Surgical Solutions

Chances are, you’d prefer a non-surgical approach any day of the week. But, when medication and physiotherapy just can’t cut it, surgery might be just the thing you need to treat that troubling injury. Here, England- and Australia-trained orthopaedic surgeon DR ALAN CHEUNG shares three scenarios where surgery is usually the best solution – and what’s involved in each. Large meniscal tear #1

While this type of injury most commonly occurs during contact sports, all it takes is a sudden twist, or getting up from a squat the wrong way, to create enough force to tear the meniscus – the rubbery shock absorber that provides cushioning between your thighbone and shinbone. The result is pain, tenderness and a locking sensation.

While a small tear can sometimes be left alone, Dr Cheung says that a larger tear may prevent the knee from being straightened (known as “locking”). The torn meniscus may need to be surgically repaired or trimmed away, depending on the shape and location of the tear.

Fortunately, he says that both techniques he performs for meniscal tears at International Orthopaedic Clinic are minimally invasive keyhole surgeries that generate good results. A patient may be back to sports within several months following the procedure.

Complete ACL tear #2

As one of the four main ligaments that stabilise the knee, the anterior cruciate ligament (ACL) is commonly injured when turning suddenly or landing badly after a jump, in sports such as football, rugby, basketball and martial arts. Typical symptoms of this knee injury include immediate pain, knee instability and swelling.

When torn completely, the ACL does not tend to heal well, explains Dr Cheung. One approach, he says, is to surgically replace the torn ligament with a tissue graft – usually made up of hamstring tendons. This procedure is generally straightforward, with patients usually going home the same day. However, recovery time is long, and it can take nine to 12 months of physiotherapy to get a patient back to playing sports.

According to Dr Cheung, it’s definitely worth seeing a good physiotherapist on the recommendation of your surgeon, and undergoing rehab before considering surgery.

“This allows your knee to regain full range of movement and strength, and allows the bone bruising to settle. Some doctors have also argued that ACL reconstruction may reduce the risk of early osteoarthritis later in life.”

Osteoarthritis of the hip and #3 knee joints

For the patient with a worn-out hip and knee joint, Dr Cheung usually prescribes physiotherapy, medicine and, sometimes, a joint injection to relieve pain. However, if the pain is severe, and if the joint is too worn out, there may be no choice but to replace it.

In this case, he says robotic joint replacement is an extremely effective way of reducing pain and restoring quality of life. It involves the use of a robotic arm to assist with surgery, and helps reduce the risk of damage to nerves, blood vessels and ligaments.

Dr Cheung says that one major advantage of this method is that it allows the surgeon to plan the operation in minute detail. “Using a robot can make the process more exact, reproducible and reliable. In some cases, patients can even go home on the day of surgery.”

Of course, avoiding injury in the first place is key to preventing osteoarthritis. Dr Cheung suggests undergoing an injury prevention programme, strength training and physiotherapy to reduce risk of joint injuries.

International Orthopaedic Clinic

#05-24 Mount Elizabeth Novena Specialist Centre, 38 Irrawaddy Road

6253 7111 | ioc-ortho.com