Cases

Question 1

Osteoarthritis:

Answer 1

It is a condition where the protective cartilage in the joints breaks down, causing pain, stiffness, and swelling in the affected joints.

Question 2

Rotator Cuff Tears / Rotator Cuff Syndromes:

Answer 2

The rotator cuff is a group of muscles and tendons in the shoulder. Rotator cuff tears or syndromes occur when there is damage or inflammation in these muscles and tendons, leading to shoulder pain, weakness, and limited range of motion.

If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. This type of tear can occur with other injuries, such as a broken collarbone, a dislocated shoulder, or a wrist fracture.

Question 3

Frozen Shoulder (Adhesive Capsulitis):

Answer 3

Frozen shoulder is a condition characterized by stiffness and pain in the shoulder joint. It occurs when the capsule surrounding the shoulder joint becomes thickened and tight, restricting movement.

Question 4

Meniscal Tears:

Answer 4

The meniscus is a rubbery cartilage in the knee that acts as a shock absorber. Meniscal tears occur when this cartilage gets damaged, usually from twisting or rotating the knee forcefully. It can cause pain, swelling, and limited knee movement.

Question 5

Anterior Cruciate Ligament (ACL)

Answer 5

Injuries: The ACL is a ligament in the knee that helps stabilize the joint. ACL injuries happen when this ligament gets stretched or torn, usually from sudden stops, changes in direction, or direct impact to the knee. They can cause knee instability and difficulty in walking or participating in sports.

Question 6

Knee Ligament Functional Anatomy:

Answer 6

The knee has several ligaments that provide stability and support to the joint. These ligaments include the ACL, posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). Each ligament has a specific role in preventing excessive movement or rotation of the knee.

Question 7

Ankle Ligament Functional Anatomy

Answer 7

The ankle has several ligaments that help support and stabilize the joint. These ligaments include the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL). They provide stability to the ankle and prevent excessive rolling or twisting movements.

Question 8

Femoroacetabular impingement

Answer 8

(FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint — giving the bones an irregular shape. Because they do not fit together perfectly, the bones rub against each other during movement. Over time this friction can damage the joint, causing pain and limiting activity.

Question 9

Tendinopathy

Answer 9

Tendons are rope-like tissues that connect your muscles to your bones. Tendinopathy can develop when you injure or overuse a tendon. Although tendinopathy can become chronic, your symptoms will likely improve with rest and physical therapy.

Question 10

Carpal tunnel syndrome

Answer 10

Carpal tunnel syndrome is a common condition that causes numbness, tingling, and pain in the hand and forearm. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist.

Question 11

Trigger Finger

Answer 11

Trigger finger is a condition affecting tendons that flex the fingers and thumb. Trigger finger symptoms include pain, stiffness or clicking when you move your finger or thumb. It may also sometimes get stuck in a bent position. The condition is also known as stenosing tenosynovitis.
The ring finger and thumb are most commonly affected digits; however, the condition can affect any of the digits. When the thumb is involved, the condition is, appropriately, called trigger thumb.

Question 12

Dupuytren’s contracture

Answer 12

Dupuytren’s contracture (also called Dupuytren’s disease) is an abnormal thickening of fascia, a layer of tissue under the skin, in the palm of your hand at the base of your fingers. This thickened area may develop into a hard lump or thick band. Over time, it can cause one or more fingers to curl (contract), or pull sideways or in toward your palm.

The ring and little fingers are most commonly affected. In many cases, it affects both hands. Rarely, feet may also be affecte

Question 13

Spinal stenosis

Answer 13

Stenosis, which means narrowing, can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles.

Spinal stenosis can happen in any part of your spine but is most common in the lower back.

Symptoms of spinal stenosis vary widely from person to person and range from no symptoms to pain in the back or neck and numbness, tingling and weakness in the arms and/or legs

Question 14

Cauda Equina Syndrome

Answer 14

CES) is a rare but serious neurological condition affecting the bundle of nerve roots at the lower end of the spinal cord. The CE provides innervation to the lower limbs, and sphincter,controls the function of the bladder and distal bowel and sensation to the skin around the bottom and back passage[1].

CES occurs when the nerves below the spinal cord are compressed causing compromise to the bladder and bowel. The most common cause of CES is a prolapse of a lumbar disc but other conditions such as metastatic spinal cord compression can also cause CES

Question 15

Disc Pathology

Answer 15

Disc pathology refers to problems that can occur with the soft discs between the bones in your spine. It can happen due to aging, injury, or poor spinal mechanics. Common issues include disc degeneration, hernia, which can cause symptoms like back or neck pain, numbness, or weakness in the arms or legs.

Question 16

Spondylosis

Answer 16

Spondylosis is spinal osteoarthritis that occurs with aging. It involves degenerative changes in the bones, joints, and ligaments of the spine. Symptoms include stiffness, limited motion, localized pain, and sometimes nerve compression leading to radiating pain, numbness, or weakness.

Question 17

Total knee replacement

Answer 17

The surgery typically involves the following steps:

Preparation: The patient is positioned on the operating table, and anesthesia is administered to ensure a pain-free procedure. General anesthesia or regional anesthesia (spinal or epidural) may be used.
Incision: The surgeon makes an incision over the knee to access the joint.
Bone Preparation: The damaged surfaces of the thigh bone, shin bone, and kneecap are carefully removed . The bones are reshaped to accommodate the artificial components.
Implant Placement: The artificial components, which typically consist of a metal femoral component, a metal and plastic tibial component, and sometimes a plastic patellar component, are secured to the prepared bone surfaces using bone cement or are press-fit into the bone.
Knee Stability and Alignment: The surgeon ensures proper alignment and stability of the knee joint by testing its range of motion and balancing the soft tissues around the joint.
Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Question 18

Total hip replacement

Answer 18

Total hip replacement (THR) is a surgical procedure that involves the replacement of a damaged or diseased hip joint with an artificial joint, also known as a prosthesis. The hip joint is a ball-and-socket joint where the head of the femur (thigh bone) fits into the acetabulum (socket) of the pelvis.

THR is usually performed when other treatments, such as medication, physical therapy have failed to alleviate hip pain and improve mobility. The most common reason for undergoing THR is osteoarthritis.
During a total hip replacement surgery, the damaged femoral head is removed, and a metal stem is inserted into the hollow center of the femur. A metal or ceramic ball is then attached to the top of the stem. The damaged cartilage in the acetabulum is removed, and a metal socket lined with a plastic, ceramic, or metal liner is implanted. The new ball and socket components work together to recreate the smooth gliding motion of a healthy hip joint.
THR can significantly relieve pain, improve joint function, and enhance the overall quality of life for individuals with severe hip joint damage or degenerative conditions. Physiotherapy is usually prescribed following surgery to help restore strength, flexibility, and mobility in the hip joint.
It’s important to note that THR is a major surgical procedure. It is typically recommended for individuals who have exhausted conservative treatment options and for whom the benefits of surgery outweigh the risks. The decision to undergo a total hip replacement is made in consultation with an orthopedic surgeon based on an individual’s specific condition and overall health.

Question 19

What is hip arthroscopy

Answer 19

Hip arthroscopy is a minimally invasive surgical procedure used to diagnose and treat various hip joint conditions. It involves the use of a small camera called an arthroscope, which is inserted into the hip joint through small incisions. The arthroscope allows the surgeon to visualize the inside of the hip joint and perform certain surgical procedures.

During hip arthroscopy, the surgeon may address a range of hip problems, including:

Labral tears: The labrum is a ring of cartilage that lines the rim of the hip socket. Tears in the labrum can cause hip pain and instability. The surgeon can repair or trim the torn labrum during the arthroscopic procedure.
Femoroacetabular impingement (FAI): FAI occurs when there is abnormal contact between the ball (femoral head) and socket (acetabulum) of the hip joint. This can lead to pain, limited range of motion, and cartilage damage. Arthroscopy can be used to reshape the bone and correct the impingement.
Synovitis: Synovitis refers to inflammation of the synovial lining of the hip joint. Arthroscopy can help remove the inflamed tissue and alleviate pain.
Loose bodies: Sometimes, loose fragments of bone or cartilage can float within the hip joint, causing pain and restricted movement. These loose bodies can be removed using arthroscopic techniques.
Hip joint infections: In cases of hip joint infections, arthroscopy can aid in the diagnosis and treatment by allowing the surgeon to take samples, clean the joint, and potentially administer antibiotics directly.
Hip arthroscopy is typically performed under general anesthesia, and the surgeon uses specialized instruments to perform the necessary repairs or procedures. Compared to traditional open surgery, hip arthroscopy offers smaller incisions, reduced trauma to surrounding tissues, shorter recovery time, and potentially less postoperative pain.

It’s important to note that the suitability of hip arthroscopy as a treatment option depends on several factors, including the specific condition, the patient’s overall health, and the surgeon’s evaluation. A consultation with an orthopedic specialist is necessary to determine the best course of action for each individual case.

Question 20

Knee arthroscopy

Answer 20

Knee arthroscopy is a minimally invasive surgical procedure. It involves inserting a small camera, called an arthroscope, into the knee joint through small incisions. The arthroscope allows the surgeon to visualize the inside of the knee on a monitor and perform necessary surgical interventions.

Knee arthroscopy is a minimally invasive surgical procedure used to diagnose and treat various conditions affecting the knee joint. It involves inserting a small camera, called an arthroscope, into the knee joint through small incisions. The arthroscope allows the surgeon to visualize the inside of the knee on a monitor and perform necessary surgical interventions.
. Some common procedures performed using arthroscopy include:

Removal of torn meniscus: The meniscus is a rubbery cartilage in the knee that acts as a shock absorber.

Repair of ligaments: Ligament injuries, such as a torn anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), can be repaired or reconstructed using arthroscopy. This may involve using sutures or grafts to stabilize the knee joint.
Removal of loose bodies: Sometimes, loose fragments of bone or cartilage may be present within the knee joint, causing pain and limited mobility. These loose bodies can be removed during arthroscopy.
Treatment of patella (kneecap) conditions: Arthroscopy can be used to address various issues related to the patella, including patellar instability, patellar tracking disorders, or patellar fractures.
Synovial biopsy and synovectomy: If there is inflammation or abnormal growth of the synovial lining within the knee joint, a biopsy may be performed using arthroscopy. In some cases, a synovectomy, which involves removing the inflamed synovial tissue, may also be performed.
Knee arthroscopy is generally considered less invasive than traditional open knee surgery, resulting in smaller incisions, less tissue damage, and quicker recovery times. However, the specific procedures performed during arthroscopy depend on the individual’s condition and the surgeon’s assessment. It is important to consult with a qualified orthopedic surgeon for an accurate diagnosis and appropriate treatment options.

Removal of torn meniscus: The meniscus is a rubbery cartilage in the knee that acts as a shock absorber. If it gets torn, the surgeon can trim or repair the damaged portion using arthroscopic techniques.
Repair of ligaments: Ligament injuries, such as a torn anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), can be repaired or reconstructed using arthroscopy. This may involve using sutures or grafts to stabilize the knee joint.
Removal of loose bodies: Sometimes, loose fragments of bone or cartilage may be present within the knee joint, causing pain and limited mobility. These loose bodies can be removed during arthroscopy.
Treatment of patella (kneecap) conditions: Arthroscopy can be used to address various issues related to the patella, including patellar instability, patellar tracking disorders, or patellar fractures.
Synovial biopsy and synovectomy: If there is inflammation or abnormal growth of the synovial lining within the knee joint, a biopsy may be performed using arthroscopy. In some cases, a synovectomy, which involves removing the inflamed synovial tissue, may also be performed.
Knee arthroscopy is generally considered less invasive than traditional open knee surgery, resulting in smaller incisions, less tissue damage, and quicker recovery times. However, the specific procedures performed during arthroscopy depend on the individual’s condition and the surgeon’s assessment. It is important to consult with a qualified orthopedic surgeon for an accurate diagnosis and appropriate treatment options.