Orthopaedics

Public Service

What is Orthopaedics?   Orthopaedics covers the diagnosis and treatment of disorders of bones, joints and muscles. Orthopaedic surgeons have special skills in the surgical treatment of these conditions. The medical treatment is often shared by orthopaedic surgeons, rheumatologists, sports doctors and general practitioners (GPs).   Here are some of the most common conditions treated by orthopaedic surgeons in adult patients:

• severe osteoarthritis of the hip or knee
• fractured bones
• torn or inflamed muscles, tendons and cartilage
• dislocations of joints
• infections in bones and joints
• trapped nerves
• disorders of the spine.

Where joints have become destroyed by disease, or worn out, orthopaedic surgeons can often replace these joints with artificial ones. This results in marked relief from pain and an increase in mobility and enjoyment of life for patients.

Fractures, except for the most minor ones, are treated by orthopaedic surgeons as they have the expertise to assess the damage around the fracture and ensure the best function is obtained after the fracture is mended.

Most spinal conditions do not need a surgical operation, but a small number do. Your GP will tell you if your condition is one that could benefit from an orthopaedic opinion.

The orthopaedics department at ADHB provides specialist secondary care for the wider Auckland region and tertiary care in a few complex conditions for the whole of New Zealand. 

The four nurse specialists working in the orthopaedics department are, Julie Hislop, Katie Moloney Joanne Kalin, and Sowmia Thomas. 

Outpatient Clinics

These are held at the Greenlane Clinical Centre.  For information about this location please click here.

Services provided Soft tissue (muscles, tendons and ligaments) Orthopaedic surgeons can do operations on tendons to repair them or to improve the muscle balance around a joint. Ligaments can be repaired or reconstructed. Bones, muscles, and other connective tissues occasionally develop tumours, some of which can be cancerous. These are treated by orthopaedic surgeons. After surgery there is always a period of recovery and there is often splintage for a time. Physiotherapists are used to assist you recover function after an operation. Fracture clinics This clinic is for patients who have sustained an injury that has already been treated. These are injuries where further follow-up of that injury is required; to monitor progress of a healing bone, check the position of the bone in a cast and to decide when other steps in management such as re-manipulation of the fracture or removal of a cast is required. Often at these fracture clinics x-rays are taken on arrival.
Although an appointment time is given, the time to have x-rays, casts removed and other treatments instigated may take several hours. General outpatient clinics These are clinics for patients who have been referred by their doctor for an orthopaedic opinion on a specific concern. These clinics are usually attended by a specialist orthopaedic surgeon who will be available to advise on diagnosis and management.
 
It is best if you arrange for your General Practitioner to have any appropriate x-rays or ultrasound scans taken at an earlier date and you should bring these with you to the clinic. If you do not have x-rays, then there will be considerable delays at the clinic if we have to arrange these for you. Sometimes more sophisticated imaging is required and it is not reasonable for your GP to anticipate all the investigations we will require. None the less you should ask him/her if there are x-rays you might need and arrange to have these done first. GPs can ask for x-rays  and ultrasounds to be done at the Greenlane Clinical Centre and there is no cost to you for this. Alternatively, you can have these tests done more promptly in the private x-ray clinics. Specialty clinics Some surgeons have special expertise in one area of orthopaedics.
 
If your problem is with your spine you will be seen by one of our specialised spine surgeons. Only about 4% of the patients seen by the spine surgeons need to have a spinal operation.
 
A specialised hand surgeon and a tumour (sarcoma) surgeon attend the Greenlane Outpatient Clinic. Joint replacement Joint replacement surgery is sometimes required to treat joints that have been damaged from "wearing out" types of arthritis or from other forms of joint disease including rheumatoid arthritis.
 
In these operations the damaged joint surface is removed and replaced with artificial surfaces normally made from metal (chromium cobalt alloy, titanium), plastic (high density polyethylene) and ceramic surfaces which act as alternate bearing surfaces for the damaged joint.
These operations are major procedures which will require you to be in fairly good health otherwise and a stay of several days in hospital. These operations are followed by a significant period of rehabilitation. The hospital has a number of options for the particular operation and the type of artificial joint and these will be discussed with you when you see the surgeon and when you are booked for surgery.
 
Occasionally blood transfusions are required; if you have concerns, please raise them with your surgeon during your consultation. Osteotomy

Osteotomy is the division of a crooked or bent bone to improve alignment of the limb.

These procedures normally involve some form of internal fixation, such as rods or plates, or external fixation which involves external wires and pins to hold the bone. The type of procedure for fixation will be explained when the surgery is planned.

Arthroscopy (keyhole surgery)

A large number of orthopaedic procedures on joints are performed using an arthroscope, where a fibre optic telescope is used to look inside the joint. Through this type of keyhole surgery, fine instruments can be introduced through small incisions (portals) to allow surgery to be performed without the need for large cuts. This allows many procedures to be performed as a day stay and allows quicker return to normal function of the joint.

Arthroscopic surgery is less painful than open surgery and decreases the risk of healing problems. Arthroscopy allows access to parts of the joints which can not be accessed by other types of surgery.

Bunion correction Relief from bunions

Most bunions are treatable without surgery. Prevention is always best. To minimise your chances of developing a bunion, never force your foot into a shoe that doesn't fit. Choose shoes that conform to the shape of your feet. Go for shoes with wide insteps, broad toes and soft soles. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 6cm. If you already have a bunion, wear shoes that are roomy enough to not put pressure on it. This should relieve most of your pain. You may want to have your shoes stretched out professionally. You may also try protective pads to cushion the painful area.

Contact

Auckland City Hospital

Street address

2 Park Road
Grafton
Auckland 1023

Postal address

Private Bag 92 024 Auckland Mail Centre Auckland 1142

Phone: (09) 367 0000 extn 26196 Fracture Clinic 09 367 0000 extn 26069

Greenlane Clinical Centre

Street address

214 Green Lane West
One Tree Hill
Auckland 1051

Postal address

Private Bag 92 189 Auckland Mail Centre Auckland 1142

Phone: (09) 367 0000 extn 26196 Fracture Clinic 09 367 0000 extn 26069

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