Orthopedic Clinic

Profile

The Orthopaedic Clinic of Nicosia General Hospital is currently the largest and best-organised orthopaedic clinic in Cyprus. It serves as a referral centre for many challenging orthopaedic cases from both the public and private sectors.

The clinic is staffed by 9 orthopaedic specialists and offers 6 resident doctor positions. It has been providing training for orthopaedic specialist training and undergraduate medical students for approximately 20 and 10 years, respectively. Many Cypriot orthopaedics have completed their specialisation at Nicosia General Hospital.

The clinic comprises two wards: Orthopaedic Ward A with 30 beds and Orthopaedic Ward B with 28 beds.

It operates on a daily basis to address emergencies arriving at the Accident and Emergency Department of the hospital. Currently, it has eight operating rooms for regular operations in the mornings and 18 outpatient clinics per week during working hours. Three afternoon clinics operate each week. The clinic serves over 9000 patients annually in the outpatient clinics.

On an annual average, about 1400 patients are hospitalised in the clinic, and more than 1200 major surgical interventions are performed, as well as a significant number of minor surgeries.

AREAS OF SPECIALIZATION

Our clinic can handle almost all cases related to the field of orthopaedics, mostly directly by our physicians or, when needed, with the collaboration of our associates. Our doctors undertake general orthopaedic cases and specialise in various areas of the field

Coverage is provided in the following areas/sub-specializations of orthopaedics:

General Orthopaedics:

All the doctors in our clinic examine patients with common orthopaedic problems, such as musculoskeletal pain (i.e., pain in bones, muscles, and joints) and other injuries and disorders of the musculoskeletal system. The most common conditions we encounter in general orthopaedics are low back, spinal and joint pain. Additionally, chronic conditions such as hip osteoarthritis, knee osteoarthritis, and arthritis in other joints are common reasons for patients to visit the orthopaedic clinic. Musculoskeletal injuries of varying severity, including sprains, tendon ruptures, fractures, and follow-up care for patients who have undergone surgical treatment or are managed conservatively for bone fractures.  Common fractures undergoing conservative treatment are distal radius and hip fractures, among others.

Emergency Orthopaedic Care – Traumatology:

The clinic operates on a 24-hour basis, covering the Emergency Department, with an on-call schedule.

Fractures of upper and lower limbs, pelvis, and spine, open fractures, limp injuries, muscle lacerations, tendon and peripheral nerve injuries, polytrauma are just a few examples of cases that are treated, hospitalised, or operated on in the Clinic, on a daily basis.

Image 1: Management of comminuted supracondylar femoral fracture

Image 2: Management of comminuted fracture-dislocation of the shoulder with reverse shoulder arthroplasty

Image 3: Management of open tibia fracture in a child

Total Joint Replacement:

The degeneration of articular cartilage in the hip, knee, or shoulder (due to arthritis, rheumatic diseases, old fractures, or congenital abnormalities) are common conditions. The modern approach in managing damaged joints is their total replacement, an approach that since its establishment has allowed our patients to alleviate pain and promptly return to their daily activities. The doctors in our clinic have extensive experience in performing total hip, knee, and shoulder replacements. To this effect, we have access to and can use all available implants in the Cypriot market.

We are capable of performing knee surgeries with personalised preoperative planning and the use of personalised osteotomy tools, specially designed for each patient’s anatomy. Our results are comparable to those of international reference centres of the field.

Besides primary total joint arthroplasties, our clinic can handle complications that may arise after total joint replacements. We address complex complications, such as infections of joint arthroplasties, loosening and degradation of materials, which may require follow-up joint replacement procedures, as well as periprosthetic fractures.

Image 4: Management of hip osteoarthritis with total hip replacement

Image 5: Management of knee osteoarthritis with total knee replacement

Image 6: Management of central dislocation after hip replacement

Image 7: Management of periprosthetic femoral fracture in bipolar hemiarthroplasty.

Shoulder and Sports Injuries:

Shoulder disorders and sports injuries are among the most common conditions treated in our clinic, utilising both arthroscopic and open approaches.

Examples include, rotator cuff tears, recurrent dislocations, and shoulder instability, complex shoulder fractures and glenohumeral osteoarthritis, and interventions involving total shoulder replacement or reverse total shoulder replacement.

With the aid of our state-of-the-art arthroscopic equipment, we have in our disposal, we can perform our highly effective procedures at the highest level of safety.

Additionally, we treat other sports-related conditions and injuries. Some of the most common arthroscopic procedures we perform include the repair of the anterior cruciate ligament tears, meniscus suture, partial meniscectomy, restoration of cartilage defects, and other cartilage injuries.

Beyond common sports injuries, our clinic has experience in managing severe knee injuries, such as knee dislocations with multiple ligament and tendon tears, meniscal tears with concurrent fractures, vascular and nerve injuries, and skin defects, requiring multidisciplinary treatment by various specialties at the General Hospital of Nicosia.

Image 8: Management of massive rotator cuff tear using a subacromial balloon.

Image 9: Management of supraspinatus tendon tear of the shoulder with arthroscopic suture.

Image 10: Management of anterior cruciate ligament tear of the knee with autograft from hamstrings tendons.

Foot and Ankle Surgery:

The foot and ankle surgery unit handles injuries and other conditions affecting the ankle and the peripheral region.

Among the traumatic injuries that this department addresses are complex fractures of the ankle and foot, such as Pilon fractures with intra-articular comminution, fractures and dislocations of the talus and/or calcaneus, fractures and dislocations of the tarsus, and severe soft tissue injuries of the foot.

Chronic conditions treated by the department include deformities of the toes and feet, such as hallux valgus (bunion), hallux rigidus (arthritis of the big toe), metatarsalgia, hammertoes, claw toes, flatfoot, nerve entrapment syndromes like tarsal tunnel syndrome, as well as Morton’s neuroma. Advanced ankle and hindfoot arthritis are also managed, involving complex hindfoot fusions or ankle arthroplasty. Additionally, ankle arthroscopy is performed to address intra-articular pathological conditions, such as osteochondritis of the talus, and more.

Image 11: Management of toe deformities with osteotomies.

Image 12: Arthroscopic treatment of cartilage defect of the talus.

Hand Surgery – Microsurgery:

The hand and microsurgery team at our clinic deals with both acute and chronic cases.

The most common procedures for chronic conditions include decompression of the median and ulnar nerves at the elbow and distal forearm, treatment of arthritis of the base of the thumb, partial wrist arthrodesis in carpal osteoarthritis, and restoration of scaphoid nonunion using vascularized autograft.

Some of the urgent cases handled by this department involve tendon, nerve, and vessel repairs, as well as osteosynthesis of wrist and hand fractures. Additionally, the clinic performs revascularization for finger replantation and shaping of defects and coverage of skin defects in collaboration with the Plastic Surgery Clinic of the General Hospital of Nicosia.

Osteoporosis:

Osteoporosis is a common problem that mainly affects postmenopausal women. However, it can affect people of all ages and genders and requires timely diagnosis and management. Our specialised doctors can guide you in prevention, diagnosis, and treatment of osteoporosis.

Paediatric Orthopaedics:

Paediatric orthopaedic issues can arise even before birth. Paediatric orthopaedics deal with all musculoskeletal conditions in young patients.

Congenital hip and limb dysplasia, osteochondritis, scoliosis, kyphosis, cerebral palsy, epiphyseolysis, bone fractures from birth to adulthood, are within the scope of the paediatric orthopaedic department.

Image 13: Management of epiphyseolysis of the femoral head in a child.