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PROCEDURES

Orthopedics

Orthopedics is the study of the musculoskeletal system. Orthopedic doctors specialize in the diagnosis and treatment of problems of the musculoskeletal system which includes:

Bones
Joints
Ligaments
Tendons
Muscles
Nerves

Types of Surgical Procedures

Arthroscopy

Arthroscopy allows the orthopaedic surgeon to insert a pencil-thin device with a small lens and lighting system into tiny incisions to look inside the joint. The images inside the joint are relayed to a TV monitor, allowing the doctor to make a diagnosis. Other surgical instruments can be inserted to make repairs.  Arthroscopy often can be done on an outpatient basis. According to the American Orthopaedic Society for Sports Medicine, more than 1.4 million shoulder arthroscopies are performed worldwide each year.

Open Surgery

Open surgery may be necessary and, in some cases, may be associated with better results than arthroscopy. Open surgery often can be done through small incisions of just a few inches.  Recovery and rehabilitation is related to the type of surgery performed inside the shoulder, rather than the type of procedure.

 

Knee

Knee Meniscectomy

Meniscus is cartilage in the knee joint. It helps to stabilize and cushion the knee. A meniscectomy is the removal of all or part of the cartilage.  A meniscectomy is done when the cartilage is damaged causing pain and limited range of motion.

 

There are two methods for meniscectomy:

  1. Arthroscopy – Small incisions are made around the knee. Special tools are inserted into the knee joint guided by a tiny camera. The damaged meniscus is either repaired or removed, eliminating as little cartilage as possible. A drain may be inserted to remove fluid. The incisions are closed with stitches that are usually removed in the doctor’s office one week later.
  2. Arthrotomy—an open technique that is rarely used today. A large incision is made over the knee joint. The meniscus is then either repaired or removed. It usually results in a longer recovery period. This process is usually done when there are problems with the knee that make the arthroscopic procedure difficult.

Knee Arthroscopy

Arthroscopy is one of the most commonly used surgical procedures for the diagnosis and treatment of knee injuries. Doctors use an arthroscope, which is inserted through small incisions around the knee.

Knee arthroscopy is extremely useful in diagnosing a joint’s condition and treating knee problems such as meniscus tears and cartilage wear. An arthroscopy can provide relief from knee pain and allow the patient to resume a normal and active lifestyle.

Uni Compartmental Patella (Partial Knee Resurfacing )

In a unicompartmental knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and bone in the rest of the knee remain untouched.

Partial knee resurfacing minimizes the trauma to healthy bone and tissue as the surgeon removes only damaged bone and fits the prosthetic to that bone.

After a regional (spinal) or general anesthetic is administered, the surgeon makes a small incision to gain visibility into the injured knee compartment. He or she extracts damaged cartilage and bone tissue from the surfaces of the tibia and femur and inserts the prosthetic components, which are sized specifically to the patient’s joint. Cement is used to hold the prosthetic in place.

Anterior and Posterior Cruciate Ligament Reconstruction ACL/PCL

ACL/PCL

One of the most common knee injuries is a sprain or tear to the anterior or posterior cruciate ligament. Reconstruction of these ligaments uses a graft commonly from the patients own body, such as the tendon of the kneecap or  hamstring. Another option is allograft tissue, which is taken from a deceased donor.

Cruciate ligaments are found inside the knee joint. They cross each other to form an “X” with the anterior cruciate ligament in front and the posterior cruciate ligament in back. The cruciate ligaments control the back and forth motion of the knee .The anterior cruciate ligament runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur, as well as provides rotational stability to the knee. Damage to one or both of these ligaments severely compromises the stability of the knee as a whole.

Most ACL/PCL tears cannot be sutured (stitched) back together. To surgically repair the ACL or PCL and restore knee stability, the ligament must be reconstructed. The doctor replaces the torn ligament with a tissue graft that acts as scaffolding for a new ligament to grow on.

High Tibial Osteotomy (Osteotomy of the Knee)

Osteotomy literally means “cutting of the bone.” In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and then reshaped to relieve pressure on the knee joint.  Knee osteotomy is used for early-stage osteoarthritis that has damaged just one side of the knee joint. By shifting weight off of the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in the arthritic knee.

Osteoarthritis can develop when the bones of the knee and leg do not line up properly. This can put extra stress on either the inner (medial) or outer (lateral) side of your knee. Over time, this extra pressure can wear away the smooth cartilage that protects the bones, causing pain and stiffness.

Hip

Hip Arthroscopy Simple

Hip Arthroscopy–Simple surgery refers to the viewing of the interior of the Hip join joint through an Arthroscope and the treatment of the Removal of loose bodies, Debridement (the removal of dead, damaged or infected tissue), or Femoral Neck Osteoplasty of the Hip through a minimally invasive approach. This technique is sometimes used to help in the treatment of various joint disorders has gained popularity because of the small incisions used and shorter recovery times when compared with conventional surgical techniques (sometimes referred to as “open surgery”). Hip Arthroscopy was not feasible until recently, new technology in both the tools used and the ability to distract the hip joint has led to a recent surge in the ability to do Hip Arthroscopy and the popularity of it.

Hip Arthroscopy with femoroplasty, acetabuloplasty, or labral repair

Arthroscopy is a surgical procedure that gives doctors a clear view of the inside of a joint allowing them to diagnose and treat joint problems.  During hip arthroscopy, the surgeon inserts a small camera, called an arthroscope, into the hip joint in order to guide miniature surgical instruments.  Hip arthroscopy has been performed for many years although it is not as common as knee or shoulder arthroscopy.

Hip arthroscopy may relieve painful symptoms of damaged labrum, articular cartilage, or other soft tissues surrounding the joint. This damage can result from an injury or other orthopaedic conditions including:

  • Femoroacetabular impingement (FAI) a disorder where bone spurs (bone overgrowth) around the socket or the femoral head cause damage
  • Dysplasia, a condition where the socket is abnormally shallow and makes the labrum more susceptible to tearing
  • Snapping hip syndromes, when cause a tendon rubs across the outside of the joint. This type of snapping or popping is often harmless and does not need treatment. In some cases, however, the tendon is damaged from the repeated rubbing
  • Synovitis, when causes the tissues that surround the joint become inflamed
  • Loose bodies, fragments of bone or cartilage that become loose and move around within the joint

Hammertoe Reconstruction

Hammertoe Reconstruction

Hammertoe occurs when a toe contracts and becomes bent because of an imbalance between the tendons on the top and bottom of the toe. According to the American Podiatric Medical Association, hammertoe usually affects the second through fifth toes. The condition worsens over time and will require surgery if more conservative treatment methods fail to correct the problem. Several surgical procedures are available to treat hammertoe.

Shoulder

Total Shoulder Replacement

During this procedure, the surgeon replaces a damaged shoulder joint with artificial components

that reverse the structure of the shoulder. This procedure is most often used for patients who have had a failed total shoulder replacement. It is also helpful for patients who have had a complete tear of the rotator cuff, especially those whose injuries have led to an arthritic condition called cuff tear arthroplasty.

Implants

The implants used in the procedure will reverse the position of the shoulder’s ball and socket. The ball will be implanted in the glenoid, and the socket will be placed in the end of the humerus. Reversing the joint will allow the patient to control the arm with the deltoid muscle instead of the damaged muscles of the rotator cuff.

Preparation

In preparation for the procedure, general or regional anesthetic is administered. The surgeon cleans the skin and creates an incision along the top or the front of the shoulder.

Humerus Component

The surgeon carefully removes the head of the humerus. The upper portion of this bone is

hollowed out, and a metal socket component is inserted. It may be secured with bone cement. The socket cup is attached to the top of this implant.

Glenoid Component

Next, the surgeon reshapes the glenoid. The socket is modified to create a stable surface. The surgeon implants the new ball component. The ball and socket components are aligned to form the new joint.

End of Procedure

When the procedure is complete, the incision is closed and bandaged. The arm is placed in a sling. Typically, the patient will be able to leave the hospital two or three days after the surgery.

Physical therapy will be required to regain shoulder strength and range of motion

Hand and Wrist

Endoscopic Carpal Tunnel, Median or Ulner Nerve Repair

During carpal tunnel release surgery, the transverse carpal ligament is cut. This releases pressure on the median nerve, relieving carpal tunnel syndrome symptoms.  The carpal tunnel is formed by the wrist bones and a thick tissue roof.  Carpal tunnel syndrome is characterized by numbness or tingling in the hand, and sometimes with pain up the arm. It is caused by pressure on a nerve that passes through the carpal tunnel. Pressure can build up within the tunnel for several reasons; including irritation and swelling of the tissue that covers the tendons. If the carpal tunnel syndrome does not respond to nonsurgical treatment, one option is to repair the area surgically.

Wrist fracture repair, scaphoid fracture repair

The wrist is formed by the two bones of the forearm—the radius and the ulna—and eight small carpal bones. The carpal bones are arranged in two rows at the base of the hand. There are four bones in each row.

The scaphoid bone is one of the carpal bones on the thumb side of the wrist, just above the radius. The bone is important for both motion and stability in the wrist joint. The word “scaphoid” comes from the Greek term for “boat.” The scaphoid bone resembles a boat with its relatively long, curved shape.

The scaphoid bone can most easily be identified when your thumb is held in a “hitch-hiking” position. It is located at the base of the hollow made by the thumb tendons. Often referred to as the “anatomic snuffbox,” this area is typically the site of tenderness or pain when a fracture occurs.

About us

Founded in 1982 by local surgeons desiring to offer an outpatient surgical experience featuring excellent service, superior quality and lower transparent pricing. Today our partners include over 200 of the area's finest surgeons, performing a wide variety of surgeries at five convenient locations, specializing in same day surgical procedures. If MPSC were one of the 447 hospitals in California, it would rank 6th in outpatient surgeries performed behind Stanford, UCLA and three Kaiser Medical Centers*. Along with our world-class surgeons, we offer great affordability and tremendous quality. 99% of our patients recommend our centers of excellence to family members and friends. We are here for you. Tell us how we can help.

*California Office of Statewide Health Planning and Development, Hospital Annual Utilization Data. https://oshpd.ca.gov/HID/Hospital-Utilization, https://alirts.oshpd.ca.gov

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966 Cass St, Ste 150 Monterey, CA

831.333.4144

info@mpscllc.org

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