Patient Leaflets

ACL Reconstruction

The ACL connects the femur to the tibia. It functions as a stabiliser of the knee joint and it resists forward movement of the tibia on the femur and also acts to prevent the tibia from excessive rotation when pivoting.

Air Cast Boot

To provide protection of your foot and / or ankle as advised by the Orthopaedic consultants. Your consultant or physiotherapist will tell you how long you will need to wear this for. Your boot will be fitted by a trained professional. You will only need to wear the boot as instructed by your therapist or doctor.

Ankle Arthritis

Ankle arthritis can cause pain, stiffness and swelling of the ankle. It occurs when the cartilage, which covers the ends of bones at joints, becomes damaged.

Cartilage usually works as a shock absorber and reduces friction during movement. When it is damaged or worn, it can lead to bone rubbing directly against bone, causing pain. Extra pieces of bone can also form around the joint, as well as scarring of the joint lining, with both processes resulting in joint stiffness and swelling.

Ankle Arthrodesis

The main reason for performing an ankle fusion is arthritis. This can be age related from general wear and tear or following an ankle fracture.

Arthritis is damage to one or more joints within the body. There are two main types of arthritis, the first one, and probably the most common, is Osteoarthritis where there is a gradual wear and tear of the cartilage between the bone ends, resulting in stiffness and increasing pain. In some patients this type of arthritis can occur following an ankle fracture.

Below Knee Ilizarov Exercises

These are all general exercises to strengthen and lengthen your muscles. These exercises should be performed three times a day and repetitions gradually increased as you feel able.

Big Toe Arthritis

Hallux rigidus is a type of arthritis in your big toe. Specifically, it affects your big toe joint - the metatarsophalangeal (MTP) joint. Your MTP joint is where the base of your big toe meets your foot.

“Arthritis” is a general term for a group of more than 100 diseases. It causes inflammation (swelling) in and around your joints. Healthcare providers sometimes call hallux rigidus “big toe arthritis.”

Hallux rigidus means “stiff big toe” - the condition’s most common symptom. It causes pain and stiffness in your MTP joint. It’s a form of osteoarthritis (“wear and tear arthritis”).

Bunion

The medical name for a bunion is hallux valgus. It is an obvious lump at the base of your big toe, caused by the joint at the base of the big toe deviating towards the second toe.

Care of a Plaster Cast

A plaster is a gauze bandage that has been mixed with different resins. When mixed with water and applied, it then becomes hard. They can be known as Plaster of Paris or Synthetic plasters.

Care of your Below Elbow Plaster Cast

A backslab is usually made from plaster of Paris and does not completely encircle the whole limb. They are generally applied in Emergency departments and walk-in centres. The main reason for not applying a full plaster cast is because swelling may increase in the days after an injury. A backslab is usually temporary and will either be completed to a full plaster or changed to a new one. A full plaster encircles the limb and only allows minimal swelling.

Hinge Knee Brace

Your brace will be fitted by a Physiotherapist. The fitting will be dependent on your injury type and instructions from you consultant.

Occasionally these braces slip down whilst you are walking / moving. If this occurs, unfasten the straps, reposition the brace and re-fasten to a snug fit.

Hip Joint Replacement Surgery ERP

This booklet has been written to give you and your family / carer an understanding of a Total Hip replacement operation including things you should know before and after the operation. This is to ensure you know what to expect.

Humeral Brace

In addition to providing protection and support, the brace works by squeezing the muscles in your arm in order to keep the bones aligned. Your consultant or physiotherapist will tell you how long you need to wear the brace for and whether it can be removed for certain activities such as bathing. The brace will be sized and fitted by a nurse or physiotherapist. You may be referred to an outpatient physiotherapist to guide you through your rehabilitation and advise on further management of the brace.

Joint and Soft Tissue Injections

Injections are given to reduce pain, reduce swelling and inflammation, and to restore movement. The actual contents of an injection depend upon the individual condition. Local anaesthetics may be given to reduce pain (for example - lidocaine). Corticosteroid is given to reduce swelling and inflammation. You will be given more detailed information about the medications you have had.

Knee Arthroscopy

The aim of arthroscopic surgery is to correct mechanical problems within your knee joint. The surgeon is able to confirm the nature of the injury and remove or repair the damaged part whilst causing minimal disruption to the knee joint.

Once the structures in your joint have become damaged failure to correct the damage may result in further deterioration of your knee.

In some cases surgery will not be able to reverse the damage which has already occurred. In the majority of cases your recovery will be dictated by the degree of damage and how well you can rehabilitate your knee.

Knee Joint Replacement Surgery ERP

This booklet has been written to give you and your family / carer an understanding of a total knee replacement operation including things you should know before and after the operation. This is to ensure you know what to expect. Please note that your consultant may give you extra or slightly different advice to suit your particular case. Please ask your family / carer to read this booklet too. They will find the information helpful in understanding what your needs will be when planning your discharge.

Knee Meniscal Repair

A meniscal tear may be the result of a twist – a typical injury for someone like a netballer or footballer or from repeated squatting. These tears may cause pain, swelling and a catching or locking sensation.

If not corrected, a meniscal tear, like dirt in the ball bearings of a machine, can irritate the smooth joint surface and damage the articular cartilage. This can lead to more serious problems such as arthritis.

Knee Meniscal Root Repair

A meniscal tear may be the result of a twist – a typical injury for someone like a netballer or footballer or from repeated squatting. These tears may cause pain, swelling and a catching, locking sensation or giving way. Some are a result of degenerative changes.

A meniscal tear can happen within the meniscus itself or at its root attachment to the bone. The latter is called a root tear. Root tears are not very common and behave differently to typical meniscal tears.

Lesser Toes Deformities

The toes which are not your big toes are known as the lesser toes. They become deformed when more pressure is exerted on them than their joints can resist. When the muscles that control the toes become unbalanced, so that one set pulls harder than others, this causes the toes to bend further. In some people the tissues in the lower part of the joint at the base of the toe (metatarso-phalangeal joint) becomes weak, allowing the base of the toe to drift upwards which further unbalances it.

Living with an Ilizarov Frame

You will be shown how to care for your pin sites during your stay in hospital prior to discharge.

Metatarsalgia

Metatarsalgia is a general term used to refer to any painful foot condition affecting the metatarsal region of the foot. Traditionally, the term tends to refer to pain under the balls of the feet or “metatarsal heads”. However, there are a range of specific conditions that exist under the umbrella term “metatarsalgia”.

Morton's Neuroma

A Morton’s neuroma is swelling and inflammation of a nerve that lies between two metatarsal bones (toes) of your foot. It causes pain in the ball of your foot and possibly your toes. This swelling causes thickening of the nerve tissue that surrounds the digital nerve that leads to the toes. It is usually found at the base of the third and fourth toes. This condition can be exacerbated when wearing tight or high heeled shoes which can play a role in symptom cause and certainly make the symptoms worse. The lump (neuroma) is not dangerous and will not cause problems other than in the foot. Occasionally people have Morton’s neuromas in both feet.

Musculoskeletal Steroid Joint and Soft Tissue Injections

Your clinician administering the injection will discuss the side effects with you at the time of the injection. These are very unlikely.

Orthopaedic Supported Discharge

The aim of Orthopaedic Supported Discharge (OSD) is to provide a greater proportion of your rehabilitation within your home setting rather than in hospital. It may not be suitable for everyone however it has been found that patients can often achieve better outcomes from rehabilitating at home rather than in a hospital setting.

Plantar Fasciopathy

Plantar fasciopathy affects the ligaments that lie underneath the bones in the sole of your feet. The strongest ligament is the plantar fascia or aponeurosis that runs from the heel bone to the ball of the foot. This ligament is divided into three bands; the central and inside(medial) portions are the strongest. Weight bearing causes the foot to flatten, and the ligament stretches. Sometimes this ligament becomes overstretched/overloaded around the heel with time or increased activity. Changes can occur within the plantar fascia resulting in reduced elasticity and pain. The pain is usually over the heel area but can also be around the middle of the foot.

Rehabilitation

Rehabilitation is very important post operatively to aid your healing and help to prevent further complications, for example pressure sores and chest infections.

Rehabilitation will improve your muscle strength, range of movement, function and prevent circulation problems.

Removal of Ilizarov Frame

Depending on the site of your Ilizarov frame and how well the bone(s) are healing, the frame may be removed all at once or in stages.

Thoracolumbosacral Orthosis Brace (TLSO) - Fitting and Wearing in Lying

TLSO stands for ‘Thoracolumbosacral Orthosis’ – which means that it provides stability to the upper, middle and lower sections of your back. Your doctor has determined that wearing a back brace will aid in your rehabilitation. The purpose of this brace is to maintain your back in an appropriate position and limit the movement of your back to aid healing. This leaflet will explain the things that you should do for the duration of time that you are required to wear your brace. You are to apply your brace in LYING. Once on you are allowed to get up and mobilise. The brace must remain on until you are in the lying down position again i.e. at night time.

Thoracolumbosacral Orthosis Brace (TLSO) - Fitting and Wearing in Sitting

TLSO stands for ‘Thoracolumbosacral Orthosis’ – which means that it provides stability to the upper, middle and lower sections of your back. Your doctor has determined that wearing a back brace will aid in your rehabilitation. The purpose of this brace is to maintain your back in an appropriate position and limits the movement of your back to aid healing. This leaflet will explain the things that you should do for the duration of time that you are required to wear your brace. You are able to apply your brace in the sitting position. It does not need to be worn in bed.

Total Ankle Replacement

In most cases, a replaced ankle will maintain the range of movement that it had prior to surgery. This means that patients can walk normally, and it is thought that the risk of putting excess strain on surrounding joints is less than would be the case with a fused ankle.

The current research suggests that, provided post-operative instructions are followed, approximately 90% of patients undergoing ankle replacement surgery can expect a significant improvement in quality of life, a reduction in pain and improved mobility. The most recent studies conclude that approximately 80 - 90% of ankle replacements will still function well 10 years after surgery.