Buffalo General Medical Center
100 High Street
Buffalo, NY 14203
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Advanced Orthopedic & Spine Center
Total Knee Replacement
Each year, approximately 500,000 people (two-thirds of them women) have knee replacement surgery. For the vast majority, the procedure eliminates pain and increases mobility, allowing them to return to a more fulfilling, active lifestyle. Total knee replacement, also called arthroplasty, is a routine surgical procedure that realigns the joint (bone end surfaces) with man-made materials such as plastic, ceramic or metal. It is preformed when the damage to the knee causes constant pain, loss of mobility and diminished quality of life. At Buffalo General Medical Center, orthopedic surgeons utilize the latest, most precise computerized navigational technology to ensure a perfect fit of the new knee joint.
Total Hip Replacement
Much like knee replacements, total hip replacement is indicated when range of motion becomes limited and substantial, continuous pain is present. The need for hip replacement surgery is usually caused by arthritis, injury or tumor. During total hip replacement surgery, the damaged parts of the hip are replaced with plastic and/or metal parts. The surgery basically rebuilds the hip by replacing the ball, socket and stem.
Hip and Knee Revisions
In the majority of cases, hip and knee replacements should function for 10-20 years. Due to time, injury, infection or wear on the joint, the implant function may deteriorate, causing pain, swelling, stiffness or instability. If this occurs, joint revision surgery may be indicated.
Total shoulder replacement surgery is less common than hip or knee replacements, but the process is basically the same. The damaged joint is replaced with a plastic and metal implant, which replicates a person’s shoulder joint.
Orthopedic oncology is the practice of treating tumors of the musculoskeletal systems. These tumors can be benign or malignant and can be in the bones or soft tissue like muscles. Treatment can range from active surveillance to surgery, radiation, and/or chemotherapy, depending on the status and location of the tumor.
Arthroscopic Knee and Hip Surgery
One of the most common orthopedic surgeries is arthroscopic knee and hip surgery. During the procedure, a camera is inserted through a very small incision (about a quarter of an inch). In a separate small incision, the surgeon inserts instruments to remove damaged ligaments or cartilage.
Arthroscopic Wrist and Ankle Surgery
Arthroscopic wrist and ankle surgery is used to repair ligaments, fractures, carpel tunnel syndrome, loose bone fragments, or inflamed or damaged joints caused by arthritis.
Foot surgeries performed at Buffalo General Medical Center include bunion and hammer toe surgery and fracture repair.
Back and Neck Pain
Typically, pain of the back or neck is a benign, self-limiting disorder. Most patients spontaneously recover within a few days, weeks, or months. Patients with chronic pain will often recover more quickly if they enter into a rehabilitation or chiropractic program designed to strengthen core muscle groups in a structured way. Maintaining good nutrition, avoiding excess weight, practicing good body mechanics, and abstaining from tobacco products can also significantly reduce pain.
It is important to understand that surgery should be considered a last resort, but if surgery is appropriate, our spine group focuses on less-invasive and minimally invasive procedures to lessen the discomfort and down time associated with spine surgery. Not all patients, however, are candidates for minimally invasive surgery; sometimes a more traditional approach is necessary.
In general, surgery should be reserved for patients with intractable pain, instability of the spine, disk rupture, tumor, or nerve damage. Symptoms of a more severe condition may include leg pain associated with back pain or arm pain associated with neck pain. These combinations of symptoms often indicate that a cervical or lumbar disk--one of the rubber-like shock absorbers found between each vertebra in the spine--has ruptured and is compressing a nerve root. If this occurs, minimally invasive microsurgery can sometimes be performed to remove the broken pieces of disk. Because the surgery is conducted using microscope and microdissection techniques to minimize the disruption of normal tissue, surgery can result in immediate and dramatic pain relief, and can often be performed on an outpatient basis. After microsurgery, patients are usually able to return to their normal activities within days or weeks.
For cases of significant spinal instability, a more extensive procedure, such as interbody fusion, may be required to reduce or eliminate the abnormal motion responsible for the patient's pain. In recent years, even spinal fusions have increasingly been performed in a minimally invasive fashion, enabling shorter hospital stays and more rapid resumption of normal activities.
Minimally Invasive Spine Procedures
Vertebroplasty: A relatively new procedure, vertebroplasty stabilizes osteoporotic compression fractures to provide immediate pain relief. The procedure provides an instant internal vertebral body fusion as bone cement (methyl methacrylate polymer) is injected into a weakened vertebral body under fluoroscopic guidance. The treatment is performed with local anesthesia and some mild sedation. Vertebroplasty is also used for pain relief and stabilization of vertebral metastatic lesions and hemangiomas.
Similar to vertebroplasty is balloon kyphoplasty. In this procedure, tiny balloons are inserted into fractured vertebrae and inflated. The space created by the balloons is then filled with cement to support the bones and prevent further collapse.
Disc Surgery: Neurospine surgeons can treat lumbar disc ruptures using tubes smaller than 1-inch through the METRxTM Microendoscopic (METRxTM MED) system. In addition to allowing smaller, more cosmetic skin incisions, this technique avoids muscle cauterization and dissection techniques which can often be painful and prolong the recovery period. Instead, the muscle is spread (similar to the technique used in laparoscopic surgery) in such a way that when the procedure is over, the muscle can return to its normal preoperative state with minimal trauma. Patients often leave the hospital on the same day the procedure is performed.
Foraminotomy: Compressed or pinched nerves in the low back and neck can result in pain, numbness, and/or weakness in the arms and legs. The nerve is most often pinched in the bony canal as it exits the spinal cord to the body through an opening called a foramen. Instead of performing a traditional lengthy midline incision down the back, our surgeons are now able to place a small tube over the bony canal that is squeezing the nerve root. Once the tube is placed (under x-ray guidance and using wires with special dilators), a small amount of bone can be removed, freeing the affected nerve from the tight spinal canal. Many patients awake from surgery pain free and are often able to go home the next day.
Pedicle Screws and Interbody Fusion: Minimally invasive technologies have evolved to a point where it is now possible to insert fusion devices through a 26-mm tube, eliminating the need for large open incisions. With the aid of x-ray imaging, the screws required to stabilize the spine and keep the interbody device in place can also be inserted through small incisions and guided over wires into the proper location. For patients with pain on one side, discogenic back pain, or unilateral vertebral bone fractures, these minimally invasive approaches have produced good patient outcomes.