🧠🦴 SPINE SURGERIES – OVERVIEWSpine surgeries are performed to treat a wide range of spinal conditions including degenerative diseases, trauma, deformities, tumors, and infections affecting the cervical, thoracic, or lumbar spine.🔹 Common Indications for Spine SurgeryCondition ExamplesDegenerative Disc herniation, spinal stenosis, spondylolisthesisTrauma Vertebral fractures, dislocationsDeformity Scoliosis, kyphosisInfection Tuberculosis (Pott's spine), discitisTumors Primary or metastatic spinal tumorsInstability Due to degeneration, trauma, or surgery🔹 Goals of Spine SurgeryRelieve nerve compression (e.g. sciatica, radiculopathy)Stabilize the spine (internal fixation, fusion)Correct deformitiesRemove pathological tissue (e.g. tumor, abscess)Restore spinal alignment and function🔹 Types of Spine Surgeries1. Discectomy / MicrodiscectomyIndication: Herniated disc compressing nerve root (sciatica, radiculopathy)Microdiscectomy: Minimally invasive, less muscle damageMost common in: Lumbar spine2. Laminectomy / LaminotomyLaminectomy: Removes lamina to decompress spinal canal (for spinal stenosis)Laminotomy: Partial removal (more conservative)Common in lumbar and cervical stenosis3. Spinal FusionIndication: Instability (e.g., spondylolisthesis, fractures, severe degeneration)Joins two or more vertebrae using bone grafts + hardware (screws/rods/plates)Can be:PLIF (Posterior Lumbar Interbody Fusion)TLIF (Transforaminal Lumbar Interbody Fusion)ALIF (Anterior Lumbar Interbody Fusion)ACDF (Anterior Cervical Discectomy and Fusion)4. Vertebroplasty / KyphoplastyIndication: Osteoporotic vertebral compression fracturesVertebroplasty: Injection of bone cement into vertebral bodyKyphoplasty: Balloon inflation before cement injection to restore height5. Deformity CorrectionFor scoliosis or kyphosisInvolves long-segment instrumentation and fusionMay use pedicle screws, rods, osteotomies6. Spinal Tumor SurgeryDecompression ± excision of tumorMay involve spinal stabilization or reconstructionRequires multidisciplinary planning (oncology, radiology)7. Endoscopic Spine Surgery (MISS)Minimally invasive alternative for discectomy, decompressionUses tubular retractors and camerasReduced pain and quicker recovery🔹 Spinal Levels & SurgeriesRegion Common SurgeriesCervical ACDF, cervical laminectomy, posterior fixationThoracic Discectomy, corpectomy (e.g. for TB/tumor), deformity correctionLumbar Discectomy, TLIF, laminectomy, vertebroplasty🔹 Risks and ComplicationsInfectionNerve injuryDural tear → CSF leakImplant failureAdjacent segment degenerationNonunion (in fusion cases)Persistent pain (Failed Back Surgery Syndrome)🔹 Rehabilitation & RecoveryEarly mobilization (especially after MISS)Bracing if neededPhysiotherapy: core strengthening, posture correctionGradual return to activity🔹 Advances in Spine Surgery✅ Minimally Invasive Spine Surgery (MISS)✅ Robotic-assisted spine surgery✅ Intraoperative navigation & neuromonitoring✅ Biologics for fusion (e.g. BMPs)✅ Artificial disc replacement (motion-preserving alternative)🔹 Summary ChartSurgery Indication Approach InvasivenessDiscectomy Herniated disc Posterior Conventional or minimally invasiveLaminectomy Spinal stenosis Posterior Open or minimalFusion (e.g. TLIF) Instability, degeneration Anterior/Posterior Moderate–highVertebroplasty Compression fracture Percutaneous Minimally invasiveTumor excision Spinal tumors Any Variable

🦴 JOINT REPLACEMENT SURGERIES (ARTHROPLASTY) – OVERVIEWJoint Replacement Surgery, also called Arthroplasty, involves removing a damaged joint surface and replacing it with an artificial prosthesis to relieve pain and restore function—most commonly in advanced osteoarthritis, rheumatoid arthritis, or after trauma.🔹 Common Types of Joint Replacement SurgeriesJoint Procedure Name NotesKnee Total Knee Replacement (TKR) / Partial Knee Replacement Most common worldwideHip Total Hip Replacement (THR) Gold standard for hip OAShoulder Total Shoulder Arthroplasty (TSA) / Reverse TSA Depends on rotator cuff statusElbow Total Elbow Replacement Less common; for RA or severe traumaAnkle Total Ankle Arthroplasty For end-stage ankle arthritisFinger Joints MCP, PIP joint replacement Mostly in rheumatoid arthritis🔹 Components of Joint ProsthesesMetal: Titanium, cobalt-chromium alloysPlastic: Ultra-high-molecular-weight polyethylene (UHMWPE)Ceramic: Highly biocompatible, less wear (e.g. ceramic-on-ceramic in hips)🔹 Indications for Joint Replacement✅ Severe joint pain affecting daily activities✅ Advanced osteoarthritis or inflammatory arthritis✅ Joint deformity✅ Failure of conservative treatments (medication, therapy, injections)✅ Post-traumatic arthritis✅ Avascular necrosis (e.g. femoral head)✅ Tumors involving joints (limb salvage procedures)🔹 Types of Joint Replacement1. Total Joint ReplacementEntire articular surface replaced (e.g. TKR, THR)2. Partial Joint ReplacementOnly a part is replaced (e.g. Unicompartmental Knee Replacement)3. HemiarthroplastyOnly one side of the joint replaced (e.g. hip hemiarthroplasty for femoral neck fractures)4. Reverse Shoulder ArthroplastyUsed when rotator cuff is non-functional🔹 Surgical Approach (Example: Hip)Posterior approach: Most common, good exposure, higher dislocation riskAnterior approach: Less muscle damage, quicker recoveryLateral approach: Lower dislocation risk, possible abductor weakness🔹 Post-operative CareEarly mobilization (within 24–48 hours)Physiotherapy (ROM, strengthening, gait training)Thromboprophylaxis (DVT/PE prevention)Pain managementMonitoring for infection or implant complications🔹 Risks & ComplicationsEarly LateInfection Prosthesis looseningDVT/PE Wear of implantBleeding Periprosthetic fractureNerve injury Dislocation (hip/shoulder)Joint stiffness Aseptic loosening or osteolysis🔹 Lifespan of Joint ProsthesesTypically lasts 15–20 yearsYounger patients may require revision surgery later🔹 Advances in Joint ReplacementRobotic-assisted surgery3D-printed implants (custom-fit)Navigation systemsMinimally invasive techniquesEnhanced recovery protocols (ERAS)🔹 Summary ChartFeature Total Joint Replacement Partial ReplacementInvasiveness More LessLongevity Longer ShorterRecovery Moderate FasterIndication Extensive damage Localized damageCost Higher Lower

🦴 Minimally Invasive Joint Surgeries / Arthroscopy in OrthopaedicsMinimally invasive joint surgery—especially arthroscopy—has become the gold standard for diagnosing and treating many intra-articular conditions, offering reduced pain, quicker recovery, and smaller incisions compared to open surgery.🔹 What is Arthroscopy?Arthroscopy is a surgical technique in which a small camera (arthroscope) and miniature instruments are inserted into the joint through tiny incisions (portals) to visualize, diagnose, and treat joint problems.Camera projects images onto a monitorMinimally traumatic to skin, soft tissues, and joint capsule🔹 Advantages of Arthroscopy✅ Smaller incisions✅ Less post-operative pain✅ Faster recovery✅ Reduced hospital stay (often day care)✅ Minimal blood loss✅ Lower infection risk✅ Better cosmetic outcome🔹 Common Joints Treated ArthroscopicallyJoint Common IndicationsKnee Meniscus tear, ACL/PCL reconstruction, cartilage lesions, synovectomyShoulder Rotator cuff repair, impingement syndrome, labral tears, frozen shoulderHip Femoroacetabular impingement (FAI), labral tears, loose bodiesAnkle Anterior impingement, loose bodies, OCD (osteochondritis dissecans)Wrist TFCC tears, carpal instability, ganglion cystsElbow Loose body removal, synovitis, contracture release🔹 Common Arthroscopic Procedures🦿 Knee ArthroscopyMeniscectomy or meniscal repairACL reconstructionCartilage debridement/microfractureSynovectomyLateral release (for patellar tracking issues)💪 Shoulder ArthroscopyRotator cuff repairSubacromial decompressionSLAP lesion repairBankart repair (for recurrent dislocation)Biceps tenodesis🩻 Hip ArthroscopyLabral repairFemoroplasty (for cam/pincer lesions in FAI)Synovectomy or loose body removal🔹 Equipment UsedArthroscope (typically 2.7mm or 4.0mm)Light sourceSaline/lactated Ringer’s irrigation systemTrocar/cannula systemsPower shaversRF ablation probesSpecialized instruments (graspers, scissors, punches)🔹 ContraindicationsSevere joint arthritis (especially if joint space is obliterated)Active infectionInaccessible joint anatomy (e.g. severe deformity or scarring)Poor general health status🔹 Risks and ComplicationsInfection (rare)ThrombosisBleeding/hemarthrosisNerve or vessel injuryStiffness or incomplete resolution of symptoms🔹 Summary ChartFeature Open Surgery ArthroscopyIncision size Large Small (0.5–1 cm)Recovery time Long ShortBlood loss More MinimalHospital stay Longer Often day-careScarring Visible MinimalIndications Advanced disease Early–moderate, focal lesions