Orthopaedic Surgeries
Listed below are some of the surgery procedures that Dr. Sushant Kumar Mallik specializes in. These are in-patient procedures which will require you to stay in the hospital for duration dependent on your type of procedure. Best rest assured that you will definitely receive highly personal and attentive care throughout your stay.
Arthroscopy (Keyhole Surgery)
Arthroscopy is a minimally invasive that is commonly used for knee, elbow, shoulder and ankle surgeries. Arthroscopy surgery makes small incisions which reduce recovery time, allowing patients to recover faster. The success rate is also higher due to lesser trauma to surrounding tissues.
Screw Fixation
Open reduction and internal fixation (ORIF) or Screw Fixation is used to realign and fix broken bones resulted from fractures. ORIF consists of 2 parts to the surgery namely reduction and internal fixation.The broken bone is reduced or realigned and moved back into its original position. Then, screws, nails or plates will be placed to help the bone heal in the correct proper alignment.
Knee Replacement (Arthroplasty)
Knee replacement or knee arthroplasty is a procedure where the diseased parts of the joint are replaced by artificial ones called the prostheses. After prolonged wear and tear, knees can get worn out and that will cause pain and swelling. Knee arthroplasty helps to relieve pain and swelling and allow patients to enjoy activities that they previously were unable to.
Hip Replacement
Hip replacement is a procedure where the damage bone and cartilage is removed and man-made components take over its place. Many factors may lead to the breakdown of the hip joint. Common reasons are due to osteoarthritis, osteonecrosis, injury, fracture and even bone tumor. A metal stem and ceramic ball will be used to replace the damaged femoral head. Hip replacement allows patient to enjoy decrease in pain, improve their quality of life and increase their range of motion.
Microdiscectomy Spine Surgery
Microdiscectomy spine surgery is done to remove a small portion of bone pressing onto the nerve root to relieve neural impingement and allow space for the nerve to heal. Neural impingement causes patients to suffer from leg pain. Most patients are able to enjoy an immediate relief of leg pain when they wake up after surgery.
Soft tissue surgery (Laceration / Cut)
Laceration is a wound caused by the tearing of body tissues and is often irregular. As a result, the extent of the damage is often not obvious and there can be variable degrees of damaged caused to the underlying tissues and structures depending on the trauma.
Removal of Lump
Removal of lump or biopsy is done to remove tissues from a certain part of the body of the area of concern. The removed tissue will then be sent for diagnosis and examined. Biopsy can be done in a few ways and one of the most common would be scraping. The skin at the area of concern will be scraped and samples can be obtained.
Total Hip Replacement: Step by Step
Total hip replacement surgery aims to relieve hip pain and increase hip function by resurfacing the bones that meet at the hip joint. The surgeon removes the femoral head and replaces it with an artificial one. This prosthetic femur head is shaped like a ball, and fits perfectly into the rounded cup prosthesis that becomes the new socket of the pelvis.
Below is a detailed description of a typical total hip replacement surgery. The actual surgery usually takes about two hours.
Total Hip Replacement Step-by-Step Description
Surgical procedures differ depending on the patient’s needs and the surgeon’s approach, but generally the steps are as follows:
• The patient’s vital signs are checked to make sure blood pressure, heart rate, body temperature, and oxygenation levels are normal and surgery can proceed. A mark is made on the hip undergoing surgery.
• Anesthesia is administered. A patient may receive general anesthesia (be put to sleep) or be given a regional anesthesia to block sensation from the waist down, along with a relaxant. The type of anesthesia a patient receives is decided well ahead of time.
• The surgeon makes a 10 to 12 inch incision, usually at the side or back of the hip, cutting through skin and then through muscle and other soft tissue to expose the bones at the hip joint. A surgeon performing minimally invasive total hip replacement will make a smaller incision and/or cut through less soft tissue.
• The surgeon dislocates the joint, removing the head of femur from its socket in the pelvis. This socket is called the acetabulum.• The arthritic femoral head is cut off with a bone saw.
• The surgeon prepares the acetabelum for its acetabular cup prosthesis by using a special tool called a reamer to grind down and shape the socket.
• The acetabular cup is placed into the reshaped socket. This cup may be porous to allow the bone to grow into it over time. Other acetabular cups are adhered with special bone cement. The type of cup and how it is adhered to the bone can depend on the surgeon’s preference and the patient’s physiology.
• The surgeon puts a rounded acetabular insert/liner inside the acetabular cup. The insert may be ceramic or plastic and will facilitate smooth movement within the new joint.
• The surgeon prepares the femur bone and inserts the prosthetic femoral stem into it. The femoral stem is a narrow, tapered metal shaft that fits several inches down inside the femur. The top of the stem is designed to hold a prosthetic ball that will replace the femoral head.
• A temporary prosthetic ball is attached to the top of the femoral stem. This ball is specially shaped to move with the new acetabulum cup and insert. The surgeon will insert a temporary ball into the new socket and move the hip around, checking to make sure the joint has ease of motion and does not dislocate.
• The surgeon will remove the trial component and insert the final ball into the new socket, checking again for ease of movement and dislocation. The surgeon will also attempt to restore optimal leg length using one of several clinical techniques. Finally, X-rays are often taken to assure proper sizing and positioning of the components.
• The muscle and other soft tissues that were cut are repaired and the skin incision is stitched or stapled back together.
• Depending on the surgeon’s preference and surgical technique/approach to the hip, prior to transferring the patient to the recovery room, a wedge pillow may be placed between the legs to prevent dislocation of the hip replacement.
After surgery, patients may spend several hours in a recovery room while the surgical anesthesia wears off. Afterwards, a patient typically is taken to a hospital room where he or she will spend 2 to 5 days recovering before being discharged.
A surgeon may give a patient a list of recommended post-surgical precautions. Hip precautions typically address one of two issues:
• Range-of-motion precautions.
These precautions are recommended to minimize the chance of dislocation. For example, a patient may be told not to cross his or her legs.
• Weight bearing precautions.
These precautions maximize the chance that the natural bone has an opportunity to grow into the implants. For example, a patient may be told not to stand or walk without using crutches or a walker.
These precautions are frequently recommended for a minimum of 6 weeks.
Knee Joint Replacement: Step by Step
A total knee replacement (TKR) is a complex procedure that requires an orthopedic surgeon to make precise measurements and skillfully remove the diseased portions of your bone, in order to shape the remaining bone to accommodate the knee implant. During the procedure, the surgeon builds the artificial knee inside your leg, one component at a time, to create a highly realistic artificial joint.
Step 1: Making the Knee IncisionThe surgeon makes an incision across the front of your knee to gain access to the patella, more commonly referred to as the kneecap. In a traditional knee replacement, the incision is usually about 8 to 10 inches long. In minimally invasive knee surgery, the incision is usually about 4 to 6 inches long. The jury is still out as to whether or not the pros of the smaller scar outweigh the cons of a smaller surgical area. Talk to your doctor about which procedure is right for you.
Step 2: Rotating the Patella (Kneecap) The first part of your knee that is exposed is your kneecap, called the patella. Once your knee is open, the surgeon rotates the patella outside the knee area. This allows the surgeon to view the area needed to perform the surgical procedure.
Step 3: Preparing the Femur (Thighbone) The first bone your surgeon will resurface is your femur, commonly known as the thighbone. Once the surgeon has opened up and exposed your knee joint, he or she will carefully measure your bones and make precise cuts using special instruments. The damaged bone and cartilage from the end of the femur is cut away. The end of your femur is cut and resurfaced to fit the first part of the artificial knee, the femoral component.
Step 4: Implanting the Femoral Component The surgeon attaches the metal femoral component to the end of your femur and uses bone cement to seal it into place.
Step 5: Preparing the Tibia (Shinbone) The next bone your surgeon resurfaces is your tibia, or shinbone.The surgeon removes damaged bone and cartilage from the top of the tibia and then shapes the bone to fit the metal and plastic tibial components.
Step 6: Implanting the Tibial Component The bottom portion of the implant, called the tibial tray, is fitted to the tibia and secured into place using bone cement. Once the tray is in place, the surgeon will snap in a polyethylene (medical-grade plastic) insert to sit between the tibial tray and the femoral component, and act as a kind of buffer. This insert will provide support for your body as you bend and flex your knee.
Step 7: Re-Adjusting the Patella Before returning the patella to its normal position, the surgeon might need to flatten the patella and fit it with an additional plastic component in order to ensure a proper fit with the rest of your implant. The plastic piece, if needed, is cemented to underlying bone.
Step 8: Finalizing the Procedure Your surgeon will bend and flex the knee to ensure that the implant is working correctly, and that alignment, sizing, and positioning is suitable. To complete the procedure, the surgeon will close the incision with stitches or staples, and then bandage it and prep you for recovery. You may leave the operating room with your leg in a continuous passive motion (CPM) machine that will gently bend and flex your new knee for you while you are lying down.
