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Orthopaedic trauma

Yes, a fracture is the same thing as a broken bone, however, each and every fracture is as unique as the patient who sustains it. While many of the fractures and other injuries sustained by younger patients are managed as sports injuries, traumatic injuries in the very young and the very old require specific experience Read on … !

Pelvic Trauma

Pelvic injuries, fractures and traumas can be divided into fractures of the acetabulum, stable / unstable fractures of the pelvic ring and avulsion fractures.

Acetabular (hip joint cup) fractures in children and adults result from high velocity trauma such as hip dislocations or motor vehicle accidents. Low velocity trauma such as a fall out of Read on … !

Injuries and Accidents

We specialise in treatment of trauma of the lower limb (including hip, knee and foot trauma) as well as trauma of the pelvis and upper limb (including hand, elbow and shoulder trauma).

Trauma orthopedics does not only involve treatment of broken bones (fractures) and the old comical image of the patient with all four limbs Read on … !

Radicular Pain

Radicular pain refers to referred pain from a nerve root entrapment in the back, this may be due to a herniated intervertebral disc as well as other mass lesions and/or forms of spinal instability. The pain is usually experienced over the buttock area with radiation into the lower leg and foot. The character of pain Read on … !

Spinal Injuries

Spinal injuries as well as non-traumatic conditions are specialist problems which are best managed by super specialist spinal surgeons with neurosurgical input as required. While we do not treat these conditions at the Cape Joint Surgery. We recognise that patients with hip arthritis may sometimes present with symptoms of lower back pain and vice versa. Read on … !

Hip Pain

Hip pain often presents a diagnostic problem to a referring doctor, for two reasons. Firstly, what the patient describes as “hip pain”, may involve pain in the groin, pain over the lateral thigh as well as pain in the buttock, sometimes radiating down the leg. Secondly, patients who present like this, may have problems which Read on … !

Hip Pain in Adults

Hip pain in adults must be differentiated into pain of the various regions around the groin and upper thigh. While age at presentation is extremely important with hip pain in children, painful adult hip conditions may occur throughout a wide age range, depending often on the predisposing factors.

 

Groin pain in adults:

Femoro-acetabular impingement

Read on … !

Hip Pain in Childhood

Hip pain in children / pathology may often presents with knee pain (referred pain) and every child that presents in such a way should have been examined and possibly imaged. Children are are notoriously unable to distinguish between specific locations of pain around the hip. Hip pathologies in children occurred at different times of their Read on … !

Total Hip Replacement

A total hip replacement is a very successful procedure for patients with arthritis of the hip. Arthritis of the hip can be caused by osteoarthritis, inflammatory arthritis, or secondary arthritis due to an injury or deformity. Hip fractures are often treated with a hip replacement if screw and plate fixation can not be done.

Minimally Read on … !

Revision Hip Replacement

Revision Hip replacement is the term used for the procedures performed to repair or replace a failed or malfunctioning hip replacement. This is specialized surgery that should only be done by surgeons with experience in hip replacement surgery and with superspecialist revision surgery experience. The indications for revision surgery include aseptic loosening (implant loosening without Read on … !

Femoroacetabular Impingement (FAI)

 

 

Until the advent of MRI scanning and hip arthroscopy, FAI was an underdiagnosed condition of hip pain and young adults. FAI is a mechanical problem related to impingement between the neck of the femur and the rim of the acetabulum and it’s attached acetabular labrum. This impingement most commonly occurs in flexion, adduction Read on … !

Use of 3D Printing in planning of Total Hip Replacement with Difficult Analtomy

3D printing is the latest technology that is applied in Orthopaedics now available at Cape Joint Surgery

This technology is mostly used by the major Orthopaedic companies to design implants however Dr Engela at Cape Joint Surgery used this technology to plan difficult surgery.

We at Cape Joint Surgery have our own 3D printer Read on … !

Nerve Entrapment Syndromes

Nerve Entrapment Syndromes : Multiple peripheral nerves may be entrapped around the hip and may mimic hip pain.

 

The lateral femoral cutaneous nerve (meralgia parastheticum) is usually entrapped with scar tissue from previous abdominal surgeries or tight clothing, obesity has also been described as a cause. A positive Tinel’s sign is usually found just Read on … !

Transient Osteoporosis of the Hip

Transient Osteoporosis of the Hip occurs in pregnant patients (third trimester) as well as middle-aged male athletes. The groin pain is usually activity related and diagnosis is usually confirmed with an MRI scan.

Any further enquiries may be made either telephonically to the secretarial staff at the Cape Joint Surgery ((021) 797 0947) or via Read on … !

Bursitis

There are multiple bursae around the hip and, while inflammation of all of them has been described, the more commonly involved ones are the trochanteric bursa, the ischiogluteal bursa and the iliopsoas bursa.

 

Trochanteric bursitis present as lateral thigh pain and patients often complain of being unable to sleep on the affected side. Rising Read on … !

Avascular necrosis

Avascular necrosis of the femoral head occurs in a significant amount of younger patients and several theories exist regarding the aetiology of non-traumatic cases. It is well described in alcoholics as well as patients on corticosteroids and those with sickle cell disease. Traumatic causes such as displaced fractures and hip dislocations may also cause avascular Read on … !

Tumours

Hip pain may be caused by tumours, which may be either benign or malignant.

Benign tumours such as osteochondromas may cause pain secondary to compression of- or erosion into adjacent soft tissue structures and/or mechanical impingement problems. Other benign tumours, such as osteoid osteomas may cause pain secondary to acute inflammation. Despite the tumour Read on … !

Subacute Osteitis

Subacute osteitis is a rare condition, which may occur around the hip in young children. This usually results after a bone infection has been partially treated with antibiotics, which were discontinued too early. The diagnosis may not have been made in this case is often when antibiotics were prescribed empirically for a child which was Read on … !

Avulsion Fractures

Avulsion fractures, or, pull off fractures as they are more commonly known, around the hip are fairly common in children and they may occur in a number of locations, including the ischial tuberosity (hamstrings), the anterior superior iliac spine (Sartorius) as well as the anterior inferior iliac spine (rectus femoris) and the lesser trochanter of Read on … !

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis consists of a spectrum of inflammatory arthropathys which affects children (girls in the early teenage years more often than boys). The patients present with synovitis of various joints (usually a polyarthropathy (more than one joint involved), although initial presentation may be in the form of a monoarthropathy). The wrist-, knee-, and ankle Read on … !