Common Causes of Hip Pain in Young Adults Wondering what the common causes of hip pain in young adults are? this blog will provide you with the information that you need to understand possible causes and will recommend when to seek treatment. Signs & Symptoms Hip pain tends to present with a variety of symptoms including: Clicking or “locking” of the hip joint Pain in the groin which may be made worse by various positions such as sitting or prolonged walking Difficulty putting on shoes and socks Pain in the buttocks Hip pain in older individuals can be caused by osteoarthritis (“wear and tear”) of the ball and socket joint. In younger individuals, a myriad of reasons for hip pain exist.: Simple groin strains – which respond well to physiotherapy Inflammation of the tendons around the hip Subtle hip shape deformities such as Dysplasia, and Impingement. Early osteoarthritis. This blog will be delving further into hip pain caused by subtle deformities of the hip joint that give rise to either Dysplasia and/or Impingement. What is Hip Dysplasia? Dysplasia quite simply means “abnormal development”.  Thereby hip dysplasia indicates that in a certain individual, their hip (the ball and socket joint) has not developed normally.  There is usually a genetic cause for this, and it frequently runs in families. Most commonly, hip dysplasia is characterized by a “shallow” socket that does not adequately cover the femoral head. When the femoral head is not completely covered by the socket, the hip is unstable, may become painful and eventually develop osteoarthritis.  Patients often feel like the hip may dislocate, and it may click on occasion. In its severest form, it presents in newborns with a dislocated hip. This is picked up at birth and treated.  In its mildest form, it may not become symptomatic until the patient is in their 20’s or 30’s. How is Hip Dysplasia Diagnosed? Hip Dysplasia is diagnosed with a combination of clinical history, examination findings and imaging.  Dysplasia is often seen on a standard radiograph (“X-Ray”) of the Pelvis and both hips.  Additional investigations which help guide treatment options include CT and MRI scans. Finally, a diagnostic injection of local anaesthetic into the hip joint may be performed to ensure the correct diagnosis is reached. What is the treatment of Hip Dysplasia? As with most hip conditions, we would always advise non-operative treatment initially. This includes physiotherapy and painkillers.  However, if non-surgical treatment fails, hip dysplasia is corrected by surgery. If hip dysplasia goes untreated, arthritis is likely to develop. Symptomatic hip dysplasia is likely to continue to cause symptoms until the deformity is surgically corrected. Many patients benefit from a procedure called a periacetabular osteotomy or PAO. The medical term “periacetabular” means “around the acetabulum” or “around the hip socket.” The term “osteotomy” refers to any procedure in which bone is cut. Thus, a PAO is a procedure where the bone is cut around the hip socket. The socket is placed into the optimal position and secured using 3 or 4 bone screws. The surgery is performed under a general anaesthetic, through a minimally invasive surgical incision (about 10cm) in the bikini-line region of your upper thigh.  The surgery itself can take up to 3 hours.  After surgery, the patient would be required to walk with crutches for up to 3 months. By correcting the patient’s anatomy, the procedure has been shown in numerous studies to relieve hip pain and delay the progression of osteoarthritis within one’s hip. What is Hip Impingement? Hip impingement, or femoroacetabular impingement (FAI), is a condition where the bones in the hip joint are abnormally shaped. Either the hip socket has too much bone along the rim of the socket. Or the femoral head on the leg bone isn’t sufficiently rounded. This abnormal shape of the joint leads to uneven wearing, friction and pinching of the soft tissues around the hip. It is possible to have both socket and femoral head deformities at the same time. Hip impingement can affect anyone of any age. The causes of hip impingement include many sporting activities including martial arts, weight training, golf and football, but also lifestyle and occupational causes. Often there may be a genetic cause and it may run in families. The impingement often occurs when the hip is flexed or “bent up”.  This may occur when sitting for long periods, squatting, or running. How is Hip Impingement Diagnosed? Hip Impingement is diagnosed with a combination of clinical history, examination findings and imaging. Impingement is often seen on a standard radiograph (“X-Ray”) of the Pelvis and both hips.  Additional investigations which help guide treatment options include CT and MRI scans. How is Hip Impingement Treated? As with most hip conditions, we would always advise non-operative treatment initially. This includes physiotherapy and painkillers.  This being said, if non-surgical treatment fails, hip impingement is often corrected by surgery. If hip impingement goes untreated, arthritis is likely to develop. Surgical treatment is directed to the aspect of the hip, which is not normal.  Often this is either due to excess bone on the socket and/or femoral head (ball) of the hip joint.  In this case, a keyhole operation to the hip (hip arthroscopy) can be beneficial.  This procedure is performed under general anaesthesia and may take up to 3 hours to perform fully.  During this procedure, the leg is attached to a specialised traction device and table which enables a small gap between the ball and socket to be achieved.  Once the gap is opened, we are able to insert a camera through a small incision to the side of the hip.  A second small opening is made adjacent to that to allow us to insert further equipment such as a small shaver/burr to remove the excess bone and tissue.  This is usually a day case procedure and the patient is expected to make a full recovery within 6 weeks. If there is an issue with the rotational alignment of the socket and/or ball of the femur, then we may advocate a procedure to correct this.  Correcting the rotational malalignment of the socket would involve performing a periacetabular osteotomy (as described above).  Rotational malalignment of the ball of the femur would involve an osteotomy (cut to bone) to the femur (thigh bone) and fixation with a metal plate on the side of the bone. Book an Appointment Hip Dysplasia and Impingement are relatively common conditions that are amenable to treatment if identified early. The majority of patients with the condition, once diagnosed, may be treated with good results.  Do not delay in seeking specialised orthopaedic assessment if you suspect you may suffer from either of these conditions.  Early treatment avoids progression to arthritis and the inevitable hip replacement. Book an appointment at Coriel Orthopaedic Group today or contact us to find out more.Book Treatment

Get Painful Heel Treatment in Doncaster Heel pain can have a significant impact on one’s quality of life. We will try to explore the causes of painful heel, symptoms, diagnosis and various ways to cope with this condition. Amongst the many bones in the foot, the heel bone is the largest. It is prone to overuse and injuries resulting in mild to disabling pain. What are the causes of Painful Heel? There are several causes of painful heel but to list a few, these are: Plantar fasciitis: This is the most common cause for painful heel. It is an inflammation of the plantar fascia, which is a thick band of tissue in the sole of foot. Heel spurs: These can form around the heel bone. The spurs at the back of heel can be quiet troublesome. Repetitive stress & strain: Excessive running, jogging and walking can predispose to stress injuries and inflammation. Bursitis: Inflammation of the fluid sac at the back of the heel can lead to painful heel Achilles tendonitis: The Achilles tendon attaches to the back of the heel and recurrent inflammation can lead to chronic pain in this region. Foot structure: People with high arches sometimes are prone for painful heel while others, having flat feet can also have pain in the sole and arch of foot. Medical causes: High uric acid and low vitamin D and other inflammatory conditions can predispose to heel pain too. Referred pain: Pain around the heel can come from the lower back or nerves. Symptoms of Painful heel The common symptoms are early morning stiffness and pain. Pain can also be at the end of the day which is mainly activity related. The pain can remain constant and can get very chronic making it challenging to deal with. Diagnosis and Treatment of Painful Heel in Doncaster It is crucial to consult your doctor and a specialist to arrive at an accurate diagnosis and management plan. The specialist will take a detailed medical history, perform a physical examination, and order some investigations like x-rays and ultrasound scan before making a definitive management plan. The treatment of painful heel generally involves non-operative measures and this depends on the cause of painful heel. Rest: You need to avoid activities that cause pain. Ice: Inflammation may settle by the application of ice packs to the affected heel. Footwear modification: Cushioning the insoles and proper support can ease of the discomfort. Physiotherapy: This is beneficial for tight muscles at the back of the leg. Orthotic insoles: These are beneficial for improving your foot alignment and can give good relief in symptoms. Anti-inflammatory medications: For the relief of inflammation these medications can help, but please get in touch with your doctor. Local injections: In some cases, corticosteroid injections are necessary. Preventing and Coping with Painful heel Painful heel can be very disabling. You can cope with the condition by following certain strategies: Avoid overexertion by avoiding repetitive activities Take proper care of your feet by practising good foot hygiene. Soaking feet in warm water can help some symptoms. Have a healthy lifestyle by eating a balanced diet and regular exercises. Reducing body weight (speak to your doctor). You may like to get in touch with other people suffering from similar conditions for emotional support and coping mechanisms. Get Painful Heel Treatment in Doncaster If you are experiencing pain in your heel that is not improving by simple measures, please get in touch with your doctor for help and onward referral to a specialist for proper evaluation and management.Book Treatment #orthopaedicsurgeons #coriel #corielorthopaedic #surgeonsindoncaster #privatesurgeonsdoncaster

Get Trochanteric Bursitis Treatment in Doncaster By Andrew Bruce What is Trochanteric Bursitis? Trochanteric Bursitis (TB) is also known as Greater Trochanteric Pain Syndrome (GTPS). It is characterised by inflammation of the bursa near the Greater Trochanter of the Femur (the bony prominence at the outer aspect of the hip) What is a bursa? A bursa is a small, fluid-filled sac that acts a cushion between bones, muscles, and tendons, reducing friction and allowing smooth movement. Symptoms The main symptom is pain at the outer aspect of the hip / thigh, which often radiates down towards, and just below, the knee. The pain can often be exacerbated by activities including, walking, running, climbing stairs, and lying on the affected side. It is common, when rising from a chair, to get pain which requires a few seconds of standing, before being able to walk normally. Who is affected? It can occur in people of all ages but is more common in middle-aged and older people. It can sometimes occur in people who have had surgery such as hip replacement. Common Causes Repetitive stress: Overuse or repetitive movements of the hip, such as running, standing for excessive periods, can lead to irritation and inflammation of the bursa. Poor Posture: Any activity that involves poor posture, or altered hip biomechanics can place extra stress on the area and cause inflammation. Trauma: A fall onto, or a direct blow to, the area can lead to inflammation within the bursa. Muscular Imbalance or Weakness: Weakness and tightness within the muscle groups around the hip are a leading cause of GTPS. Underlying Inflammatory Conditions: In some cases, conditions such as Rheumatoid Arthritis can contribute to the development of GTPS. How is it diagnosed? It is principally diagnosed on physical examination, but imaging, such as Ultrasound, X-Ray and MRI may be helpful, particularly to rule out other causes of pain. How is it treated? Treatment almost always starts with conservative measures such as: Rest: Avoidance of activities that aggravate the pain may help reduce the inflammation and symptoms Ice: Applying Ice packs to the affected area can help reduce the inflammation and pain Pain Relief: Over-the-counter anti-Inflammatory tablets, such as ibuprofen, have been shown to be helpful in reducing pain and inflammation. Massaging Anti-Inflammatory Gel into the area may also be helpful. Massage: Gentle massage around the affected area is helpful in some people. Physiotherapy: Targeted exercises, over 6 – 12 weeks, are designed to strengthen the muscles around the hip and are the mainstay of treatment. Graduated stretches may also help to relieve the pressure over the bursa. Use of Walking aids: The use of a walking stick or elbow crutches may be helpful in the early stages, to help offload the affected hip. Steroid Injection: If the measures above fail to improve symptoms, injection of local anaesthetic and steroid (cortisone) has been shown to be helpful. These can either be “blind” or with the assistance of ultrasound guidance. Others: If conservative measures fail to improve or resolve symptoms other more interventional options may be considered. These may include Platelet Rich Plasma (PRP) injections, Extra Corporeal Shockwave Therapy, and in rare cases surgery to remove the bursa. Summary GTPS is a common condition that is amenable to treatment. The majority of patients with the condition, once diagnosed, can be fairly easily treated with good results. Get Trochanteric Bursitis Treatment in Doncaster today from Coriel Orthopaedic Group.Book Treatment #doncaster #TrochantericBursitisTreatment #TrochantericBursitisTreatmentinDoncaster

What is Shoulder Osteoarthritis Shoulder Osteoarthritis Treatment in Doncaster In a healthy shoulder, the surfaces of the ball and socket are covered with cartilage, which allows the bones to move smoothly over each other and acts as a shock absorber. In osteoarthritis, this cartilage degenerates, becoming thin, rough and uneven. The fluid-filled space in the joint gets smaller and bone rubs against bone, which is uncomfortable and can lead to bony lumps or spurs forming. Shoulder arthritis refers to degenerative change in the joint, most commonly due to wear and tear. As we grow older, the cartilage lining of the bones in a joint slowly wears away. This thinning and loss of cartilage eventually leads to wear and tear of the bone itself and is called osteoarthritis. Other conditions such as inflammatory disorders (like rheumatoid arthritis), trauma and increased high-intensity use of the joint can also predispose to shoulder arthritis. Rotator cuff arthropathy is a specific type of shoulder arthritis, in which there is severe arthritis and a large tear in the rotator cuff muscles that stabilise the shoulder joint. The patients are mainly troubled by pain and stiffness affecting their quality of life. Symptoms of shoulder osteoarthritis Shoulder arthritis causes pain, stiffness and clicking or cracking during movement. The pain can be located on the side, front or back of the shoulder and may radiate into the neck or arm. In the early stages the pain may come on when using the arm, especially when lifting heavy objects or raising the limb. The pain can progress over time, until the shoulder is painful even at rest. Shoulder arthritis can make it difficult to dress, brush your hair or do up a seatbelt (Activities of daily living) and also can affect sleep. Management of shoulder arthritis Through assessment of your shoulder by a specialist orthopaedic surgeon, so as to tailor a treatment programme according to individual requirements. Investigations: X-rays, USS and CT scans are useful in diagnosis and planning treatment. Following treatment are available: Non-Surgical Specialist physiotherapy, anti-inflammatory medication and steroid injections can reduce the pain and stiffness of shoulder arthritis. If these conservative measures have not provided relief, Shoulder joint replacement surgery will help to relieve pain and restore shoulder mobility. Shoulder replacement The choice of surgery depends on the age of the patient, the severity of the disease and the presence of other associated shoulder problems. Shoulder replacement involves removing the arthritic joint surfaces and replacing them with a prosthetic device (ball and socket joint). This offers excellent relief pain relief and restores functional movement. There are several different types of shoulder replacement. Shoulder joint replacement could involve replacing both sides of the joint (total shoulder replacement) or the humeral bone alone (Partial shoulder replacement) Two types of total shoulder replacement are available: “Anatomic” and “Reverse”. The condition of the rotator cuff tendons within the shoulder determines which of these two types of shoulder replacement will be most appropriate – both types of shoulder replacement provide an equal degree of pain relief. In an anatomic replacement, a plastic socket is cemented in place and a metal ball is fixed to the humeral joint surface (arm bone) and this could be stemless or stemmed. In a “reverse” total shoulder joint replacement a metal hemisphere is implanted on the socket side of the shoulder joint and a plastic “socket” within a metal stem on the arm bone (humerus) side. This design of the total shoulder replacement is able to compensate for the lack of rotator cuff function by recruiting the large deltoid muscle to take on their work. Your consultant surgeon will recommend the best option for you following a full evaluation of your shoulder. Shoulder replacement surgery is carried out under general anaesthesia with a regional nerve block. Most patients who are admitted go home the next day. Following surgery, you will wear an arm sling for 3-4 weeks. Your surgeon will instruct you to do gentle range of motion exercises to increase your mobility and strength. They will recommend a formal physical therapy program to strengthen your shoulder and improve flexibility. You should be able to eat, dress, and groom yourself within a few days after surgery. Total shoulder replacement provides outstanding pain relief and patient satisfaction is typically very high. If you have any questions or simply want to find out more about Shoulder Osteoarthritis Treatment in Doncaster please get in touch with us.

From Exams to Excellence: Meet Mr Dan Morell, the Hand Surgeon The hand surgery training pathway is a long journey. There are lots of exams and time locked away in a room away from family and friends with your head in a book. There are lots of sacrifices, missed birthdays, weddings, and festive seasons (you get the idea!). Surgical subspecialty training in orthopaedics: Towards the end of surgical subspecialty training in orthopaedics, most surgeons will take an exam which signifies their competency in that speciality. For Orthopaedic surgeons, that is the FRCS (Fellowship of the Royal College of Surgeons) exam. It consists of a written component followed by a 2-day clinical and viva exam that is conducted by trained examiners made up of senior Orthopaedic surgeons from across the country. FRCS Exam: Everything up to that point is focused on the exam and it becomes like a heavy burden across your shoulders, weighing down every decision you make. The relief of success is one of elation and freedom, as for most surgeons, this will mark the very end of a long line of academic exams. Unfortunately, for a hand surgeon, this isn’t the case. One more exam looms the British Diploma of Hand surgery. British Diploma of Hand Surgery: Hand surgery is a combination of both plastic and orthopaedic surgery and the Diploma is designed to cover the entire breadth of the hand surgery curriculum. It includes approx. 1200 educational hours; 32 tutorials; a literature review – amongst other coursework; a written exam and this is all followed by a 2-day viva and clinical exam. Challenges of studying while working: I began studying for the Diploma during my fellowship in 2017/18 at the Pulvertaft Hand Centre in Derby. Studying whilst working is difficult, especially when the commute is long, and although I achieved the majority of the required tutorials, I soon realized that I wasn’t going to be able to complete the Diploma within the year. In October 2018, I succeeded in getting a job as a consultant at Doncaster and Bassetlaw Teaching Hospitals. The task of managing theatre lists, clinics and the endless pile of admin became my main focus. COVID-19 Pandemic: In late 2019, I refocused on the exam, but the COVID pandemic disrupted everything, making exams seem insignificant compared to what the world and the NHS faced. Decision-making: Fast-forward 2 years and I’d now become an established hand surgeon. I had a choice to make… The driving force for many to work toward the Diploma is the subsequent enrichment of the CV. With this additional feather in your cap, work opportunities become more accessible. Having been a consultant in post for 4 years altered the landscape for me. I weighed up my options and discussed them with colleagues, family and friends; they asked: “If you pass, will you earn more money?”…. “No.” So why are you going to put yourself through it then?” I also had to consider the risk of failure, in front of peers whom I admire and respect. That would surely only do my reputation damage. On the flip side, I felt like there was something missing: a small niggling feeling called regret. I didn’t like this feeling and I wanted to be assured that when I see patients, I can confidently advise them that I have studied the entire breadth of what is known about the surgery of the hand. Although it was a gamble, I decided to go for it. The Exam Experience: Six months of studying later, coursework and more weekends locked away from my wife and daughter, I’m in Birmingham ready to sit the clinical. Waiting for that bell to ring to go into that room, where destiny awaits is a bit like sitting at the edge of an aeroplane preparing to leap out and skydive: heart racing at 100 miles per hour. Why am I so nervous? Because this is important to me. I want to succeed. The results arrive the following day with a phone call from the exam supervisor. It’s good news. Suddenly all that stress is worth it. My family share in my joy; it’s not just my success but our success as they have been the ones to carry me through it.

What is your Rotator Cuff and why is it a Painful Topic? Shoulder pain is very common and rotator cuff problems are a frequent source of that pain.  We often take our shoulder movements for granted but issues in the shoulder can be very debilitating. They often cause us problems with simple daily activities such as washing, dressing, brushing our hair and even getting a good night’s sleep.  If this sounds familiar, then please read on to find out how you can get the right rotator cuff support. What is the rotator cuff? Four muscles, known as the rotator cuff, attach to the shoulder blade and surround the ball and socket joint. Individually they rotate the shoulder in different positions but together as a team, their main job is to hold the ball in the socket.  This provides stability and allows the bigger muscles to move the arm into various positions.  Each of the muscles forms a tendon which attaches along the edge of the ball (head of the humerus bone) forming a single cuff of a tendon (hence the name rotator cuff). What causes rotator cuff pain? Disorders of the rotator cuff range from mild inflammation to a full-thickness tear of one or more of the tendons. The Most Common Cause of Rotator Cuff Tears: Not just an acute injury, but also due to chronic wear and tear from repetitive actions in certain sports and occupations such as tennis, swimming, golf, or heavy lifting jobs like plumbing, electrical work, and carpentry. What are the symptoms? Pain Experience pain radiating from your shoulder to your upper arm during overhead activities or when reaching your hand to your back? This discomfort can also cause a general ache even at rest, and may even disrupt your sleep, especially if you roll onto the affected side Weakness This is usually due to a tear in the tendon but can also be secondary to pain caused by an inflamed tendon.  With very large tears it may be very difficult to lift the arm at all; almost as if it is paralysed.  This is called pseudoparalysis (false paralysis). Clicking and cracking Dysfunction of the rotator cuff tendons can lead to poor control of the ball in the socket of the shoulder which often causes clicking, popping or cracking when you move the shoulder.  This can sometimes be painful. What should you do if you think you have an injury? If you think you may have a rotator cuff problem, you should speak to your GP as you will require further investigations to diagnose the problem.  Following this, it is likely you will be referred to see a specialist shoulder surgeon to discuss the treatment options.  The common shoulder investigations are: Radiographs (X-rays) – This will show the bones of the shoulder and, although you can’t see the soft tissues clearly on x-ray, sometimes changes in the bone where the tendons attach can give an indication of problems with the tendons themselves.  Any arthritis in the shoulder will also be detected with this investigation. Ultrasound – This is a simple, non-invasive investigation, which is very good at looking at the rotator cuff tendons.  It is very reliable at detecting inflammation, thickening and tears of the rotator cuff.  Ultrasound can also be used to accurately give injections into the shoulder if indicated. Magnetic Resonance Imaging (MRI) – This is a very reliable investigation which gives a clear view of the tissues in the shoulder including bones, cartilage, ligaments and tendons. The MRI not only identifies rotator cuff tears and inflammation but also determines the quality and level of retraction of the tendons. This helps determine which tears are repairable. Identify Shoulder Joint Arthritis with MRI Scans What treatments are available for rotator cuff injuries? Treatment depends on the severity of the injury. Treat rotator cuff tendinosis with an injection to reduce inflammation and follow up with physiotherapy to strengthen the rotator cuff muscles and prevent the recurrence of inflammation. In the case of a rotator cuff tendon tear, surgical intervention is more likely.  However, not all patients need surgery.  Up to 50% of people over the age of 60 will have chronic tears and no symptoms at all.  Unfortunately, these tears never heal and if symptoms are affecting daily life and sleep then treatment will often be required.  If the tear is small, strengthening the remaining tendons with physio may improve symptoms, but often the weakness never fully improves.  A steroid injection may help improve the associated inflammation but will not repair the tear.  With bigger tears, surgery is often indicated.  This involves keyhole surgery to repair the tendon back to the bone using small anchors. What are the consequences if I don’t get treatment for my rotator cuff problem? Large, retracted rotator cuff tears can be difficult to repair.  If the tendon has been torn for a long period of time (many months or years) and the tendon quality is poor, the surgeon may be unable to repair it.  The rotator cuff tendons play an important role in stabilising the ball within the socket of the shoulder joint.  Tears over a long period of time can, therefore, lead to arthritis in the shoulder.  In both scenarios, keyhole surgery is unlikely to successfully improve symptoms.  In these cases, a shoulder replacement may be the best option to get rid of patients’ pain and improve function. If you are experiencing symptoms of a rotator cuff injury it is important you seek medical advice soon, especially if you have had an acute injury to prevent less severe injuries from getting worse. Get Rotator Cuff Support. Book Today #shouldersupport #rotatorcuffsupport #shoulderpain #rotatorcuffpain #shouldertreatment #shoulderinjury #arthritis

There are several causes for a painful ankle. Keep reading to learn more about the cause of your symptoms and how you can get treatment for ankle arthritis in Doncaster. What can cause a painful ankle? Pain around the ankle is generated from the soft tissues around the ankle including the tendons, nerves and ligaments or from within the joint itself. Most commonly, pain is caused following an injury to any of the above structures. The other causes include arthritis, gout, rheumatoid arthritis, injury to the ankle, stress fractures, a sprained ankle, Achilles tendonitis and infections. When does your ankle pain signify ankle arthritis? It is difficult to be certain of ankle arthritis. If you have constant pain in your ankle and you are noticing stiffness in the joint limiting the movements, please consult your doctor who will examine you and perform weight-bearing x-rays of your ankle. You may need a referral to an orthopaedic foot and ankle specialist. You may also need a few more investigations depending on the stage and type of arthritis. Commonly, ankle arthritis is injury related. Other causes of ankle arthritis include reactive, inflammatory, gout, infective and rheumatoid arthritis among a few others. You may need some routine blood tests and scans to determine the root cause of your symptoms. How can you manage ankle arthritis? Support your ankle with a brace that you can get from the local chemist or online stores. Modify your lifestyle – include physical activities, take routine anti-inflammatory medications (advice from your doctor), and do some physiotherapy. If these measures fail to relieve your symptoms, you may need to seek specialist advice. Seeking Treatment for ankle arthritis – what are my other options for managing it? The management will depend on how bad your arthritis is. In very early stages, a single injection in the joint will suffice, followed by continued non-operative treatment. If the arthritis is associated with some mechanical symptoms, a joint cleaning procedure carried out through a keyhole (arthroscopic) surgery may be useful. This is called ankle debridement. It is a day case procedure involving a couple of very tiny cuts in the front of the ankle and assessing the inside of the joint through a telescope to clear off the painful inflamed tissues from within the joint. If there are associated deformities of the bones or joints, you may be eligible for a re-alignment procedure which will bring your ankle and heel to a straight position. If your ankle arthritis has progressed to bone-on-bone (end-stage), you will be offered a fusion (ankle arthrodesis) or an ankle replacement. Which is better for you: a fusion or a replacement? An ankle fusion is a preferred option for someone who is less than 50 years of age, has a physically demanding job, and has an active lifestyle, with good joints in the rest of the foot. Ankle replacement, on the other hand, is suitable for someone with a sedentary lifestyle and with good muscle balance around the ankle. If other joints in your foot are also affected by arthritis, an ankle replacement is advantageous. However, in the case of severe deformity and instability in the ankle joint along with high BMI, an ankle replacement is not preferred. Your specialist will discuss this in detail. Get in touch with us to find out how we can help you today: Get In Touch

Complications following any Orthopaedic surgery can occur. Blood clots, more commonly known as deep vein thrombosis (DVT) can easily form in the limbs, especially the legs, following any surgery that results in reduced activity for a period of days. Keep reading to find out how to prevent blood clots after surgery and whether you might be at an increased risk. What can happen if you get a blood clot after surgery? It is fair to say that we as clinicians have become quite obsessed with trying to prevent postoperative DVT as it can have significant consequences. Not only can the clot travel to the lungs, with possible fatal consequences, but also may cause long-term damage to the veins, reducing circulation and increasing long-term swelling and pain. This situation is known as post-thrombotic syndrome. How can I prevent a blood clot after surgery? Now, whilst this information might be a bit scary, understanding the risk factors that can lead to DVT will help you to reduce the risk. We as clinicians consider a number of risk factors as part of the pre-operative workup. We complete specific forms which are attached to the medical notes documenting any of the risks identified. Unfortunately, whilst we can identify risks and provide appropriate prophylactic measures, we do not have a definitive formula for prevention.  What we mean by that is that we can only reduce the risk and not eliminate it completely. How do I know if I’m more at risk? Factors we consider include: 1. Age – patients over 60 are at higher risk 2. Weight – obesity increases risk, especially BMI greater than 30 3. Personal or family history – patient history or first-degree relative history of clots 4. HRT or contraceptive medication – oestrogen-containing medication increases risk 5. Varicose or pre-existing damaged veins 6. Immobility post-op – patients who are non-weight bearing or immobilised in a cast have an increased risk 7. Duration of surgery – operations taking longer than 90mins have a higher risk 8. Type of surgery – hip and knee replacement carries a high risk 9. Smoking – damages circulation and can increase risk How can I prevent blood clots after surgery? Some of these factors such as weight and smoking can be improved by yourself. Keeping yourself fit and choosing a healthy lifestyle will reduce risk significantly should you ever need an operation. Temporarily stopping HRT/contraceptive medication 4 weeks before surgery reduces risk. Keeping well-hydrated post-op, by drinking 2 litres of water daily, will also reduce risk. If your surgeon considers your risk to be low, then simple exercises to move the affected limb along with good hydration will be advised. In high-risk cases, whilst in hospital, mechanical pumps to squeeze the calf, compression stockings and injections of blood thinners into your tummy may be prescribed. You may go home with injections to self-administer or a blood thinning tablet to take daily for a prescribed period of time. After the first 2 weeks, aspirin may be used for a period of 6-8 weeks to further reduce risk. If you are particularly worried about blood clots, do speak to your surgeon who will discuss this in more detail. Get more tips on how to recover from surgery and learn how we can help you treat a range of conditions in Doncaster below: Recovering From Surgery Treat Orthopaedic Conditions

Enhanced Recovery from Surgery – The 3 Phases A common question patients ask is: how can I have the best recovery from surgery? Of course, it depends on the type of surgery, but you should consider the recovery in 3 phases. Understanding these phases will help you manage your expectations for the most enhanced recovery from surgery. What is orthopaedic surgery? Orthopaedic surgery is basically a controlled injury to soft tissues and bones. It involves cutting the skin and essentially breaking the bone. The only difference from a normal injury is the mechanism of how it is done. Phase 1. Injury: This phase involves an initial period of wound healing. At this point, the swelling and reaction to injury will be at its highest. This is why your surgeon will ask you to rest and minimise normal activities to essential things like “going to the toilet” or “going up to bed”. You may be asked to elevate your limb and use ICE to minimise swelling. This phase usually lasts around 2 weeks, at which time any stitches or clips holding the wound together will be removed. Phase 2. Acceptance: This is the period of initial recovery as you start going back to more normal activity and work. This phase really does depend on the procedure undertaken. In general, it will be another 4 weeks after the injury phase is complete. The patient will be allowed to mobilise more, and may begin some physiotherapy but, in essence, will need to “accept” the time specified. Phase 3. Frustration: This may well be quite a difficult phase. Usually around 6-8 weeks post-op, your surgeon will advise you to return back to normal activity. Your own body, however, will dictate what you can do by swelling and causing pain if you overdo things. In this phase, you need to listen to your body and continue to rest, ICE and elevate as needed. You will likely become “frustrated” with progress, as it will feel like a long time. Remember, however, the less you do in the initial “injury phase”, the quicker you will get through the “frustration phase”. Normally things really start to improve at around 10 weeks post-op. Enhanced Recovery from Surgery – where to learn more In essence, listen to the advice given, listen to your body and have a quick and safe recovery. Make sure to check out our blog for more health tips and get treatment for a range of conditions below: Latest News Treat Orthopaedic Conditions

Is the NHS being affected by the private healthcare system? So you attend a private hospital as an NHS patient. It may leave you confused? Is the NHS being privatised? will I be asked for any payment? How is it that I can be seen in a private hospital if I’m not private? How do the NHS and the private healthcare system work alongside each other? How the NHS & private healthcare system work together The reality is, NHS & Private healthcare going hand in hand is not a new thing. In fact, the independent sector has been offering NHS care for at least 20 years. Initially, this was under “spot purchase” where NHS hospitals would outsource work to reduce waiting times. Latterly private hospitals have become primary providers of care through ‘choose and book’. This is where your GP practice can book directly for any qualified provider service either traditional NHS or independent hospital. Is the treatment quality worth the cost? So does this cost more? The answer is no. Each patient treatment episode carries a standard NHS tariff which is paid to both NHS and private hospitals when they do the work. You may find that treatment times vary, with private hospitals seeing and treating patients quicker, however, there are measures in place to prevent patients treated at NHS hospitals from being disadvantaged. The main advantage to patients is that you will always see the chosen consultant in the private sector, whereas in the NHS you may see a member of the consultants’ team Remember, on the whole, the patient has the right to choose (within reason and area) who they wish to see, so consider that when you visit your GP and discuss your preferences with them. Looking for private orthopaedic treatment? Our specialist consultants can treat a range of conditions – from foot and ankle injuries to groin pain. Learn more and get in touch below: Conditions We Treat Contact Us

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Often when it comes to discussing surgical procedures, some patients will say, “I don’t want to know the details just get on with it”. Problem is, in modern day medicine, the law on consent has shifted from “Doctor knows best” to “shared decision and responsibility”. This is certainly a good thing as it means that the the patient receives a much more detailed explanation of the planned procedure and risks associated with the procedure. Written advice sheets are now more or less mandatory, some with diagrams demonstrating the surgery. Back in the day we used the Bolam test to measure consent to treatment. This essentially meant the the procedure carried out was in line with what a “body of medical opinion” would do. In other words, do your medical mates accept it was the  right procedure. This was further modified by Bolitho in that the Judgment stated that treatment must also be “reasonable” and “logical”. The real sea change came in 2015 in the case of Montgomery Vs Lanarkshire health board. In this case the Judge ruled that the patient must be given enough information on which to make and informed decision. The key words here are informed and information! In this case the Judge ruled that the patient if provided with enough information is capable of weighing up the pros and cons and can take responsibility for their own decisions. This means in practice that the surgeon will and must explain the  procedure and risks in such a way that they can be understood, and  also weigh the % risk to the individual patient. An example would be:- The risk of stiffness in a joint post surgery may be 10%. If the patient was sedentary and limited in daily activity, this risk might not be an issue, however if the patient was a professional athlete, the risk may be unacceptable and the may decline surgery. The risk to both patients although still 10% is weighed very differently. Make sure when you attend for consultation that the risks are fully explained to you!