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Republic of Ireland Offices
Ivowen Commercial Centre
Kilsheelan, Clonmel
Co. Tipperary E91 XR62
United Kingdom Offices
167-169 Great Portland Street
London W1W 5PF
info@dhi-care.com
UK+44 207 117 2603
IE+353 89 426 5861
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Experience excellence in orthopedic surgery at our trusted organization, where many patients seek our exceptional care. Our esteemed partner hospitals in Belgium host a team of highly skilled surgeons and dedicated staff who are committed to provide outstanding service and extending a warm welcome to our valued clientele.
With unwavering confidence in our expertise, the consultant orthopedic surgeons execute procedures with precision and proficiency, utilizing cutting-edge techniques and state-of-the-art prosthetics. Their mastery has earned them recognition as some of the world's foremost experts in this field.
Our proficiency is evident in the remarkable recovery of our senior hip/knee replacement/resurfacing clients, where many return to active sports such as tennis and golf within two months.
Under the guidance of experienced physiotherapists and with state-of-the-art facilities, our patients benefit from personalized physiotherapy sessions designed to expedite their return to normal life.
Read more inspiring stories | View FAQs
Total hip replacement (hip arthroplasty) is a surgical procedure in which a damaged or worn hip joint is replaced with a durable artificial implant (prosthesis). It is most often recommended for patients experiencing persistent hip pain, stiffness, or reduced mobility that interferes with daily activities and does not improve with non-surgical treatments such as medication, physiotherapy, or lifestyle adjustments.
The goal of hip replacement is to relieve pain, restore movement, and significantly improve quality of life. With modern techniques and technology, patients can expect faster recovery, greater comfort, and long-term success.
We use a modern anterior approach, where the hip joint is accessed from the front rather than the side or back. This technique avoids cutting through major muscles, offering several benefits:
• Faster Recovery times
• Reduced pain
• Fewer movement restrictions during rehabilitation
• Shorter hospital stays
• Lower risk of dislocation after surgery
Because of this muscle-sparing approach, patients are often able to return to their normal daily activities much sooner compared with traditional methods..
We also provide robotically assisted hip replacement, which combines the surgeon’s expertise with advanced robotic precision. The surgeon remains fully in control at all times, while the robotic system enhances accuracy, consistency, and safety.Using pre-operative imaging and 3D planning software, the system maps each patient’s anatomy in detail. During the procedure, the robotic arm guides the surgeon within carefully defined parameters, ensuring optimal implant positioning and alignment.Key benefits include:• Unmatched accuracy: Ensures precise placement and alignment of the implant• Personalized planning: Tailored 3D imaging for each patient• Less tissue trauma: Precision reduces soft tissue damage, easing recovery• Improved longevity: Correct implant positioning extends implant lifespan and lowers risk of complications• Consistent results: Robotics ensure a high level of precision across all cases
Custom-Built Hip Prostheses
For active patients, athletes, or those with complex cases or previous hip surgeries, we also offer custom-made hip implants designed to each individual’s anatomy. This advanced solution uses CT scanning and 3D modelling to create a prosthesis that replicates the patient’s unique hip structure, maximizing mobility and stability
How it works:
1. CT Scan – Captures the exact structure of the hip joint
2. 3D Modelling – Specialized software creates a digital model of the joint
3. Implant Design – Surgeons and engineers design the implant with precise dimensions and alignment
4. Manufacturing – A custom prosthesis, often titanium, is produced to replicate the patient’s anatomy and unique joint structure.
Advantages of a custom implant:
• Perfect fit to individual anatomy
• Greater comfort and mobility
• Ideal for complex or revision cases
• Improved joint stability
•Accurate restoration of leg length and muscle function
Total hip replacement involves removing the top of the femur.
The cup implant is fitted into the prepared hip socket.
Inserting the tapered hip prosthesis into the femur.
The femoral head is fitted to the prosthetic stem.
The femoral head is inserted into the cup implant.
The finished hip replacement.
Hip revision is a complex procedure aimed at addressing issues with an existing hip replacement. Over time, artificial hip components may wear out or become loose, leading to pain and reduced mobility. Infection around the prosthesis is another reason for revision. This surgery involves removing the old prosthesis, repairing bone damage, and inserting new components. It requires meticulous planning and precision, as bone quality and the presence of scar tissue from the previous surgery can complicate the process. The goal is to restore stability, function, and pain relief to the hip, although it's generally considered more challenging than the initial replacement surgery.
A minimally invasive procedure that allows orthopedic surgeons to diagnose and treat a variety of hip conditions without making large incisions. Through small cuts, a camera and specialized instruments are inserted into the hip joint, allowing for detailed visualization and treatment. This technique is often used for conditions like femoroacetabular impingement (FAI), labral tears, and the removal of loose cartilage fragments. Hip arthroscopy can lead to a quicker recovery, less pain, and shorter hospital stays compared to open surgeries, making it a preferred option for suitable candidates.
The head of the femur is capped with a ball cap.
The cap is inserted into the cup implant which is press fitted into the prepared hip socket.
Hip resurfacing is most appropriate for physically active patients with good bone quality and adequate femoral and acetabular bone stock. Such patients will generally be under the age of 65. However, patients with the following indications are also suitable for hip resurfacing.
Patients with the following indications are NOT suitable for hip resurfacing.
Knee replacement surgery, or knee arthroplasty, is a procedure to relieve pain and restore function in severely damaged knee joints. The surgery involves replacing the damaged parts of the knee with artificial components. There are several types of knee replacements:
The decision to undergo surgery is based on factors like pain, disability, and overall health. The surgery has a high success rate, and most replacements function well for many years. Post-surgery, rehabilitation and physical therapy are crucial for recovery.
Total knee replacement surgery, also known as total knee arthroplasty, involves removing and replacing the entire knee joint with a prosthetic implant. This procedure is typically recommended for individuals with severe arthritis or significant knee damage that impairs daily activities and causes persistent pain not alleviated by other treatments. The goal of total knee replacement is to relieve pain, correct leg alignment, and restore function, allowing patients to return to normal activities with improved comfort. Surgeons replace the damaged ends of the thigh bone (femur) and shin bone (tibia) with custom-fitted components. Recovery includes a structured rehabilitation program to help patients regain strength and mobility. This surgery is highly successful in improving the lives of those affected by knee joint issues, offering long-term results and a return to a more active lifestyle.
The Oxford Knee is a special type of knee replacement surgery that only replaces one side of the knee joint. This method is commonly used for partial knee replacements. It includes a unique part that mimics the knee's natural movement by moving smoothly as the knee bends and straightens. This surgery is mainly for people who have arthritis or bone damage in just one part of their knee. The replaced part is attached using a special cement during the surgery.
The Anterior Cruciate Ligament (ACL) is an essential component of the knee joint, acting like a strong, elastic band that connects the femur (thighbone) to the tibia (shinbone). This crucial ligament provides both flexibility and lateral stability to the knee, ensuring that the joint only pivots in the desired direction. It plays a vital role in preventing sideways movement of the knee, thus maintaining its stability.
ACL injuries commonly occur during activities that involve sudden changes in direction, rapid deceleration, or landing from a jump. This is particularly prevalent among young people aged 15 to 25, especially those participating in sports like basketball that require frequent pivoting. An ACL tear is often accompanied by a popping sound, followed by knee instability, pain, and swelling. Such injuries can occur from twisting the knee or falling on it, leading to a torn ligament and subsequent knee instability.
The first line of treatment for an ACL injury involves the RICE protocol (Rest, Ice, Compression, Elevation), along with the use of a knee brace, crutches, and pain relievers. Immediate consultation with an orthopedic surgeon is crucial to assess the severity of the injury and to determine whether the ligament can heal naturally or requires surgery.
If the ligament is stretched but not completely torn, it can often heal over time without surgical intervention. However, this requires a period of rest without engaging in strenuous activities or training. Recovery time varies depending on the individual's age and fitness level, generally taking about 2 months before the leg can be used gradually. Full physical activity might take 6 months or more to resume. Sometimes cortisone injections are administered to aid in the healing process.
When the ACL is severely torn and cannot heal naturally, surgical reconstruction is the only option. ACL reconstruction surgery can effectively restore full function to many individuals who have experienced an ACL tear. During this procedure, the damaged ligament is replaced with a graft, either from another part of the patient's body or from a donor, which then integrates into the body over time, restoring stability to the knee joint. Post-surgery, a significant rehabilitation period is required to regain strength and mobility in the knee.
Holes are drilled in the femur and tibia, and the torn ACL is removed
The graft is passed through the drill holes to replace the torn anterior cruciate ligament.
The graft is anchored in place using screws or staples.
Meniscus repair is a surgical procedure focused on the knee's cartilage, typically performed arthroscopically, a less invasive method than traditional open knee surgery. This procedure is necessary when there's a tear in the meniscus, the cartilage within the knee. Since much of the meniscus lacks blood supply, its natural healing capacity is limited, especially with age-related deterioration.
When the meniscus tears, the fragment can move abnormally within the joint, potentially getting trapped between the femur and tibia bones, leading to pain, swelling, and difficulty in movement. The meniscus is crucial for knee stability, lubrication, nutrition of joint tissues, and shock absorption.
Diagnosis of meniscus issues may involve physical exams, X-rays, CT scans, or MRIs. While meniscus repair is possible and preferred to preserve the cartilage, recovery is slower due to its limited healing ability. In contrast, meniscectomy, the removal of the torn meniscus, has a quicker recovery but is less favourable as one ages.
Post-surgery, patients usually can walk without crutches in 48 hours. An active rehabilitation program follows after a week to strengthen muscles around the knee. However, patients are advised to limit certain activities for about 6 weeks or until rehabilitation is complete. This process is aided by sports physiotherapists. Arthroscopic surgery is advantageous as it is less traumatic to the knee's muscles, ligaments, and tissues compared to traditional knee surgery.
A Baker's knee cyst, also known as a popliteal cyst, is a fluid-filled swelling behind the knee, often resulting from knee joint problems like arthritis or a cartilage tear.
This fluid-filled swelling behind the knee, often results from knee joint problems such as arthritis or a cartilage tear. These conditions lead to an overproduction of synovial fluid, forming the cyst. Symptoms can include swelling, pain, tightness, and stiffness in the knee. It's crucial to seek medical advice if these symptoms appear, as they can sometimes indicate more serious issues. Diagnosis typically involves imaging tests such as ultrasound or MRI. While rare, complications like cyst bursting can occur, necessitating immediate medical attention. Treatment focuses on addressing the underlying knee issue and may include physical therapy, fluid drainage, corticosteroid injections, or surgery to remove or repair the torn cartilage or the cyst itself.
Knee arthroscopy is an orthopedic surgical procedure that allows surgeons to visualize, diagnose, and treat issues inside the knee joint. The process involves making a small incision through which a fibre optic camera and instruments are inserted. This setup enables the surgeon to see inside the knee joint and conduct necessary procedures through a much smaller incision compared to traditional surgery.
The camera projects the image of the joint's interior onto a screen, aiding in the assessment and treatment of various conditions. Knee arthroscopy can be used for multiple purposes, including:
During the operation, conducted under general anaesthesia, the arthroscope (a pen-sized telescope connected to a television) is inserted through small cuts around the knee. Depending on the issue, the surgeon may trim cartilage, repair ligaments, remove loose bones, or cleanse the joint.
Post-operative care involves an overnight hospital stay to monitor for anaesthesia side effects. Recovery includes managing minor pain and stiffness, and activities like driving or manual work may be restricted for a few weeks. Potential complications are rare but can include bleeding, infection, or deep vein thrombosis (DVT). Measures are taken to minimize risks, such as using blood thinners and compression stockings to prevent DVT.
Total shoulder replacement is the replacement of worn or damaged parts of the shoulder joint with artificial prosthetic components.
Indicated for patients with severe arthritis, this surgery involves replacing the damaged joint surfaces with artificial components. The surgeon removes the damaged head of the humerus and replaces it with a metal implant. Similarly, the socket in the scapula is replaced with a plastic implant. This procedure relieves pain and restores mobility in patients with advanced joint deterioration.
Each of these surgeries requires careful planning and execution. The patient is usually positioned in a specific way on the operating table, and the area is prepared with surgical soaps. During arthroscopy, small incisions (portals) are made to insert a camera and instruments. The surgeon uses these tools to repair or replace the damaged structures within the shoulder.
Recovery from shoulder surgery varies depending on the type of procedure performed but typically involves wearing a sling, followed by physiotherapy to regain strength and mobility. Full recovery may require several weeks to months, with restrictions on heavy labour and contact sports for a period. The effectiveness of the surgery is often dependent on the patient's adherence to post-operative care and rehabilitation.
This surgery also utilizes arthroscopy - a minimally invasive surgical procedure where an examination and sometimes treatment is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Alleviating the need for open surgery.
The surgeon inserts a camera and specialized instruments through small incisions around the shoulder to reattach torn tendons to the humerus. This procedure is critical for restoring the shoulder's strength and functionality, especially for lifting and overhead activities.
This surgery is designed to alleviate impingement problems in the shoulder. The surgeon uses arthroscopy (a minimally invasive procedure involving small incisions and a camera) to widen the space between the acromion (part of the scapula) and the rotator cuff tendons. This is done to prevent the tendons from being pinched, which can cause pain and limit movement.
This procedure is often necessary following a shoulder dislocation. The surgeon again uses arthroscopy to examine the inside of the shoulder joint and repair any damaged structures, such as torn ligaments. The goal is to stabilize the joint and prevent future dislocations.
Surgical treatment for a bunion, a painful deformity of the bones and joint between the foot and the big toe.
The joint and bones are repaired and stabilized, often under general anaesthesia.
Recovery requires keeping the foot protected, with full recovery taking 3 to 5 weeks. A cast with a hard walking sole may be used for mobility during recovery.
A deformity in the second, third, or fourth toes where the toe is bent at the middle joint.
Resulting from improper fitting shoes or muscle imbalance.
Can become fixed and require surgery if left untreated. Surgery is needed to correct the deformity.
A form of degenerative arthritis at the base of the big toe, causing stiffness and pain.
Difficulty in movements, swelling, inflammation, and pain even at rest in advanced stages.
Addressing biomechanical and structural abnormalities, and in severe cases, surgery may be required.
Connects the calf muscle to the heel bone and is crucial for walking, running, and jumping.
Tendonitis (inflammation) or rupture.
Surgical reattachment or sewing of the tendon ends, followed by casting. Non-operative treatment includes casting until healing is complete.
Used for treating degenerative arthritis in the ankle joint.
Removal of ankle joint surfaces and allowing the tibia and talus to fuse.
Involves significant swelling, use of a plaster cast for 3-4 months, and gradual weight-bearing rehabilitation.
Minimally invasive procedure for diagnosing and treating ankle disorders.
Small incisions for a pencil slim camera to view inside the ankle.
Quick recovery with minimal scarring, often as a day case.
This condition involves excessive pressure on the median nerve within the carpal tunnel in the wrist, leading to symptoms like numbness, tingling, and pain in the hand. Surgical treatment, known as carpal tunnel release, involves making an incision in the wrist to relieve pressure on the nerve. Both open release surgery and endoscopic surgery are options, with recovery taking several months.
Also called tenosynovitis, this is an inflammation of the tendons around the wrist joint. The condition causes pain and swelling over the inflamed area. Treatment focuses on reducing inflammation and pain, sometimes requiring surgery if the condition is severe or persistent.
This surgery treats Dupuytren's contracture, where the fascia under the skin of the palm thickens and contracts, preventing the straightening of the fingers. Surgical options include open fasciectomy, where the thickened tissue is cut open and removed, and needle fasciectomy, which uses a needle to cut the tissue under the skin.
This procedure involves the removal of the trapezium bone at the base of the thumb, often due to arthritis. The surgery aims to alleviate pain and improve function, sometimes involving ligament reconstruction.
Trigger finger occurs when a finger's tendon movement is restricted, causing the finger to lock or catch during extension. This condition results from the irritation and thickening of the tendon as it moves through a tunnel in the hand, leading to pain and catching sensations during finger movement. Surgical treatment, aimed at widening the tunnel to ease tendon movement, involves a small incision in the palm. Post-surgery, recovery typically takes about 6 to 8 weeks, with immediate movement of the fingers usually possible.
Trigger finger is most common in the thumb, index finger, and middle finger.
Each of these surgeries addresses distinct conditions affecting the hand and wrist, ranging from nerve compression to tendon inflammation and joint problems. The treatments typically involve a surgical approach followed by a period of recovery and rehabilitation.
Tennis elbow is a condition where the outer part of the elbow becomes painful and tender, often due to strain or overuse. This condition is not limited to tennis players; it can affect anyone who engages in activities involving repetitive wrist movements or elbow lifting, like using road drills or gardening. Symptoms include pain on the outer part of the elbow, discomfort during wrist movements or lifting, and tenderness in the elbow. Pain can also radiate down the forearm. Non-surgical treatments include rest, ice, NSAIDs, and physical therapy. In cases where these treatments are ineffective, surgery might be necessary, which involves removing or repairing the damaged tendon.
Aetiology - Inflammation of the sciatic nerve, usually due to pressure from a herniated disc.
Characteristic Symptoms - Radiating leg pain, numbness, pins-and-needles sensations, and muscle weakness in the leg.
Conservative Treatments - Rest, anti-inflammatory drugs, and muscle relaxants.
Physiotherapy - Targeted exercises to strengthen back muscles.
Surgical Intervention - Considered when conservative treatments fail to provide relief.
Symptomatology - Intense leg pain, abnormal sensations like tingling or numbness, muscle weakness, and in severe cases, bowel or bladder issues.
Conservative Management - Includes medication, rest, and physical therapy.
Microdiscectomy - Removing or trimming the herniated portion of the disc to alleviate nerve compression. Typically carried out under general anaesthesia, through a small incision in the back.
Postoperative Care - Includes pain management, gradual return to activities, and avoiding strenuous movements.
Risks and Complications - Recurrence of disc herniation, potential spinal fluid leaks, and infection.
Degenerative disc disease is characterized by the gradual degeneration of the intervertebral discs Age-related wear and tear of spinal discs, leading to chronic pain.
Surgical Solution - Spinal Fusion
Stabilizes the spine by fusing the affected vertebrae, often using bone grafts or metal implants.
Isthmic or Degenerative Spondylolisthesis - Slippage of a vertebra, typically in the lower back, due to a fracture or degeneration.
Surgical Treatment - removing parts of the vertebra (laminectomy) and fusing the spine to stabilize the affected area.
Causes - Mostly age-related degenerative changes or spinal injuries.
Symptoms - Pain and numbness in extremities, depending on the stenosis location.
Non-Surgical - Physical therapy and medication.
Surgical - Decompressive laminectomy, sometimes accompanied by spinal fusion.
Pathophysiology - Dysfunction of nerve roots in the cauda equina, often due to severe disc herniation.
Signs and Symptoms - Severe lower back pain, loss of sensation, bladder, bowel, and sexual dysfunction.
Treatment Urgency - Immediate surgical intervention is often necessary.
Neuro-regeneration refers to the regrowth or repair of nervous tissues, cells or cell products. Such mechanisms may include generation of new neurons, glia, axons, myelin, or synapses. When an axon is damaged, the distal segment undergoes Wallerian degeneration, losing its myelin sheath.
Regeneration Potential is dependent on the duration and extent of nerve compression.
Nerve Asleep - Temporary shutdown due to pressure, reversible upon decompression.
Axon Damage - Can regrow if the myelin sheath is intact.
Severe Damage - Regeneration unlikely if both axon and myelin sheath are damaged.
Scoliosis is a medical condition characterized by an abnormal lateral (sideways) curvature of the spine. It can affect people of any age, but it most commonly occurs during the growth spurt just before puberty. The causes, symptoms, and treatment options can vary between children and adults, reflecting differences in the severity, progression, and impact of the condition.
In many cases, the cause of scoliosis is unknown (idiopathic), especially in children and adolescents. However, some scoliosis cases are associated with neuromuscular conditions (such as cerebral palsy or muscular dystrophy), birth defects affecting the development of the bones of the spine, and injuries or infections of the spine.
Treatment for scoliosis is highly individualized and depends on factors such as the severity of the curve, the cause, and whether the curve is worsening, as well as the age and physical condition of the patient.
Symptoms can vary widely in severity, from mild to severe, and may include:
For adults, treatment often focuses on relieving symptoms rather than correcting the curve, as the spine is no longer growing. This can include pain management strategies, physical therapy, and in some cases, surgery.
It's essential for individuals with scoliosis or parents of children with scoliosis to work closely with healthcare professionals to monitor the condition and decide on the best treatment plan. Early detection and treatment can be key to preventing severe complications and improving quality of life.
Orthopedic surgery is the branch of surgery focused on treating conditions and injuries related to the musculoskeletal system. Patients considering orthopedic surgery often have questions about the procedure, recovery, and expected outcomes. Here are some of the most common frequently asked questions (FAQs) -
When Is Orthopedic Surgery Recommended?
Orthopedic surgery may be necessary for severe joint pain, arthritis, injuries limiting daily activities, degenerative diseases, or conditions unimproved by other treatments. Its goal is to alleviate pain, enhance function, and improve mobility and quality of life. Generally if you notice that your mobility is restricted you should seek a medical opinion.
How Should I Prepare for Orthopedic Surgery?
Prior to booking we will require you to complete a detailed Medical History Questionnaire (MHQ). This will give the consultant surgeon an indication as to whether you are a suitable candidate for surgery. Preparation involves consultation, understanding the surgery, and pre-surgery assessments including x-rays and blood tests. During your consultation with the Surgeon you will be able to ask questions and discuss any concerns. Pre-surgical physical therapy might also be recommended.
How Long is the Hospital Stay Duration Post-Surgery?
Stay varies by procedure, age and condition of the patient. Our partner hospitals skilled surgeons will have you out and about as soon as possible, physiotherapists will bring you to a good level of mobility and fitness prior to you leaving the hospital facility. In some cases you may elect to stay nearby and continue further physiotherapy prior to returning home.
What Post-Surgery Expectations should I have?
Post-operative care includes pain management, wound care, and physiotherapy to regain strength and mobility. Initial discomfort is normal but improves gradually with comprehensive care. It should be noted that in comparable cases DHI clients have returned to active sports such as tennis and golf weeks, and in some cases months, prior to patients treated in the other facilities. This is due to a combination of factors, highly skilled surgeons, advanced prosthetics, and excellent modern facilities and equipment.
What Are the Risks of Orthopedic Surgery?
Risks may include infection, blood clots, and reactions to anaesthesia. Hospitals employ measures like low-weight heparin and strict blood screening to minimize these risks. When traveling home by air low-weight heparin can be administered before the flight.
What Types of Prostheses are Used?
Hospitals prefer Zimmer orthopedics prosthesis for their durability, available in both cemented and cement-less options, tailored to patient needs. Surgeons in our partner facilities have a choice of hundreds of different types and sizes and will fit an exact size and best matched unit often chosen and measured with a Zimmer engineer present, unlike some government healthcare systems where surgeons just have half a dozen sizes to choose from.
Are there Alternatives to Joint Replacement?
Alternatives may include medications, physical therapy, or less invasive surgeries, depending on the severity and impact of the condition.
Is Delaying Surgery Risky?
Surgery delays certainly worsen the condition, it is important to get surgery as soon as possible, particularly in the case of knee and hip joints. Continued use (walking etc), when surgery is required will likely increase the duration hospital, make the surgery more difficult and complex, increase recovery time, and physiotherapy required, as well as reduce the likelihood of a very successful outcome with excellent mobility post surgery. Timing should be carefully considered, based on your health, symptom severity, and personal circumstances. If you are aware that you need joint replacement please act as soon as possible.
Will I need to make any lifestyle changes after the surgery to maintain the results?
There should be no need to expect to make any lifestyle changes after the results and indeed it is likely that previous lost mobility will return improving lifestyle.
What is the Duration of Physiotherapy After Surgery?
Physiotherapy, lasting a few days and sometimes weeks, is important for restoring mobility, strength, and function, tailored to your recovery and procedure. Your physiotherapist will give you exercises to do at home.
How long will my new Joint Replacements Last?
Joint replacements can last 20 to 25 years. Longevity can be maximized by adhering to recommended activity levels, maintaining a healthy weight, and engaging in regular, tailored physical therapy or exercise.
How soon after surgery can I drive or return to work?
This depends on the type of surgery, the level of degeneration prior to surgery and your general health and age. Generally our clients return to normal activity after a few weeks.
Will I need assistance or support from family members or caregivers during my recovery?
Most of our clients are single often elderly people who do not have family support available. They are able to manage without any significant problems.