Orthopaedic surgery Treatments

Shoulder and upper limb surgery

The shoulder service includes a shoulder clinic and the shoulder day surgery unit for most shoulder injuries and disorders including: 

• fractures and shoulder dislocations 
• shoulder total and surface replacement 
• rotator cuff disorders 
• subacromial impingement 
• stiff and frozen shoulder 
• humeral, shoulder and clavicular fractures 
• tennis and golfer’s elbow 
• carpal tunnel syndrome 
• arthritis of the base of the thumb 
• Dupuytren’s contracture of the hand and wrist ganglia 

The majority of shoulder surgery is performed arthroscopically (keyhole surgery).

A new one-stop shoulder clinic is being develped to provide clinical and ultrasound scan diagnosis of shoulder disorders in a single consultation. 

Spinal surgery

The spinal surgery service offers a comprehensive range of spinal procedures including: 

• Fusion with instrumentation
• Cervical (neck) and lumbar (lower back) artificial disc replacement or fusion 
• Pain procedures (epidural, joint or nerve root injections)
• Discectomies (removal of discs) 

Spinal decompressions

Use of soft stabilisation devices e.g. Wallis, Coflex, etc.  We also offer minimally invasive procedures in the form of:

• Kyphoplasty for spinal vertebral collapse and myeloma 
• IDET (Intradiscal Electrothermal Therapy) 

Cervical / lumbar percutaneous nucleoplasty

We treat adult scoliosis, but not children. We have experience with spinal TB, fractures without neurological deficits, myeloma and bony secondaries.

Most spinal procedures can be carried out as day cases. For inpatient care, the length of stay depends on the procedure being carried out.

The consultant team is supported by an Extended Scope Practitioner (ESP) who is a highly experienced musculoskeletal physiotherapist who has undergone extra training to perform this role. 

Patients are seen by the ESP if they present with simple low back or leg pain.
The ESP then performs a full assessment and will refer for appropriate investigations such as blood tests and MRI or for treatment such as physiotherapy and epidural injection. 

The ESP will refer patients to the consultant if they have a complex medical history, previous back surgery, lumps and bumps or immediate urgent indication for surgical opinion. 

Knee Surgery

The assessment and management of knee conditions. Acute injuries are assessed in either the fracture clinic or the elective knee clinic. The majority of knee procedures are carried out as day cases. All knee replacements are operated on by our surgeons at the South West London Elective Orthopaedic Centre (SWELEOC).