A human begins to move early before birth. It's a means of self-expression, self-realization, and recognition of the surrounding world. Movement
in a human can become impaired due to congenital or acquired disorders. Typically, these problems are accompanied by pain. In order to regain the joy of movement and to live a full life, it's important to
seek out and contact medical specialists as soon as possible.
The following specialists provide consultations and perform surgeries:
Juozas Belickas, MD, PhD, an orthopedist-traumatologist
Gintautas Pocius, MD, an orthopedist-traumatologist
Hammertoe is a deformity that causes a toe to become bent upward in the middle so it resembles a hammer. Hammertoes often occur in conjunction with other toe problems. It is possible to develop corns on top of the middle joint of the hammertoe.
Patients who have hammertoes try to manage them by treating the symptoms. This involves padding the toe and changing or stretching shoewear for comfort. If you still experience discomfort from the hammertoe you may consider surgery.
The hammertoe can be flexible or stiff. Depending on the flexibility of the toe and the preference of your orthopaedic foot and ankle surgeon, several different surgeries can be used to treat the hammertoe.
How Is the Surgery Performed?
Most often, hammertoe correction is done as an outpatient procedure. This means that you can go home the same day as the surgery. The surgery can either be done with you fully asleep, or it may be done with you awake after you have been given medicine that makes the foot go numb temporarily.
What Should Be Known After Surgery?
You may be given a special shoe to wear after surgery to help with walking. Recovery normally can take a few weeks depending on the type of surgery that was done.
You will be asked to keep your foot elevated at the level of your heart for the first few weeks after surgery, which requires lying on a couch or bed with your foot up. You may also need either crutches or a walker after surgery depending on your ability to walk.
Stitches are usually taken out two to three weeks after surgery, and if pins were placed, these will be taken out within a few weeks. You may not put your foot under water until the stitches and pins are removed.
If the hammertoe is on your right foot, you may not be able to drive a car for a number of weeks depending on the type of surgery you have.
Your orthopaedic surgeon may ask you to do exercises to stretch and move the toe at home after surgery. This can help with flexibility of the toe and to maintain motion in the toe.
It is normal to have swelling after surgery. It may take up to one year before the swelling resolves.
Hallux valgus is a deformity at the base of the big toe, or metatarsophalangeal (MTP) joint, in which the great toe, or hallux, is deviated or points toward the lesser toes; in severe types of the deformity, the great toe goes over or under the second toe.
How Is the Surgery Performed?
The procedure is usually performed under local anasthetic and, depending on the degree of deformity, can take from 20
to 90 minutes to complete.
The goal of the procedure is to correct the deviation of the first metatarsal, to remove bony prominences, and to restore the normal function of the joint.
During the surgery, the bony prominences are removed, the bone repositioned into a proper position, and fixed with special screws and plates.
Finally the repair of the tendons and ligaments around the joint is performed.
What Should Be Known After Surgery?
* Typically, after the procedure, the patient can step on the heel of the foot affected, while wearing a special surgical shoe;
* Most patients resume their daily routines completely within 6 -
12 weeks;
* The surgical wound should be re-dressed once per week;
* The stitches are removed after 14-18 days;
* For approximately 1 week, cold compresses should be applied to the foot and kept
on for 20 minutes a few times per day.
The repair of the Achilles tendon is a surgical procedure that aims to restore the anatomy and function of this tendon.
A tendon is a strong, rope-like structure that connects muscle to bone. When the muscle contracts, it pulls on the tendon, which in turn moves the bone. The Achilles tendon is the largest and strongest tendon in the body. It links the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). This muscle/tendon unit produces the majority of force that pushes the foot down during walking or running. The repair of the Achilles tendon is required:
* If after trauma, the referral to a physician was delayed for
several weeks and the ends of the tendon retracted too far to be sutured together;
* If a large portion of the tendon was damaged due to trauma;
* If after suturing the tendon, infectious complications occurred, and this lead to a tendon defect after healing;
* If inflammation of the Achilles tendon is present;
* If a deformity of the foot in which the foot is fixed in an abnormal position (pes equinus) is present, and the Achilles tendon needs to be lengthened in order
for the patient to walk with the full weight on his/her foot;
* After a surgical lengthening of the tibia.
How Is the Surgery Performed?
The surgery is usually performed under local anasthetic. It is a complex surgical procedure that can take from
90 minutes to 3 hours to complete.
If there is a tendon defect, the tendon is sutured, and the gap is closed by using either a piece of the same Achilles tendon or another tendon
in a tendon transfer.
What Should Be Known After Surgery?
* The sutures are removed after 12-14 days;
* Immediately after the procedure, the foot is immobilized with the help of a special cast for 6-8 weeks.
The goal of Achilles tendon repair is to reconnect the calf muscles with the heel bone to restore push-off strength.
How Is the Surgery Performed?
The procedure is performed under local anasthetic, and takes from 45
to 90 minutes to complete.
There are several surgical methods to repair a ruptured Achilles tendon. An open approach is most frequently employed: the ends of the tendon are sutured with special strong sutures, and a precise reconstruction done.
What Should Be Known After Surgery?
* The sutures are removed after 12-14 days;
* Immediately after the procedure, the foot is immobilized for 4-6 weeks with the help of a special cast.
Shoulder reconstruction surgery involves the repair of rotator cuff tears, recurrent shoulder dislocation, or torn surface (articular) cartilage.
Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small cut (incision) in the skin..
How Is the Surgery Performed?
The surgery is performed under local or general anesthetic. Depending on the extent of damage, time in surgery varies from 45 minutes to 4 hours to complete.
The tears of the tendons and the glenoid labrum are fixed by special suture anchors. The torn cartilage is repaired, and part of the coracoid process is removed.
What Should Be Known After Surgery?
* The sutures are removed after 12-14 days;
* Passive range of motion exercises are encouraged after 1 week, and active range of motion exercises, after 3-4 weeks;
* Most patients resume their daily routines completely within 2-4 months.
Anterior and posterior cruciate ligament tears are one of the most common knee injuries that occur in skiing or contact sports.
When these ligaments tear, patients experience a sense of instability in their knee joint. In this case, conservative treatment or ordinary ligament suturing is not effective. In order to restore knee stability, ligament reconstruction
must be done by using autografts, i.e., fragments of other ligaments or tendons harvested from the same patient.
The surgery is done by a minimally invasive arthroscopic approach.
During the procedure, an arthroscope, a thin, pencil-sized instrument
equipped with a fiberoptic video camera, is used, and the surgeons' manipulations are watched on a video screen.
How Is the Surgery Performed?
During arthroscopic ACL reconstruction, the surgeon makes several small incisions-usually two or three-around the knee. Sterile saline (salt) solution is pumped into the knee through one incision to expand it and to wash blood from the area. This allows the doctor to see the knee structures more clearly.
The procedure is usually made under spinal anesthesia, and time in surgery varies from 40 minutes to
90 minutes.
An arthroscope is inserted into the knee joint through a small incision measuring 0.5 - 1 cm. Additionally 1 or 2 incisions of the same size are
made to introduce arthroscopic instruments. Additional incisions are made to harvest a graft. With the assistance of the arthroscope, a new ligament formed from the graft is inserted into the knee joint through special tunnels and is fixed in place in the area of the tibia and the femur using special implants.
What Should Be Known After Surgery?
* Partial weight bearing on the foot affected is allowed on the first day after the procedure;
* Ice should be applied to the operated knee for 2 weeks;
* The wound should be re-dressed 1-2 times per week;
* The sutures are removed after 10-14 days;
* Physical activity should be restricted for 4 weeks. Light jogging can be resumed after 4 months, and return to contact sports is allowed after 6 months;
* Rehabilitation should begin after 3 weeks;
* Routine activities can be resumed completely within 2-3 months.
Symptoms include discomfort and, sometimes, acute shoulder pain when raising the arms above the head, reaching into a back pocket or while sleeping on the affected shoulder. People who frequently work with their arms above their heads may be more likely to get shoulder impingement syndrome.
Due to the narrowed space between the humerus and the acromial process of the scapula, the motions of the shoulder joint become painful and limited. Trauma and inflammation can contribute to the development of shoulder impingement.
How Is the Surgery Performed?
The surgery is performed under local or general anesthetic. Depending on the extent of damage, time in surgery varies from 30 minutes to 1.5 hours.
The surgery is done by a minimally invasive arthroscopic approach. An arthroscope is a thin, pencil-sized instrument equipped with a fiberoptic video camera, and all
the surgeons' manipulations are watched on a video screen. During the procedure, part of the coracoid process is removed
and the normal function of the shoulder is restored.
What Should be Known After Surgery?
* The sutures are removed after 12-14 days.
* Passive range of motion exercises are encouraged after 1 week, and active range of motion exercises after 3-4 weeks;
* Routine activities can be resumed completely within 2-4 months.
Lateral epicondylitis, or inflammation of the lateral epicondyle of the humerus, is also known as tennis elbow. It is characterized by chronic pain at the lateral or medial aspects of the elbow after unusual physical load. Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.
Lateral epicondylitis needs to be treated surgically when conservative treatment is not effective.
How Is the Surgery Performed?
The procedure is usually done under local anesthetic. It takes 30-45 minutes to complete.
Surgical treatment involves debridement of the inflammation-damaged tissues. As inflammation is
caused by repetitive and stressful motions, the affected tendon is released and reattached to another location of the bone. This results in reduced irritation and
a slightly changed range of motion of the joint.
What Should be Known After Surgery?
* The wound should be re-dressed 1-2 times per week;
* The sutures are removed after 10-14 days;
* Usual motions at the elbow joint can be resumed after 2 weeks, and more strenuous physical activity is allowed after 4-6 weeks.
The restoration of the integrity of the forearm bones, or osteosynthesis, is performed when the forearm bones are fractured, the fracture is complicated, or the ends of the fractured bone are displaced.
Osteosynthesis is a surgical procedure that stabilizes and joins the ends of fractured (broken) bones by mechanical devices such as metal plates, pins, rods, wires or screws.
This treatment method is superior to conservative treatment because it allows the restoration of the structural integrity of the bone and early movement of the extremity, and reduces the risk of complications during bone healing.
How Is the Surgery Performed?
The surgery is usually performed under local or general anesthetic and time in surgery varies from 30 minutes to
90 minutes.
The surgical procedure involves an open approach. Once the integrity of the bone has been restored, the bone is fixed with proper implants (screws, plates, or other mechanical means).
What Should be Known After Surgery?
* The arm is immobilized in a plaster or cosmetic cast for 4-6 weeks;
* The wound should be re-dressed 1-2 times per week;
* The sutures are removed after 10-14 days;
* Routine activities can be resumed completely after 12 weeks when the bones heal;
* Metal constructions (plates, screws etc.) are removed after 1 year following the surgical procedure, when the bones heal completely.
A surgical procedure for the removal of a metal construction is
required after previous osteosynthesis, or other surgeries, during which special implants were used. It is usually done after 1 year, when the bones
have healed completely.
How Is the Surgery Performed?
The procedure is performed under local, spinal, or general
anesthesia. Time in surgery can vary and depends on the number of metal constructions
used and their anatomic location.
The surgical procedure involves an open approach. Surgical incisions through which the implants are removed are usually placed at the site of scars. Metal constructions are removed by using special instruments.
The length of the operation depends on the bones from which the implants are removed:
* A large-scale surgical procedure for the removal of a metal construction when implants are removed from the humerus or the femur (long bones of a human);
* A moderate-scale surgical procedure for the removal of a metal construction, when implants are removed from the forearm bones, tibia, or clavicle;
* A small-scale surgical procedure for the removal of a metal construction, when implants are removed from the bones of the hand and foot.
What Should be Known After Surgery?
* The wound should be re-dressed 1-2 times per week;
* The sutures are removed after 10-14 days;
* Routine activities can be resumed when the surgical wounds heal completely;
* Specific postoperative care guidelines depending on the extent of surgery.
The restoration of the integrity of small bones (hand and foot), or osteosynthesis, is performed when the fractures of these bones are complicated or the ends of the fractured bone are displaced.
Osteosynthesis is the restoration of the structural integrity of the bone by using special implants, such as screws, plates, etc.
This treatment method is superior to conservative treatment because it allows the restoration of the structural integrity of the bone and early movement of the extremity, and reduces the risk of complications during bone healing.
How Is the Surgery Performed?
The surgery is usually performed under local or general anesthesia, and time in surgery varies from 30
to 90 minutes.
The surgical procedure involves an open approach. Once the integrity of the bone has been restored, the bone is fixed with proper implants (screws, plates, or other mechanical means).
What Should be Known After Surgery?
* The arm is immobilized in a plaster or cosmetic cast for 4-6 weeks;
* The wound should be re-dressed 1-2 times per week;
* The sutures are removed after 10-14 days;
* Routine activities can be resumed completely after 12 weeks, when the bones heal;
* Metal constructions are removed after 1 year following the surgical procedure, when the bones heal completely.
A surgical procedure for endoprosthetic joint replacement is done when articular surfaces are worn due to osteoarthritis or previous traumas that cause severe pain and when conservative treatment is not effective. Endoprosthetic joint replacement is indicated for degenerative diseases; but it can also be indicated for older people with femoral neck fractures or for non-reconstructible comminuted fractures around the shoulder or caput radii.
Endoprosthetic joint replacement surgery is performed on the joints of the shoulder, knee, ankle, hip, and great toe.
How Is the Surgery Performed?
The procedure is performed under local, spinal, or general anesthesia. Time in surgery depends on which joint is being replaced.
The surgical procedure involves an open approach. The damaged articular surfaces are removed together with part of the underlying bone using specialized instruments, and the removed cartilage and bone are replaced with the components of an endoprosthesis.
The shape of metal, polymeric, and ceramic implants is similar to that of natural articular surfaces.
Depending on the method of fixation to hold the implant in place there are 2 types of implants:
* Cemented implants that are held in place using bone cement;
* Cementless implants coated with hydroxyapatite crystals which help the new bone grow into the surface of the implant. This implant technology ensures greater longevity for an artificial joint and is very suitable for physically active persons.
What Should be Known After Surgery?
* The wound should re-dressed 1-2 times per week;
* The sutures are removed after 10-14 days;
* Routine activities can be resumed within 3-4 months;
* Specific postoperative care guidelines depend on the type of implant and which joint was replaced.
Articular cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. Healthy cartilage in our joints makes it easier to move. It allows the bones to glide over each other with very little friction.
Most commonly, articular cartilage repair is performed to treat a local cartilage defect and is not
required for the treatment of generalized cartilage damage (for example advanced osteoarthritis).
Repair can be done by autologous chondrocyte implantation, which involves harvesting, culturing, multiplying, and reimplanting autologous chondrocytes (cartilage cells of the same person), or by using cartilage substitutes.
How Is the Surgery Performed?
The procedure is typically performed under spinal anesthesia, and takes from 45 minutes to 1.5 hours to complete.
The location and size of a cartilage lesion is identified arthroscopically. Considering the location of the identified lesion, an additional small incision is
made. The cartilage defect is covered with a cartilage substitute or cultured autologous chondrocytes, and the cover sealed with fibrin glue.
What Should be Known After Surgery?
* Weight bearing on the foot affected is allowed after 4 weeks;
* Motions at the joint treated can be resumed on the first day after the procedure;
* It is recommended to apply ice to the operated joint for 2-4 days;
* The wound should be re-dressed 1-2 times per week;
* The sutures are removed after 10-14 days;
* Physical activity should be restricted for 6 weeks;
* Routine activities can be resumed completely within 2-3 months;
* Partial weight bearing on the foot affected is allowed on the first day after the procedure.
What is The Orthokine® therapy?
The Orthokine®-therapy is a unique way to treat osteoarthritis and back pain biologicaly, without the use of any foreign substances. The Orthokine®-therapy uses individual autologous proteins derived from the patient's blood, then applied as a medication. This therapy is a complete autologous form of treatment.
Helps to relieve pain and protects the joints
The Orthokine®-therapy makes use of
antiinflammatory and analgesic proteins derived from the blood, which is
injected into the nerval root. One of these proteins is the
Interleukin-1-Receptor-Antagonist. The autologous serum eases pain and
prevents nerval inflammation and an improvement in back pain is achieved.
The Orthokine®-therapy provides you with autologous antiinflammatory and analgesic medication derived from your blood, which is injected into the diseased joint. One of the proteins is the Interleukin-1-Receptor-Antagonist, which acts as an antiinflammatory and analgesic agent
and therefore a cartilage protector. The injection is equivalent to a routine orthopedic treatment which is usually tolerated very well. Joint pain usually resolves quite quickly after treatment, and this leads to the improvement of joint function. The Orthokine®-Therapy has a beneficiary effect on the cartilage.
The Orthokine®-therapy - Autologous Proteins against Arthritis
* Eases pain;
* Improves mobility;
* Prevents degenerative joint disease.
The Orthokine®-therapy - Autologous Proteins against Back Pain
* Eases pain;
* Prevents inflammation;
* Has a long-lasting effect.
When The Orthokine® method can be applied?
Efficiency of The Orthokine® treatment has been proved to these
traumas of the body without surgical treatment:
* Joint osteoarthritis (stage I-III) - induced pain;
* Backache;
* Tendon and muscle damage.
The Orthokine® method can be applied to several lesions simultaneously.
