Start with what you need treated.

Osteotomy surgically cuts a bone, usually near a joint, and repositions it to correct malalignment, which can help relieve pain by redistributing weight-bearing forces more evenly across a joint, particularly useful in early to moderate arthritis affecting only one part of a joint, or to correct significant deformity affecting a limb's overall alignment. The surgeon precisely plans the angle and amount of bone repositioning needed based on detailed imaging, then secures the newly aligned bone in its corrected position using plates, screws, or other hardware while the bone heals in its new alignment. The procedure is performed under general or regional anesthesia and typically takes one to two hours depending on the specific joint and complexity of the correction needed. Patients generally require a period of limited weight-bearing while the osteotomy heals, monitored with follow-up X-rays, followed by physical therapy to restore strength and function. This procedure can be particularly valuable for younger, active patients with early arthritis affecting only part of a joint, as it can significantly relieve pain and potentially delay the need for a full joint replacement by many years.

Pelvic reconstructive surgery addresses significant damage to the pelvic bones, which can result from high-energy trauma such as a serious car accident, removal of a tumor affecting the pelvic bones, or congenital abnormalities affecting pelvic structure, requiring careful surgical planning to restore both the structural stability of the pelvis and its important functional roles in supporting the spine, hips, and pelvic organs. Depending on the specific damage, the reconstruction may involve plates, screws, bone grafts, or specialized implants to rebuild and stabilize the pelvic bones, often requiring a highly individualized surgical approach given the complexity and variability of pelvic injuries and defects. The procedure is performed under general anesthesia and can take several hours given the complexity typically involved in these cases. Recovery is often prolonged, given the severity of the underlying condition necessitating this surgery, with an extended period of limited weight-bearing and comprehensive rehabilitation needed to regain function. A multidisciplinary team, often including orthopedic and sometimes other surgical specialists depending on the underlying cause, coordinates the complex treatment and recovery process for these challenging cases.

PCL reconstruction surgically replaces a torn posterior cruciate ligament, one of the key stabilizing ligaments of the knee that is less commonly injured than the ACL but can result in significant knee instability when severely torn, using a graft taken from the patient's own tissue or from a donor. Using arthroscopic, minimally invasive technique, the surgeon creates precise tunnels in the thigh and shin bones and threads the graft through these tunnels, carefully securing it in a position that recreates the function of the original PCL and restores knee stability. The procedure is performed under regional nerve block or general anesthesia and typically takes one and a half to two and a half hours, often slightly more technically demanding than ACL reconstruction given the ligament's anatomical location. A structured, carefully progressed physical therapy program is essential following surgery, typically with a somewhat more cautious initial rehabilitation approach compared to ACL reconstruction to protect the healing graft. Most patients experience significantly improved knee stability, with return to sports and full activity generally taking six to nine months or longer following successful reconstruction and dedicated rehabilitation.

Revision ACL reconstruction is performed when a previous ACL reconstruction has failed, either due to re-injury causing the graft to tear again, improper initial graft placement, or graft loosening over time, requiring removal of the failed graft and any associated hardware before placing a new graft to restore knee stability. This is generally a more complex procedure than a first-time ACL reconstruction, often requiring careful evaluation of why the original surgery failed, sometimes needing bone grafting to address enlarged tunnels from the previous surgery, and potentially using a different graft source than was used originally. The procedure is performed under regional nerve block or general anesthesia using arthroscopic technique, typically taking longer than a primary ACL reconstruction given the added complexity, often two to three hours. Rehabilitation following revision surgery is generally more cautious and prolonged compared to primary ACL reconstruction, reflecting the more complex nature of the surgery and the goal of protecting the new graft as thoroughly as possible. While outcomes following revision surgery are generally good, they are typically somewhat less predictable than primary ACL reconstruction, with return to sports and full activity often taking nine months to a year or longer.

Revision hip replacement is performed when a previous hip replacement has failed due to implant wear, loosening, dislocation, infection, or fracture around the implant, requiring removal of the original implant components and replacement with new prosthetics, often needing specialized revision implants and sometimes bone grafting to address bone loss that has occurred around the failed implant over time. This is generally a more complex and technically demanding surgery than a first-time hip replacement, given the presence of scar tissue from previous surgery and, in many cases, significant bone loss requiring careful reconstruction to ensure a stable, durable new implant. The procedure is performed under spinal or general anesthesia and typically takes longer than a primary hip replacement, often two to four hours or more depending on the complexity of the revision required. If infection is the cause of implant failure, treatment may need to occur in stages, first removing the infected implant and treating the infection with a course of antibiotics, followed by a second surgery to place the new implant once the infection has cleared. Recovery from revision surgery is generally more prolonged than after primary hip replacement, with dedicated physical therapy playing a crucial role in optimizing the functional outcome.

Revision shoulder replacement is performed when a previous shoulder replacement has failed due to implant loosening, wear, instability, rotator cuff failure, or infection, requiring removal of the original implant components and replacement with new prosthetics, sometimes needing specialized revision implants to address bone loss or soft tissue deficiencies that have developed around the failed implant. This surgery is generally more complex than a first-time shoulder replacement, given the presence of scar tissue from previous surgery and often compromised soft tissue and bone quality that need to be carefully addressed to achieve a stable, functional new implant. The procedure is performed under regional nerve block or general anesthesia and typically takes longer than a primary shoulder replacement, often two to three hours or more depending on the complexity of the revision required. If infection is the underlying cause, treatment may need to occur in stages, first removing the infected implant and treating the infection with antibiotics, followed by a second surgery for the new implant once the infection has resolved. Recovery from revision surgery is generally more prolonged, with structured physical therapy important for optimizing shoulder function, though outcomes are typically somewhat more variable than with primary shoulder replacement given the more complex starting point.

Shoulder replacement surgery resurfaces or replaces the damaged ball-and-socket components of the shoulder joint with an artificial implant, addressing severe arthritis, complex fractures, or rotator cuff-related joint damage that has not responded to conservative treatment. Depending on the specific condition and the health of the surrounding rotator cuff tendons, the surgeon may perform a standard shoulder replacement, or in cases where the rotator cuff is significantly damaged, a specialized reverse shoulder replacement, which uses a different implant configuration that relies on different shoulder muscles to achieve good function. The procedure is performed under regional nerve block or general anesthesia and typically takes one and a half to two and a half hours. A sling is worn for a period after surgery to protect the healing repair, with a carefully structured physical therapy program beginning soon after surgery to gradually restore shoulder motion and strength. Most patients experience substantial pain relief and significantly improved shoulder function, with the specific type of implant used tailored to each patient's individual shoulder condition and rotator cuff status to optimize their functional outcome.

Tetralogy of Fallot (TOF) repair corrects a combination of four related heart defects, including a hole between the ventricles and narrowing of the pulmonary valve area, which together cause oxygen-poor blood to be pumped to the body, resulting in the bluish skin discoloration characteristic of this condition. The surgeon closes the ventricular septal defect with a patch and relieves the narrowing obstructing blood flow to the lungs, sometimes requiring a patch to enlarge the pulmonary valve area, restoring normal blood flow patterns through the heart. This complex operation is performed under general anesthesia using cardiopulmonary bypass, typically taking three to five hours, usually performed within the first year of life. The child requires close monitoring in a pediatric cardiac intensive care unit immediately after surgery, with careful attention to heart rhythm and function during recovery. Long-term outcomes following TOF repair are generally excellent, with most children going on to lead normal, active lives. Lifelong cardiology follow-up is recommended to monitor pulmonary valve function, as some patients may eventually need a valve replacement procedure many years later.

Clubfoot treatment most commonly uses the Ponseti method, a highly effective, non-surgical approach that begins shortly after birth, involving a series of gentle manipulations and plaster casts applied weekly over about six to eight weeks to gradually correct the foot's abnormal position. This is often followed by a minor procedure to release a tight heel cord (Achilles tendon), performed under local anesthesia, and then a bracing protocol using special shoes connected by a bar, worn full-time initially and then part-time until around age four to five, to maintain the correction as the child grows. For the small proportion of cases that do not respond adequately to casting, or that relapse despite treatment, more extensive surgery may be needed to further correct the foot's position, performed under general anesthesia. Regular follow-up visits throughout early childhood monitor the foot's continued correct alignment and function as the child grows and becomes more active. With appropriate treatment, particularly when started early using the Ponseti method, the vast majority of children with clubfoot achieve a flexible, functional, pain-free foot allowing normal walking, running, and participation in sports and other activities.

Pediatric hip dysplasia surgery corrects an abnormally shallow or malformed hip socket that has not adequately developed to cover and stabilize the ball of the thigh bone, a condition that if left untreated can lead to hip instability, abnormal gait, and early arthritis later in life. While many cases of hip dysplasia diagnosed in early infancy can be successfully treated with a special harness or brace alone, cases diagnosed later or those not responding to bracing may require surgical correction, ranging from a closed reduction with casting to more extensive open surgery to reposition the hip joint and reshape the socket (osteotomy) for older children with more established dysplasia. The procedure is performed under general anesthesia, with duration and complexity varying based on the child's age and the severity of the dysplasia. Following surgery, a cast is typically applied for several weeks to maintain the corrected hip position while healing occurs. Regular follow-up throughout childhood monitors the hip's continued proper development, with the vast majority of children achieving a stable, well-functioning hip joint when the condition is identified and treated appropriately.

Pediatric inguinal hernia repair closes a weakness or opening in the groin muscle wall through which abdominal contents, such as a loop of intestine, can protrude, creating a visible and sometimes uncomfortable bulge, a relatively common condition in infants and young children, particularly boys, due to incomplete closure of a normal developmental structure. The surgeon repairs the defect either through a small incision directly over the hernia or using laparoscopic technique with tiny incisions and a camera, both approaches effectively closing the weak area to prevent the abdominal contents from protruding again. The procedure is performed under general anesthesia and typically takes 30 to 45 minutes for a single-sided hernia. Most children recover quickly, going home the same day and returning to normal activity, including school, within about a week, with activity restrictions to protect the healing incision for a few weeks. Hernia repair in children is a very safe, routine procedure with an excellent success rate and low complication rate. Prompt treatment is generally recommended once a hernia is identified, since there is a risk of the protruding tissue becoming trapped (incarcerated) if left untreated.

Lung cancer treatment is carefully individualized based on the specific type, whether non-small cell or small cell lung cancer, the stage at diagnosis, and increasingly, the molecular and genetic characteristics of the tumor identified through specialized testing, which can guide the use of targeted therapies designed to attack specific features of the cancer cells. For earlier-stage lung cancer confined to the lung, surgical removal of the affected lung tissue, ranging from a smaller wedge resection to removal of an entire lobe or lung, offers the best chance of cure, performed under general anesthesia using either traditional open surgery or minimally invasive techniques. More advanced lung cancer, or cases where surgery is not appropriate, are typically treated with combinations of chemotherapy, radiation therapy, targeted therapy, and immunotherapy, tailored to the specific tumor characteristics and extent of disease. Surgery requires a hospital stay of several days with attention to lung function recovery and pain management, while systemic treatments are generally administered on an outpatient basis over multiple cycles. A multidisciplinary team of thoracic surgeons, medical oncologists, and radiation oncologists coordinates the individualized treatment plan, with regular follow-up monitoring treatment response and watching for recurrence.