How it works
Surgery
Specialized in the treatment of shoulder, knee and elbow.
SURGERIES ORTHOPAEDICS POBERAJ
Surgeries for the Institute for Health Insurance of Slovenia insured persons are carried out based on a referral issued by a general doctor.
Self-pay surgeries are performed based on a valid price list.
We cooperate with health insurance companies: Triglav and Vzajemna.
SHOULDER SURGERY
How is a rotator cuff injury in the shoulder joint treated?
What happens if you get hurt? For example, if you fall on your outstretched arm, or directly on your shoulder, or you caught your hand behind the fence when you slipped on the stairs…
The tendon can tear at its insertion. Because the torn tendon is pulled by a muscle away from its insertion, it can never heal itself back to its footprint and the defect slowly grows.
Your shoulder hurts, especially at night, the pain outlasts your sleep, you also notice less strength, depending on which and how many of the tendons you have injured.
The X-ray imaging will not show the rupture, at least an US examination is required, ideally a magnetic-resonance investigation. Clinical examination is crucial in a decision making for surgical treatment.
The rototor cuff consists of 4 muscles: subscapularis in the front, supraspinatus at the top, infraspinatus and teres minor, at the back. All the muscles are connected with the bone by the tendons.
We do an arthroscopic surgery in the day hospital which means that you are discharged home the same day. We use conductive anesthesia, scalenic block, and do not need general anesthesia. The joint is not opened but we rather use a camera and special instruments to enter into the shoulder through a few mm large incisions. The tendon is pulled back to the footprint and fixed with special anchors and sutures.
The tendons then take 3 months to heal firmly on the bone and rehabilitation is adapted accordingly. To keep the tendon tight in contact with the bone, for the first 6 weeks you mostly wear a detachable splint and do some simple exercises, at home. 3 months after surgery, we will refer you to a rehab center for 14 days, where you continue intensive exercises during which you are able to perform most of the lighter physical work and daily activities. The final function of the shoulder will be restored within 6 months to one year after surgery.
Despite relatively long rehabilitation, arthroscopic reconstruction of the rotator cuff are extremely successful, as 90% of your pain settles, as well as the function of the shoulder joint improves.
How is an anterior cruciate ligament (ACL) injury treated?
The anterior cruciate ligament takes place inside the knee joint between the tibia and femur and contributes significantly to the stability of the joint.
How can you injure your anterior cruciate ligament? Most often this happens in ball or skiing sports, where there are sudden changes in direction of movement and contacts with other players. Excessive rotation of the joint and the move of tibia forward against femur leads to the stretching of the ligament and its rupture.
When do you need a reconstruction of ACL? If you have a confirmed injury with MRI and a clinical examination, you don’t necessarily need surgery unless you’re a professional athlete.
If, after a few weeks of rehabilitation after an injury, you still experience knee instability in the sports you train or even in normal daily activities, then surgery is necessary.
During the procedure we replace the torn ligament with your own tissue. We have an option of patellar ligament, quadriceps tendon or semitendinosus and gracilis tendons from the back of the thigh. After the preparation of the new ligament, drilling of the tunnels follows into the tibia and femur and introduction of the new ligament to the anatomical site.
If, prior to the procedure, we find an increased degree of rotational instability and you’re engaged in ball sports, we usually choose additional stabilization on the outside of the knee, called lateral tenodesis, which improves rotational stability and thus also protects the new cruciate ligament from re-injury.
When will you be able to start playing e.g. football again?
Rehabilitation takes place simultaneously on two levels: physical therapy and biological healing with ingrow of the new ligament.
Muscle and proprioception training will be performed step-by-step under the control of physiotherapists, while biological healing processes will take place, which usually takes 9 to 12 months. This is also the period of time when you can safely return back to the sports field.
KNEE SURGERY
KNEE SURGERY
How is an anterior cruciate ligament (ACL) injury treated?
The anterior cruciate ligament takes place inside the knee joint between the tibia and femur and contributes significantly to the stability of the joint.
How can you injure your anterior cruciate ligament? Most often this happens in ball or skiing sports, where there are sudden changes in direction of movement and contacts with other players. Excessive rotation of the joint and the move of tibia forward against femur leads to the stretching of the ligament and its rupture.
When do you need a reconstruction of ACL? If you have a confirmed injury with MRI and a clinical examination, you don’t necessarily need surgery unless you’re a professional athlete.
If, after a few weeks of rehabilitation after an injury, you still experience knee instability in the sports you train or even in normal daily activities, then surgery is necessary.
During the procedure we replace the torn ligament with your own tissue. We have an option of patellar ligament, quadriceps tendon or semitendinosus and gracilis tendons from the back of the thigh. After the preparation of the new ligament, drilling of the tunnels follows into the tibia and femur and introduction of the new ligament to the anatomical site.
If, prior to the procedure, we find an increased degree of rotational instability and you’re engaged in ball sports, we usually choose additional stabilization on the outside of the knee, called lateral tenodesis, which improves rotational stability and thus also protects the new cruciate ligament from re-injury.
When will you be able to start playing e.g. football again?
Rehabilitation takes place simultaneously on two levels: physical therapy and biological healing with ingrow of the new ligament.
Muscle and proprioception training will be performed step-by-step under the control of physiotherapists, while biological healing processes will take place, which usually takes 9 to 12 months. This is also the period of time when you can safely return back to the sports field.
ELBOW SURGERY
What about the elbow?
Elbow surgeries that we perform:
– Arthroscopic debridement and arthrolysis;
– Arthroscopic removal of loose bodies;
– Surgical treatment of epicondylitis.
