Orthopedic Services

Hong Kong Adventist Hospital - Tsuen Wan offers comprehensive orthopedic specialist services that include examinations, treatments, surgery, and rehabilitation, covering the areas of general orthopedics, joint surgery, sports medicine, and post-surgery rehabilitation. All services are managed by our highly experienced orthopedic surgeons with the support of our friendly and attentive staff, and state-of-the-art facilities and equipment, ensuring that our patients receive the best possible care.

Overview of Services

Treatment of general trauma, such as fractures; reduction and fixation of joint dislocation; treatment of shoulder, elbow, or wrist pain.
Treatment of sports injuries, such as muscle strains, joint sprains, ligament tears, chronic tendonitis due to overuse (such as tennis elbow), and fasciitis.
Treatment of common spinal conditions including spinal degeneration, disc herniation, disc degeneration, spinal stenosis, and sciatica.
Treatment of degenerative arthritis and other types of arthritis.

Common Orthopedic Surgeries

The hospital offers a variety of minimally invasive arthroscopic surgeries, minimally invasive orthopedic surgeries, and endoscopic surgeries, including:

Anterior Cruciate Ligament Reconstruction
Meniscus Reconstruction
Total Knee Replacement Surgery
Minimally Invasive Bone Grafting and Reduction

Anterior Cruciate Ligament Reconstruction

The anterior cruciate ligament (ACL) is the fibrous tissue connecting the femur and tibia. Its function is to limit the forward movement of the tibia and maintain the stability of the knee joint. If the knee is overextended, over-rotated or sustains high impact trauma, it may be torn. This subsequently undermines a patient’s ability to move and exercise.

An ACL tear is a very common sports injury. It is often seen in sports that require frequent and rapid changes in direction and jumping, such as football and basketball.

Treatment depends on the severity of the injury. If the tear is not serious, conservative treatment (such as physiotherapy) is generally recommended. Traditional arthroscopic ACL reconstruction or the newly introduced artificial cruciate ligament reconstruction may be considered if the tear is severe, involves a meniscus tear, or if the patient is active in sports. Surgery restores the stability and mobility of the patient's knee joint.

	Traditional Arthroscopic Anterior Cruciate Ligament Reconstruction	Artificial Cruciate Ligament Reconstruction
Wound	1 surgical wound of about 3 cm	3 surgical wounds of about 1 cm each
Surgical Procedure	An accessory hamstring or part of the patellar ligament of the knee is transplanted to the injured knee to connect the femur and tibia, replacing the torn ACL.	The artificial cruciate ligament (artificial fibers), which has similar tenacity to a human ligament, is inserted into the knee as a scaffold through arthroscopy. The original ligament tissues regrow along the supporting artificial cruciate ligament and ultimately bond together.

Meniscus Reconstruction

The meniscus is a crescent-shaped fibrocartilaginous structure in the knee. There are two menisci in each knee - one at the inner side (medial) and one at the lateral side (outside) of the knee to stabilize the knee joint. The menisci also act as buffers and shock absorbers.

A meniscus tear is a common sports injury. The menisci can be torn if the knee is twisted or rotated forcefully.

Treatment depends on the location and severity of the meniscal injury. The outside (periphery) of the meniscus is well-supplied with blood vessels and can usually heal well. Therefore, a lateral (peripheral) tear can be repaired by arthroscopy and the injury will then heal gradually.

If the tear is more serious, surgical removal of the torn meniscus may be required. Artificial meniscal reconstruction can be considered though this procedure is not suitable for everyone. Reconstruction is usually only recommended to patients aged between 18 and 50 with intact meniscus corners and intact or partially degraded articular cartilage in the knee. Physiotherapy is required after surgery.

	Meniscus Repair	Artificial Meniscus Reconstruction (MIS)
Wound	A few small surgical wounds	A few small surgical wounds
Surgical Procedure	General or regional anesthesia is required. Through arthroscopy, the torn meniscus is repaired with special sutures.	General or regional anesthesia is required. An artificial meniscus, composed of aliphatic polyurethane, is implanted with arthroscopy into the knee joint and sutured to the original meniscus. The artificial meniscus is full of sponge-like holes. Tissue cells of the original meniscus will grow to fill up the holes in the artificial meniscus and form a new meniscus over the course of about 18 months. The artificial meniscus will decompose after about a year and will be absorbed by the body.
Blood Loss	Minimal	Minimal
Trauma and Scarring	Minimal	Minimal
Pain	Minimal	Minimal
Length of Hospital Stay	A few days	A few days

Total Knee Replacement Surgery

The knee joint is the largest joint in the human body. It consists of the thighbone (femur), the shinbone (tibia), the patella, the anterior and posterior cruciate ligaments, and the menisci. It supports most of the weight of the body and acts as a pivot for the lower leg. The distal end of the femur and the proximal end of the tibia are covered with cartilage, which act as lubricants and shock absorbers while reducing friction and wearing between bones.

Knee cartilage degenerates gradually with age. Degradation of the knee joint may be accelerated if a person is overweight, has poor posture, suffers from knee injuries, or subjects the knees to long-term overuse, resulting in degenerative arthritis (osteoarthritis). Common symptoms include frequent pain, joint stiffness, and deformation, and in some cases, it may even be difficult for a person to walk, affecting his or her quality of life.

In minor cases, drugs combined with weight reduction, adequate exercise, or physiotherapy can reduce joint pain and improve mobility. If the above methods do not relieve symptoms or if the condition is more serious, patients can consider artificial knee joint replacement surgery. New technology has reduced the amount of blood loss during surgery and postoperative pain. Some patients can even consider replacing both knees with artificial joints during the same operation.

	Artificial Knee Joint Replacement Surgery
Wound	About 7 to 10 cm
Surgical Procedure	General or spinal/epidural anesthesia is required. An incision is made at the middle of the knee and the damaged cartilage at the distal end of the femur and the proximal end of the tibia is removed. Artificial metal joint components are fitted into the joint and fixed with acrylic (polymethylmethacrylate, PMMA) cement. A wear-resistant plastic is then placed between the two artificial joint components so that the joints can move smoothly.
Length of Hospital Stay	About a week

Minimally Invasive Bone Grafting and Reduction

The shoulder joint, also known as the ball-and-socket joint, is the human joint that offers the largest range of motion. If the shoulder is pulled externally or is subjected to sudden impact, the upper part of the humerus can dislocate from its normal position. This is known as a dislocated shoulder. Shoulder dislocation is a common sports injury, and is often seen in sports such as basketball, rugby, and cycling.

The younger the patient is at the time of his or her first shoulder dislocation, the greater the risk of recurrence. Each occurrence causes damage to the joint and ligaments. A lack of appropriate treatment following the first dislocation episode can also increase the risk of recurrence, causing easier shoulder dislocation in the future. To avoid recurrent dislocation, surgical procedures to fix the joint are generally recommended. This can be done with traditional open surgery or minimally invasive surgery.

	Traditional Open Surgery	Minimally Invasive Surgery
Wound	About 10 cm	A few incisions of about 1 cm each
Surgical Procedure	The ligament tissues are fixed to the bone with metal or plastic anchors.	Damaged ligaments and bone tissues are repaired through arthroscopy to provide support for the glenoid fossa (glenoid cavity).
Blood Loss	Significant	Minimal
Trauma and Scarring	Involves a large incision and cutting of the muscles	Minimal
Pain	Significant	Minimal
Recovery Period	About 6 months	About 6 weeks