Orthopedic Surgery & Traumatology

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The quality and price of orthopedic surgery varies widely between countries. The treatments offered in Spain is of the high standard, and is reasonably priced. Vithas Xanit International Hospital is renowned for its expertise in Sports Medicine and Orthopedics, and the hospital has treated numerous prestige athletes requiring surgery.

The Orthopedic Surgery, Traumatology and Sports Medicine Service at Vithas Xanit International Hospital offers its patients the best and most up-to-date techniques for treating all types of affliction connected to the musculoskeletal system:
• Innovative techniques in regenerative medicine.
• Minimally invasive surgery (MIS).
• Percutaneous surgery and prosthetic surgery.

The surgeries in high demand in this particular field are hip replacement and knee replacement.

Orthopedic surgery requires intensive rehabilitation lasting for several weeks, and beginning immediately after the prosthesis has been fitted. The physiotherapy center at Vithas Xanit International Hospital has a team of professionals specializing in different areas of rehabilitation who work closely with the medical traumatology team.

The physiotherapy treatment at the Vithas Xanit begins prior to the surgery in order to shorten recovery times and ensure that normal daily activities can be resumed as much as possible.

> HIP REPLACEMENT SURGERY – HIP ARTHROPLASTY

The hip replacement or hip arthroplasty is one of the most common surgeries.
The hip joint joins the pelvis with the upper end of the femur.

Reasons for hip prosthesis :
• Severe arthrosis
• Certain types of fractures of the femur

Hip replacement procedure :
A hip prosthesis replaces the hip joint. At the same time it replaces the articular part of the pelvis and the upper articular part of the femur.
A hip prosthesis comprises of three elements:
• A hemispherical dome, which is placed in the cavity of the pelvis, or acetabulum, which remains in place once the femur has been removed.
• A rod fixed to the interior of upper end of the femur.
• A sphere that replaces the femur head and is housed in the pelvis cavity. This part of prosthesis is what will really allow for the movement of the hip.

Type of surgery and anesthesia:
Although it is a very frequent intervention and it can be performed using minimally invasive techniques (MIS), this procedure is still considered major surgery. The surgery lasts approx. 2 hours and is carried out under general or locoregional (spinal) anesthesia. The patient remains in hospital for 5 to 10 days, depending on the case.

Hip replacement rehab.: Hip replacement surgery requires intensive rehabilitation for several weeks starting from the first day after the placement of the total hip prosthesis.

Hip surgery – postoperative follow-up:
Follow-up X-rays are recommended, 1, 2, 5, 7 and 10 years after surgery. A check-up is also recommended every 2 years.

> KNEE REPLACEMENT SURGERY – KNEE ARTHROPLASTY

The knee is a complex joint that connects the leg (the tibia) to the thigh (the femur). It consists of three bones: the femur, the patella and the tibia, joined by ligaments that stabilize the knee joint.

Main reasons for knee replacement:
• Articulate wear
• Severe arthrosis
• Certain types of fractures of the knee.

Knee replacement procedure:
In most cases, patients undergoing a knee arthroplasty tend to have ligaments which are healthy and little damaged. The knee replacement surgery consists of replacing the part of the damaged bone and cartilages of the femur, the patella and the tibia with prosthesis.
Knee prosthesis consists of three elements:
• A femoral prosthesis, which is an articulated metal piece fixed to the femur,
• A patella or femorotibial prosthesis, which is a piece of plastic that which enables movement and helps to stabilize the joint.
• Tibia prosthesis : this is a prosthesis upon which rests the joint and which is fixed to the tibia.

Type of surgery and anesthesia:
Although it is a very frequent intervention and can be performed using minimally invasive techniques (MIS), this is still considered to be major surgery.
The surgery lasts or approx. 2 hours and is carried out under general or locoregional (spinal) anesthesia.
The patient remains in hospital for 5 to 10 days, depending on the case.

Rehab. following a knee replacement:
The knee replacement is a surgery which requires an intensive rehabilitation for several weeks beginning from the  day after the total knee prosthesis is fitted.

Postoperative follow-up knee surgery:
Follow-up X-rays are recommended,1 , 3, 5, 7 and 10 years after surgery.

> SHOULDER REPLACEMENT SURGERY – SHOULDER ARTHROPLASTY

The shoulder joint is the most mobile part of the body and also the least stable. It is one of the joints that we most use on a daily basis.
The shoulder joint, the shoulder blade and the upper part of the humerus (upper arm bone).

Main reasons for a shoulder replacement:
• Severe arthrosis
• Vascular necrosis of the humeral head
• Some shoulder injuries
• Certain types of fractures of the humerus.

Shoulder replacement procedure:
The shoulder surgery replaces the shoulder joint. At the same time it replaces the articular part of the shoulder blade and the upper articular part of the humerus.
The shoulder prosthesis consists of three elements:
• A hemispherical dome, which is placed in the cavity of the shoulder blade, or glenoid, which remains after the removal of the humerus head.
• A rod fixed to the interior of the upper end of the humerus in which it is fixed.
• A sphere that replaces the head of the humerus and is housed in the shoulder blade cavity.  This is the part of prosthesis that will really enable the movement of the shoulder.

Type of surgery and anesthesia:
This type of surgery can be performed using minimally invasive techniques (MIS). The surgery takes several hours and is performed under general anesthesia.
The patient remains in hospital for 5 to 10 days, depending on the case.

Shoulder arthroplasty rehab:
Shoulder surgery requires an intensive rehabilitation for several weeks starting on the first day after the total shoulder prosthesis is fitted.

Postoperative follow-up – shoulder replacement:
Follow-up with X-rays are recommended, after 1, 2, 5, 7 and 10 years after surgery and a medical check up is recommended every 2 years.

> ARTHROSCOPY OF THE JOINTS – RECONSTRUCTIVE SURGERY OF THE JOINTS

The tissues of the joints which can be repaired through surgery are :
• The ligaments
• The cruciate ligaments of the knee
• The joint capsules
• The cartilages
• The menisci (in certain cases)

Reasons for arthroscopy of the joints :
• Accidents
• Diseases.

Arthroscopy of the joints – techniques :
Arthroscopy is an endoscopic surgery which enables us to view the interior of a joint through a camera. It consists of introducing an optic fiber through small incisions (from 4 to 8 mm). An intubation is also introduced for the instruments which allows us to directly intervene on the joint.
• Arthroscopy of ligaments reconstruction :
The ligaments can be re-tensed, sewn or replaced when necessary. To replace a ligament, an autograft or allograft (donor graft) is used.
• Arthroscopy for reconstruction of the capsule:
The damaged area of the capsule is repaired.

• Arthroscopy for cartilage reconstruction:
In certain types of lesions, grafting of cartilaginous cells can be performed.

• Arthroscopy for reconstruction of the knee meniscus:
With certain types of lesions, meniscus can be sutured.

Type of surgeries and anesthesia:
These minimally invasive surgeries are performed under general or locoregional anesthesia. Depending on the reconstruction surgery, the patient usually remains in hospital less than 24 hours.

Rehabilitation following reconstructive surgery of the joints:
After an arthroscopy of joints, rehabilitation is necessary for several weeks.

Postoperative follow-up following an arthroscopy of the joints:
Periodic check-ups are highly recommended.

> ENDOSCOPIC SURGERY FOR CARPAL TUNNEL

The carpal tunnel is located in the “transition” area between the hand and the forearm at the height of the wrist. There are nine flexor tendons of the fingers and the median nerve which provides sensitivity to the thumb, the index finger, the middle finger and part of the ring finger.

Reasons for endoscopy of the carpal tunnel
Carpal tunnel syndrome is a carpal compression of the nerve at the height of the wrist that is manifested by:
• Numbness and tingling of the mediums finger
• A pain in the hand which goes up to the forearm
• A motor deficiency

Endoscopic surgery for carpal tunnel surgery
Through a small incision in the wrist, the surgeon bisects the annular ligament of the carpus (ligament that can be found around the carpal bone), thus reducing the pressure within the carpal tunnel. As the ligament heals it becomes wider, and its resection has none long-term consequences. Sometimes, the surgeon may resect the sheath of the tendons when it is inflamed.

Type of surgery and anesthesia:
This is a short ambulatory surgery, which is usually performed under local or locoregional anesthesia.

> HALLUX VALGUS PERCUTANEOUS SURGERY

Reasons for percutaneous surgery of the Hallux Valgus
• Deformation of the forefoot at the big toe level.
• Pain at the exotosis level (anchor of the metatarsal bone joint and the big toe).
This pathology is found 95% in women.

Hallux Valgus Surgery procedure:
Hallux Valgus percutaneous surgery is a minimally invasive surgery which aims is to straighten the first metatarsal bone by osteotomy: resection of this bone, and alignment of the big toe with the metatarsal, also by osteotomy and resections of ligaments.
The surgeon inserts a few tiny instruments through small incisions to access the soft tissues and perform the osteotomy of the foot. During this procedure the surgeon is guided by “touch” and with the help of x-rays.
This surgical technique does not allow to fit bone fixings. Therefore, the bones are stabilized with silicone pieces and strong bandages for 20 days.

Type of surgery and anesthesia:
The Hallux Valgus percutaneous surgery  is ambulatory and it is usually done under local or locoregional anesthesia.

Postoperative follow-up:
A postoperative medical check-up is usual a week after the intervention.

1-    Information and reasons for your orthopedic surgery
Within 24 hours of receiving your request for information, we will contact you by e-mail or phone to assess your needs, identify your reasons for surgery and answer your questions directly.

2-     Diagnosis and selection of trauma surgery
To begin with we recommend that you visit our Orthopedic and Trauma Unit in order that the specialist can discuss your case, and decide which kind of spinal surgery best suits your particular requirements.
• Medical records:
We will send you a list of examinations and medical tests results that we will need to see during your first visit to Vithas Xanit International Hospital. In the event that our doctors deem necessary an additional screening test, this could be carried out during the same visit (except in the case of tests which require anesthesia in which case they will need to be pre-booked).
You may send us a copy of your medical information before planning before first visit.
• Diagnosis: The professionals involved in the diagnosis and treatment of orthopedic and trauma pathologies will study your medical history, the results of your medical tests and examinations, and establish a precise and reliable diagnosis.
We will advise you and help you to decide which type of orthopedic surgery is best suited for your individual case.

We will provide you with complete information: treatment process, programming and a detailed budget.

3-    Orthopedic surgery process
• Treatment protocol
The process and the scheduling of your orthopedic surgery will depend on your particular case.
• An assigned medical team.
You shall be treated by the same team of doctors throughout the whole treatment process.

4-    Your travel plans and orthopedic surgery
Once your orthopedic surgery treatment has been confirmed and accepted, our International Services Team at Vithas Xanit International Hospital will be at your disposal to assist you in the organizing of your trip to Malaga and will remain in constant contact with you.

5-    Your arrival
Upon your arrival in Malaga, a representative of Vithas Xanit International Hospital will be waiting to greet you. We will help you to organize your transfers and accompany you to our hospital.

6-    Orthopedic surgery follow-up.
• Maintaining contact with you.

Once you have been discharged our International Services Team will be at your disposal shall you require any further medical assistance. They will assist you with any administrative requirements that you may have.
• Informing your referring doctor.
We shall provide you with a full medical report which you can give to your own doctor back home.

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