About Hip, Knee and ACL Surgery

Orthopaedic Riga specialises in three orthopaedic surgeries: hip replacement, knee replacement and ACL reconstruction.

Total Hip Replacement.

Hip Construction Scheme | Orthopaedicriga.co.ukTotal hip replacement surgery — also known as hip arthroplasty — is a procedure in which a doctor surgically removes a painful hip joint with arthritis, and replaces it with an artificial joint, often made from metal and plastic components. It usually is performed when all other treatment options have failed to provide adequate pain relief. The procedure should relieve a painful hip joint, making walking easier.

The hospital stay after knee joint replacement is usually four to five days.

You can expect your new hip joint to reduce the pain you felt before your surgery and increase the range of motion in your joint, but don't expect to be able to do everything you couldn't do before surgery. High-impact activities, such as running or playing basketball, may be too stressful on your artificial joint. However, in time, you may be able to swim, play golf, hike or ride a bike comfortably. A patient needs to understand that it is a major procedure that has risks and side effects and requires permanent changes in your lifestyle. Before deciding to have hip replacement surgery, it is important to understand what is involved and what lifestyle changes you must make. What you can do is visit your doctor, he or she will be able to answer the question, do you need surgery or not.

Indications for surgery:

Conditions that can damage the hip joint, sometimes necessitating hip replacement surgery, include:
· Osteoarthritis. Commonly known as wear-and-tear arthritis. Osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.
· Rheumatoid arthritis. Caused by an overactive immune system, rheumatoid arthritis produces a type of inflammation that can erode bone and cartilage and deform joints.
· Osteonecrosis. If there is inadequate blood supply to the ball portion of the hip joint, the bone may collapse and deform.

You might consider a hip replacement if you're experiencing hip pain that:
· Persists, despite pain medication.
· Worsens with walking, even with a cane or walker.
· Interferes with your sleep.
· Affects your ability to go up or down stairs.
· Makes it difficult to rise from a seated position.

Absolute contraindications. We do not operate on patients with uncontrolled diabetes mellitus, acute heart, lung, neurological or vascular diseases, as well as other systemic diseases that would put a patient at risk if surgery was performed.


Total Knee Replacement.

Knee Bones Scheme | Orthopaedicriga.co.ukKnee replacement surgery — also known as knee arthroplasty — can help relieve pain and restore function in severely diseased knee joints. During knee replacement, a surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers. Nowadays, you and your doctor can choose from a variety of designs that take into account your age, weight, activity level and overall health. Most knee replacement joints attempt to act like your knee, with its ability to roll and glide as it bends.

The hospital stay after knee joint replacement is usually four to five days. After knee joint replacement, people are standing and moving the joint the day after surgery. After about six weeks, most people are walking comfortably with minimal assistance.

There are three basic steps to a knee replacement procedure:
1. Prepare the bone. The damaged cartilage surfaces, at the ends of the femur and tibia, are removed along with a small amount of underlying bone.
2. Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or "press-fit" into the bone.
3. Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.

Indications for surgery:

There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:
· Severe knee pain or stiffness that limits everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.
· Moderate or severe knee pain while resting, either day or night.
· Chronic knee inflammation and swelling that does not improve with rest or medication.
· Knee deformity — a bowing in or out of your knee.
· Failure to substantially improve with other treatments, such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries.

There are no absolute age or weight restrictions for total knee replacement surgery.

Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo total knee replacement are aged 50 to 80, but orthopaedic surgeons evaluate patients individually. Total knee replacements have been performed successfully at all ages, from a young teenager with juvenile arthritis to an elderly patient with degenerative arthritis.

Absolute contraindications. We do not operate on patients with uncontrolled diabetes mellitus, acute heart, lung, neurological or vascular diseases, as well as other systemic diseases that would put a patient at risk if surgery was performed.


ACL Reconstruction.

Knee Bones Scheme 1| Orthopaedicriga.co.ukACL reconstruction is surgery to replace a torn anterior cruciate ligament (ACL) — one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops and changes in direction — such as basketball, soccer, football, tennis, downhill skiing, volleyball and gymnastics. In an ACL reconstruction, the torn ligament is removed and replaced with a piece of tendon from another part of your knee or from a deceased donor, as well as fixed into the place of the original ligament. This surgery is an outpatient procedure that is performed through small incisions around your knee joint. Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone (femur) to your shinbone (tibia) and helps stabilize your knee joint.

Most ACL injuries happen during sports and fitness activities that can put stress on the knee:
· Suddenly slowing down and changing direction (cutting).
· Pivoting with your foot firmly planted.
· Landing from a jump incorrectly.
· Stopping suddenly.
· Receiving a direct blow to the knee.

You will be in the outpatient surgical facility for approximately 90 minutes, but your surgery often only takes about 30 to 60 minutes. It is usually performed as an arthroscopically assisted procedure. Most people could go home a few hours after surgery. We recommend that our patients stay at the clinic until the next morning. You will need to use crutches and a possible brace at a later stage.

Within two to three weeks after surgery, the patient is usually walking on level surfaces without a brace or crutches. At about five to six weeks, he or she can usually go up and down stairs without support. For the next several months, exercises are done to regain motion in the knee. When the knee has a full range of motion (usually at six to eight weeks), muscle-strengthening exercises are undertaken. At six months, the patient is usually running and at nine months, participating in sports.

Indications for surgery:

ACL reconstruction is generally recommended if:
· You are an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting.
· More than one ligament or the cartilage in your knee is injured.
· You are young and active.
· The injury is causing your knee to buckle during everyday activities.

Absolute contraindications. We do not operate on patients with uncontrolled diabetes mellitus, acute heart, lung, neurological or vascular diseases, as well as other systemic diseases that would put a patient at risk if surgery was performed.

Procedure prices

Procedure   Surgery   Implant
Hip replacement   £ 2 980   from £ 1 440
Knee replacement   £ 2 980   £ 1 980
ACL reconstruction   £ 1 980   £ 340