The majority of surgical procedures performed on Dept. for the orthopedic surgery are:
1. Primary and revision hip surgery
2. Primary and revision knee surgery
3. Arthroscopic knee surgery (debridement, meniscal suture, meniscectomies, ACL reconstructions…)
4. Arthroscopic shoulder surgery (rotator cuff lesions, Bankart lesions, SLAP lesions…)
Hip and knee replacement surgery
Annually, over 550 people undergo the hip or knee replacement surgery on our Department and, after surgery, go back to an active life of a good quality. Our numbers and our results ensure the position of the leading joint replacement center in Bosnia and Herzegovina, and as one of the leading centers in the region.
Usually, the first approach in treatment is not surgical, then conservative, with pain killers, physiotherapy and changes in the life style. When such treatment approach does not alleviate patient’s symptoms any more, we consider the joint replacement. Joint replacement surgery, as any other surgery has to consider contraindications and risks and these are discussed with the patient and the family. Prior to surgery, it is necessary to have a health checkup and to bring one’s health condition to the optimum. It is very important to check out for the possible local infections (tooth root canal, ulcers, etc.) and to control the existing conditions with the prescribed medications (metabolic disorders, allergies and other chronic diseases).
Today, we use a wide range of artificial implants for every joint but basically, major divisions are between cement and non-cement ones, primary and revision ones. Lately, the surgical techniques of minimal invasive surgery allowed for the more rapid patient’s recovery and shorter hospital stay. Despite the advancements, decision on joint implant prosthesis and surgical technique approach must be carefully made for every individual patient. Prior to surgery, our surgical team carefully considers all advantages and risks and shares their professional opinion with the patient. Surgery is usually done under spinal anesthesia, sometimes in general anesthesia (as agreed between anesthesiologist and the patient). The surgical procedure itsel lasts for an hour in average while the postoperative stay on Department is up to two weeks.
After the arthroplasty (hip or knee joint replacement) you can expect pain free life. You will be able to continue with many activities, but it will be necessary to change the way you do these activities. However, the changes do not happen overnight and you will have to take an active part in this process or healing.
Artificial joints (implants, implanting material)
We have at disposal all types of artificial joint which are available on the markets in developed countries. All implanting materials which we use are produced by the respectable international companies (as guaranteed by ISO certificate and CE standards), made of biologically indifferent materials (alloy TiAlVa4, CoCrMo, UMWPH, ceramics). Results which are presented on the orthopedic congresses and symposiums speak about the long term of follow up of these prosthesis and their survival in over 90% patients.
Combined injuries of the capsule and ligaments of knee (most commonly, meniscal injuries and ACL injuries) occur during the various physical activities and quite often are the cause for termination of successful sport careers. There is higher frequency of these injuries among women due to lower muscle strength and coordination, more lax joint and smaller ligaments.
The role of meniscus is to alleviate the loading during the contact between joint surfaces, to support the knee stability and to distribute synovial fluid in the joint. Cruciate ligaments stabilize and protect joints, preventing the oversized motions. Their function is supported by the nearby tendons and muscles. In case of cruciate injuries, the other structures become exposed to the higher pressure, torsion and friction and thus are subjec to early degenerative changes. Typically, the patient with cruciate injuries complaints on pain, blocked and unstable knee.
Diagnostics is based on thorough clinical examination and other methods such as X-ray, CT, NMR, and arthroscopy). Introduction of the arthroscopy almost fifty years ago, brought a revolution in the knee surgery.
Ever since, the arthroscopy equipment is constantly improving along with the various diagnostic and surgical technique, to mention only the arthroscopic partial meniscectomy, meniscal repair and arthroscopic reconstruction of the anterior cruciate. Arthroscopy requires minimal cuts – one hole is used for visualization of the inner knee structures via camera and the other hole is used as a working channel to introduce the special surgical instruments in the knee.
Department for the orthopedic surgery has a team of experienced doctors. For many years, the team has been trained in Banjaluka, Serbia, Slovenia and Germany. The annually number of arthroscopic surgeries is over 150. The arthroscopic ACL reconstruction is done by using the modern techniques of autograft fixation which allows the early rehabilitation protocol, early loading, renewal of the knee stability and more rapid return to the sports activities.