Many patients come to this country from around the world to seek orthopedics care and surgeries. Orthopedics in Iran, hospitals and facilities boast some of the most advanced technologies in this fields and state-of-the-art and orthopedic equipment.
Patients with joint diseases, knee arthritis, weight gain related join problems can take advantage of high quality Orthopedic care services such as knee surgeries and treatment of bone fractures. Iran’s professional doctors and surgeons with high medical knowledge and experience, are at par with highly advanced countries in this field.
Iranian Orthopedic Surgeons Association, established in 1973, is one of the oldest associations in the country expanded after the 1979 Islamic Revolution. Currently, over 850 orthopedists in IRAN are members of this association.
Orthopedics in Iran is a specialty of immense breadth and variety. Orthopaedic surgeons treat a wide variety of diseases and conditions, including: fractures and dislocations, torn ligaments, sprains, and strains, tendon injuries, pulled muscles, and bursitis, ruptured disks, sciatica, low back pain, and scoliosis, knock knees, bow legs, bunions, and hammer toes, arthritis and osteoporosis, one tumors, muscular dystrophy and cerebral palsy, club foot and unequal leg length, abnormalities of the fingers and toes and growth abnormalities.
Orthopedic surgeries include 7 items:
1- Knee 2- Hip 3- Foot and Ankle 4- Shoulder 5- Elbow, Wrist and Hand 6- Orthopedic Spine 7- Pediatric orthopedics
Common orthopedic procedures:
Robotic knee surgery – (Navio Surgical System)
The NAVIO system is a development in the procedure our orthopedic surgeons carry out partial knee replacement. The system works with the surgeon’s skilled hands to reach the accurate positioning of the knee implant based on each patient’s unique anatomy.
Knee Arthroscopic Washout Procedure
This procedure is often carried out in both an outpatient surgical center and a hospital’s operating room. A small incision is made at the knee joint so the surgeon may insert the arthroscope, a long, narrow tube-like instrument with a viewing eyepiece on one end, into the joint.
The knees have four major ligaments. The Anterior Cruciate Ligament (ACL) is the front ligament and it is one of the most common damage among athletes. Two of the knee ligaments are collateral, or toward the side of the knee joint the lateral collateral ligament (LCL) may rupture after a hard hit to the outside of the knee. Like the LCL, the medial collateral ligament rests on the side of the knee. The MCL faces inward toward the opposite knee. The fourth ligament and the ligament that is toward the back of the knee is the posterior cruciate ligament. The cruciate ligaments like the ACL and PCL cross over one another. The PCL lies toward the back of the knee and it can tear whenever the joint improperly bends.
Posterior Cruciate Ligament (PCL) Reconstruction
PCL is one of the most important ligaments in the knee. Injuries to the PCL can occur in a variety of ways, including a hard blow to the shinbone or falling down on a bent knee. Double bundle PCL reconstruction has been extremely effective in restoring knee stability back to the patient both objectively with PCL stress x-rays as well as subjectively based on patients independently evaluating their outcome scores
For often people occur one episode of dislocation of the patella with no further recurrence. Surgery for curing this case, is not essential. Medial patellofemoral ligament reconstruction is a surgical method showed in patients with more severe patellar instability. MPFL is the major ligament which stabilizes the patella and helps in preventing patellar subluxation (partial dislocation) or dislocation.
Trauma and fracture management
Damages to the musculoskeletal system, such as fractured or dislocated bones, broken, and soft tissue injuries known as Trauma. Trauma Surgery is a subspecialty of orthopedic medicine that requires fellowship training beyond the usual orthopedic surgical residency.
Total hip replacement (Direct Anterior and Posterior Approach)
Total hip replacement (total hip arthroplasty or THR) is a surgical operation and treatment option in which the damaged bone (joint) and cartilage is replaced by a prosthetic component, that is, a hip prosthesis. Total hip replacement is one of the most successful and usual procedures in orthopedic surgery which started in 1960s. Most patients who experience total hip replacement are age 50 to 80
Hip arthroscopy (hip scope) is a surgical procedure to the viewing of the interior of the hip joint through an arthroscope (which inserted into the body through a small incision) and diagnose of hip pathology through a minimally invasive approach. Since 1990s, the advances in arthroscopic surgical equipment has allowed surgeons to treat problems that were untreatable or which required more open procedures.
Hip Replacement Surgery (Partial)
Hemi Hip replacement (Hemiarthroplasty): unlike THR During the hemiarthroplasty procedure the surgeon replaces one half of the joint with an artificial surface. After surgery physical therapy begins as soon as the patient feels comfortable to restore function and movement to the joint. Most patients have positive results after this surgery.
Hip Resurfacing Surgery
Hip resurfacing (Resurfacing of the hip joint) has been developed as an alternative form of THR. The concept of this surgery is an effort to save the bone during the replacement of an artificial hip joint. This preservation of bone has some advantages and choosing between THR and Hip replacement is very important decision that your doctor can make. The experience of surgeon with hip resurfacing is the most important; thus choosing the right surgeon is absolutely essential for a positive outcome.
Minimally invasive hip surgery
Minimally invasive hip surgery is another approach to THR which surgeon can use two smaller incisions instead of one big incision results in less postoperative pain and quicker recovery. Unlike THR this method is not appropriate in all cases. As an example to make this clear:
|traditional total hip replacement (THR)||Minimally Invasive|
|10 to 12 inch incision
|3 to 6 inch incision (typically just one, but sometimes two smaller incisions)|
Paediatric hip surgery
hip abnormalities or hip joint traumatic and relative problems are not restricted to adults. When a child has such problems the physical immaturity of their bones requires some special consideration which some surgeons cannot handle. In children surgery suggested when it is the only treatment to the joint.
Computer-navigated surgery (Hip Navigation Surgery)
surgeons may use computer assisted surgery (CAS) technology, during hip surgeries to ensure implants are in proper places and aligned correctly which also may help the new joint feel more natural. This technology is an interactive system consisting of: 1. An infrared navigation camera 2. Smart Instruments with LED technology 3. A computer with specialized surgical navigation software.
Especially older athletes who have been highly active in their 20’s and 30’s athletes can experience hip pain, as a result of many circumstances: Hip pointer, Bone fractures, Muscle strains and tendinitis, Stress fractures, Muscle tendon bursitis, Contusion (bruise, commonly called a hip “pointer”), Hip labral tears, Osteoarthritis Sport hip injuries are usually identified via a detailed examination by a qualified sports-medicine physician. Diagnostic tests may include imaging techniques such as X-ray or MRI.
3- FOOT AND ANKLE
Achilles Tendon Repair
The largest tendon in the body called Achilles tendon. It’s the tissue that connects your heel bone to your calf muscles and you use it when you walk or jump and run. While the Achilles tendon can endure great stresses from jumping and running, it is also vulnerable to injury. A “rupture of the tendon” is a separation and tearing of the tendon fibers thus the muscle can no longer perform its normal function. After an injury retrieval Achilles tendon function is critical. The goal to re-join the calf muscles with the heel bone to restore normal muscles activities.
Total ankle replacement (Arthroplasty)
total ankle arthroplasty (TAA) also known as total ankle replacement is a surgery that use to treat ankle arthritis and replace the damaged surfaces of ankle joint with artificial implants. Ankle replacement mostly done when u are under general anesthesia. Your surgeon will make incision to expose joint. Then the doctor will remove damaged bone and replace with some metal and plastic parts. After surgery you need to stay in hospital at least for one night.
It’s also known as ankle arthrodesis is usually done to treat arthritis in the ankle. Probably an ankle fracture is the most usual cause of arthritis of the ankle. If patients have severe ankle arthritis and more conventional methods have failed they can be candidates for an ankle arthrodesis. A fusion is a very good operation for treating a damaged joint for the ankle, especially when the patient is young and very active.
Ankle arthroscopy is a minimally invasive surgery performed through keyhole incisions performed under a general anesthesia. During the surgery a small telescope approximately three to four millimeters in diameter (arthroscope) is inserted into the ankle through few small puncture wounds that surgeon can use it to examine and repair tissues inside. This kind of surgery can be used in following problems: Ankle fractures, Ankle instability, Anterior ankle impingement, Infection, Loose bodies, Osteochondral defect (OCD)
Bunion surgery (Keyhole/Minimally invasive)
Bunion or hallux valgus is an abnormal bony bump at the big toe caused by misalignment of the bone and soft tissues around the joint. In Bunion surgery, the operation is performed with very small incisions, only a few millimetres long. The aim of this surgery is to relieve pain and realign the soft tissues and bone which is the cause of the joint deformity.
Minimally invasive ankle surgery
In foot and ankle surgery, minimally invasive refers to a type of surgery that has either a very small incision or no incision at all. Minimally invasive ankle surgeries have many advantages, including: Less injury, Less pain, Shorter surgery time. Some of these procedures include: ankle arthroscopy, fusions and gluing the joints together, for example the ankle joint and hindfoot joints.
Ankle reconstruction surgery is performed to correct the structures of the ankle and restore its natural functionality that has been lost cause by injury or disease. This surgery is typically carried out as a day case procedure. general anaesthetic is given and an injection is used around the ankle so that it’s numb and it will be pain-free after the surgery. When a effective solution is required, a surgical ankle reconstruction can cure ankle instability quickly and effectively.
Paediatric ankle surgery
Since the child is growing, Pediatric ankle disorders differ from those in adults. These conditions may be present at birth or develop later as the child grows which they can affect the way the child’s foot or ankle works. The most appropriate treatment for ankle disorders in children depends on the age of the child. In cases which surgery is needed to correct Pediatric ankle disorders, the aim is to maintain the optimum range of motion and function of the child.
Trauma and fracture management
A bone can get fractured or broken completely or partially that may be usually caused from trauma due to fall, accidents or sports. In cases with severe fracture, stabilizing apparatuses such as plates or screws is necessary. In cases involving high impact injuries or bone reconstruction and repositioning surgeries, a trauma specialist is needed to provide optimum treatment.
Open and arthroscopic management of foot and ankle soft tissue conditions
Soft tissue conditions happen due to trauma or overuse of muscles, tendons or ligaments. The cause of these injuries is mostly a sudden movement, although soft tissue injuries can also happen due to extreme overuse of fatigued parts which grow gradually, when a speicific activity is repeated over time. Arthroscopy is used to detect certain soft tissue conditions when the exact cause of ankle symptoms is unknown.
Artificial ligament reconstructive surgery
The foot joints become unstable if the ligaments get damaged. Ligament injuries often happen due to sports injury. If a ligament is torn, the knee movement is limited significantly. Artificial ligaments are designed as surgical implants in the case of natural ligament loss or as a reinforcement structure. Using artificial ligaments has some noticable advantages in comparison to other methods. Artificial ligaments accelerate the bone healing and integration process.
Limb Lengthening Surgery
Limb lengthening surgery is used to replace missing bones and to lengthen or straighten bone structures which are deformed. This surgery can be performed for both children and adults. Through the limb lengthening process, new bone and soft tissues including skin, muscle, nerves, etc. will gradually grow. Some of the indications of this surgery include: Leg Length Discrepancy, Bone Loss, post Traumatic Bone Deformities.
Bunionectomy is a surgery performed to cut or remove a bunion. A bunion is made up of bone and soft tissue and it appears when the joint at the base of the big toe gets enlarged. This condition makes walking and other activities extremely painful. The number one cause of bunions is wearing shoes that are too small or too tight. When conservative procedures such as using wide toed shoes and medication, are unsuccessful, bunionectomy is necessary to relieve your pain.
Although most sports injuries may not require surgery, but very severe injuries like broken bones require appropriate treatment, including manipulation or surgery in order to fix the damaged bones using wires, plates, rods, etc. In some cases the displaced bones can get realigned without a surgical procedure, but injuries such as a torn knee ligament, needs surgery to get repaired.
Total shoulder replacement (Arthroplasty)
Total shoulder replacement or arthroplasty, refers to a procedure for treating arthritis or degenerative joint disease of the shoulder joint. The objective of shoulder replacement surgery is to relief the pain and to restore the motion and function of the joint. This procedure involves the replacement of the arthritic ball with an artificial metal ball. When conservative treatments such as medications and are unsuccessful, shoulder replacement surgery can be considered to relieve your pain.
Reverse total shoulder replacement
The main difference between a conventional total shoulder replacement and a reverse replacement is that in a reverse replacement procedure, the metal ball and socket and are switched so their natural position is reversed. In the case of failed conventional total shoulder replacements or failed fracture surgery, the reverse total shoulder replacement surgery is an appropriate option. Also for patients with cuff tear arthropathy, this procedure is more successful because different muscles are involved in it to move the arm.
Acromioplasty is an arthroscopic procedure of the acromion, top of the shoulder blade. In the shoulder acromioplasty surgery, a small part of the acromion surface that is the cause of the tendon tissue damage is shaved. The objective of acromioplasty is to remove the roughness of the structure while maintaining its normal supporting parts. This Surgery is used to smooth the bones and create more space for the rotator cuff so that the shoulder can move with less pain.
Arthroscopy is a procedure used in orthopedics to examine, diagnose, and repair tissues inside or around the shoulder joint. In this procedure, a tiny camera called arthroscope is used to inspect or repair the tissue. In this operation, very small incisions are used to insert the camera through the skin. Shoulder arthroscopy may be indicated if the shoulder joint is damaged due to arthritis, an injury, or other conditions.
Trauma and fracture management
Shoulder fracture is often a result of traumatic events such as falling from a height, sports or motor vehicle accidents. Shoulder pain, swelling and having difficulty with moving the arm are the common symptoms of shoulder fracture. Various factors including the involved bones in the fracture and amount of the displacement determine the appropriate treatment and management plan for these injuries. The fracture may be displaced or non-displaced. While non-displaced fracture can be treated with non-surgical procedures, surgery may be a necessity to realign the bones in displaced fractures.
Shoulder Bankart Procedure
A Bankart tear is a particular injury to a part called the labrum of the shoulder. When the labrum is torn, it may lead to shoulder instability. This injury usually occurs due to the dislocation of the shoulder joint. Pain in the front of the shoulder associated with clicking or catching sensations are common symptoms of Bankart tear. Younger patients and athletes who are involved in high-risk sports, are more susceptible to have dislocations repeatedly so they are advised to have surgical treatment.
Shoulder Dislocation Repair
Shoulder dislocation occurs when the upper arm bone separates from the shoulder blade at the shoulder joint. An extreme force or rotation of the shoulder like an accident or a fall is often the cause of the shoulder dislocation which can result in intense pain, arm numbness, weakness and swelling. Shoulder dislocation has to be treated and shoulder get relocated as soon as possible. Surgical treatment for shoulder dislocation may be recommended if patients are unwilling to end their high-risk sport activities or if they are suffering from recurrent dislocations.
Shoulder reconstruction surgery is performed to improve stability and function of the Shoulder in patients with shoulder instability. This condition occurs due to injuries of the structures surrounding the shoulder joint such as the ligaments. In Shoulder reconstruction surgery, the torn or stretched ligaments are repaired in order to better support the shoulder joint. When conservative treatments such as physical therapy and are unsuccessful, shoulder reconstruction surgery may be recommended to relieve the shoulder instability.
Shoulder arthritis is usually a chronic condition and can result in disability. Shoulder arthritis occurs due to the loss of the smooth cartilage covering the surfaces of the ball and socket. Some of the most common types of shoulder arthritis are osteoarthritis, inflammatory arthritis and cuff tear arthropathy. Pain during activity is the most common symptom of shoulder arthritis that may also appear at rest. When non-surgical treatments fail to control shoulder arthritis, shoulder arthritis surgery may be a necessity.
Nerve injuries and disease
The shoulder receives its nerve supply through a complex network of nerves. These nerves can be damaged along their way from the neck to the shoulder due to various injuries and diseases such as infection, nerve inflammation, Compression or entrapment of the nerve. These injuries can result in pain and strength loss of muscles. Nerve conduction tests are performed to obtain accurate information upon the nerve injury type and severity for diagnosing the disease and defining the appropriate treatment.
Shoulder Rotator Cuff Repair
The rotator cuff is made up of a group of tendons forming a cuff over the shoulder to help stabilize and move the shoulder. A combination of overuse, injury and weakening of the tendons may results in the rotator cuff injury. If non-surgical treatments fail to improve the torn rotator cuff pain, surgery may be advised as an option. In the surgery procedure, the torn tendon is reattached to the upper arm bone so that it gets repaired.
Shoulder Resection Arthroplasty
The aim of Shoulder resection arthroplasty surgery is to repair the acromioclavicular (AC) joint of the shoulder. This joint is where the acromion and the collarbone meet. The AC joint may develop osteoarthritis in middle age which leads to pain and difficulty for shoulder movement in everyday activities. And old injury such as an acromioclavicular dislocation, may also lead to AC joint disease. Shoulder resection arthroplasty surgery is performed to restore the function, stability and motion range of the injured shoulder.
Athletic activities that involve excessive and repetitive movement such as swimming and weightlifting may lead to shoulder sport injuries and makes athletes more susceptible to these problems. Some of the most common shoulder injuries include dislocations, rotator cuff injuries and fractures. Contact sports like wrestling are more likely to cause dislocations, while sports which involve heavy weight lifting may cause rotator cuff injuries. Depending on the injury type, there are various treatments and in severe conditions, shoulder surgery may be required.
5- Elbow, Wrist and Hand
Elbow, Wrist and Hand Joint Replacement (Arthroplasty)
The aim of joint replacement surgery which is also called arthroplasty, is to treat symptoms of arthritis to restore the joint function and motion. In cases of severe tumors or trauma this surgery may be a necessity. In this surgical procedure, artificial metal and plastic structures are replaced with the worn joint. Also when non-surgical treatments including therapy or medication fail to handle the pain of end stage arthritis, joint replacement is recommended.
Elbow, Wrist and Hand Arthroscopy
In arthroscopic surgery, a tiny camera called arthroscope is used to diagnose or repair injuries inside a joint which is inserted through the skin using very small incisions. By using Elbow, wrist and hand arthroscopy the cartilage surfaces of all bones inside the joints are visualized and the ligaments between various bones of the joint can be evaluated more accurately. It is also used to remove small fracture debris and realign the bone’s broken pieces.
In cases which the elbow is severely injured or elbow arthritis causes pain that non-surgical treatments like medication fail to control it, elbow surgery may be a necessity. Also if the nerves and blood vessels are injured due to elbow injuries, or an open elbow injury has caused one or more of the elbow bones to come through the skin, surgical procedure is often needed. The most common elbow surgeries include fracture repair, elbow arthroscopy and elbow replacement.
Hands serve us during many everyday activities such as writing, eating, etc. the hands need to have movement and sensation in their muscles, tendons and joints to function properly. When the hand is injured due to trauma or various hand diseases, different types of tissues and joints need to be treated in order to restore the function and motion range of the hand. In cases which non-surgical procedures such as hand therapy or medication fail to treat hand conditions and relieve the pain, hand surgery is recommended.
Trigger Finger Surgery
Trigger finger is a common condition which causes pain and locking sensation in fingers and it happens when the tendons of one or more fingers get inflamed. It mostly occurs in the thumb, ring and middle finger. Feeling pain when straightening or bending the affected finger and swelling are common symptoms of Trigger finger condition. When conservative treatments fail to treat this condition, surgery may be recommended so that the affected tendon can move freely.