where there is still a viable blood supply with be repaired and those that are not will be trimmed.
After surgery
Patients are usually able to fully weight bearing after their surgery unless otherwise advised by A/Prof. Reid. He will see you after your surgery prior to discharge the same day. A follow up appointment will be arranged for you around day 10–14 for removal of stitches. This is performed in rooms and is not usually painful.
Rehabilitation
Rehabilitation may be facilitated with the supervision of a physiotherapist over the period of the next few weeks. Recovery time depends on the type of surgery and individual factors, but patients can usually return to normal activities within a few weeks. Physical therapy is often required to regain full strength and mobility in the knee.
You can return to activities immediately after surgery with supervision, starting with "touch weight bearing." Showering is allowed right away, provided a waterproof dressing is in place. Swimming is permitted once the wound has fully healed, typically around two weeks, after consultation with Dr. Reid or Sue, the nurse, during your wound check. Most patients can expect to return to work and resume driving approximately two weeks post-surgery.
Anterior Cruciate Ligament (ACL) Surgery
What is it?
The ACL is a major stabilising ligament of the knee particularly during movements such as running, twisting and sidestepping. The function of the ACL is to prevent the femur moving forward and rotating excessively on the tibia. Reconstruction of the ACL will potentially reduce recurrent instability of the knee joint. Usually, patients who are more active and keener to return to sport involving twisting and pivoting will typically proceed to surgery. Repairing the ACL also protects the knee from further damage.
What does surgery involve?
Reconstruction of the ACL is performed under a general anaesthetic. A tourniquet is inflated around your thigh to maintain a bloodless field during the surgery. Typically, two or three small incisions are made during a knee arthroscopy. One incision for the arthroscope and the others for the surgical instruments to treat the knee damage. A further 2–3cm incision will be made to harvest your hamstrings.
A piece of your hamstring will be used to reconstruct the anterior cruciate ligament. Fixation of the ligament will be achieved through a combination of a screw and endo-button. The keyhole techniques usually allow for a more rapid recovery than open techniques as well as shorter recovery times following surgery. A check x-ray will be undertaken to endure satisfactory placement of the screw and endo-button prior to your discharge from hospital. An overnight stay is hospital would be typical for ACL reconstruction surgery, but some patients will go home on the same day if confident to do so.
After surgery
Ice packs used regularly will help with reducing swelling following your surgery. Following your surgery, the physiotherapist will guide you through your rehabilitation. Soon after, your ACL graft should be strong enough to put all your weight on the operated leg. You will require crutches and pain killers initially for the first week or two. You may shower providing you have a waterproof dressing over your wounds. A/Prof. Reid will review your wound approximately 14 days after your surgery and our lovely nurse Sue will remove any stitches and redress your wound.
Rehabilitation
Patients will need a minimum of 2 weeks off work. You can return to driving if we have operated on your left knee and you drive an automatic. You need to be off strong pain killers and able to carry out an emergency stop at speed. You also need to be able to get out of the vehicle unassisted (in the event of an accident). So, you need to be confident about walking and maneuvering unaided. For some this will be at 2 weeks, for others it may be as much as 6 weeks. Again, discuss this at your follow up appointment and wound check at 2 weeks.
Patients who are more active such as labourers may need 2 to 3 months off work. We recommend return to competitive sport only after 8–12 months following your surgery. This is to reduce the risk of a recurrent injury, and it is recommended an experienced physiotherapist helps guide you through your rehabilitation.
Improved Quality of Life
Our experienced team can accurately diagnose complex musculoskeletal conditions and help you recover from injuries, improve function and mobility.
SPORT AND EXERCISE MEDICINE
Optimise your health for peak performance and recovery
Acute Injury Clinic
At OSSEM we know that injuries are a common problem in any sport. For this reason, we have evolved to have an easy access injury clinic that can assess and treat clients efficiently and thoroughly. After all, we want to get you back on your feet quickly and back to sport. So, whether it is a fracture, a soft tissue injury or an abrasion we have our team on hand to put you back together.
You have access to a consultant orthopaedic surgeon who has decades of experience treating acute and chronic musculoskeletal injuries. With in-house GPs available at all times, we are able to see you without a referral. You will get a comprehensive summary of your attendance and a personal, tailored treatment plan.
Sport and exercise medicine
Osteopathy and sports medicine complement each other in optimising athletic performance, preventing injuries, and treating musculoskeletal conditions. Osteopathy focuses on diagnosing, treating, and preventing issues related to the body’s muscles, bones, and joints, using manual techniques to enhance mobility and promote healing.
In sports medicine, osteopathic principles are applied to manage sports-related injuries, aid recovery, and improve overall physical function. By taking a holistic approach, osteopathy in sports medicine aims to balance the body’s structure and function, helping athletes to recover more quickly and improve their performance while reducing the risk of future injuries.