Orthopaedic Surgery

Consultant orthopaedic surgeon Dr. Alf Neuhaus has more than 20 years experience in the treatment of the ‘usual’ bone and joint pathologies, from neck and back pain, to joint problems and soft tissue (muscles, tendons, ligaments) diseases. Any conservative treatment can usually be initiated immediately. Any surgical procedure that would only require local anaesthetics could also be performed using the facilities of Clinica SANDALF. In case a general anaesthetic or epidural anaesthetic is needed for the surgical procedure orthopaedic surgeon Dr. Alf Neuhaus would perform those in a nearby private hospital. In particular the treatment of arthritis – osteoarthritis, rheumatoid arthritis, Gout – and hand and foot surgery problems are some of his main specialties.

Neck-Back Pain

Twisting your back, pinching a nerve, back ache due to over use or bad posture, neck stiffness and headaches are only some of the problems treated by orthopaedic surgeon Dr. Alf Neuhaus. Taking all the time needed to get through the relevant medical history and performing a thorough clinical exploration are the key factors to establish a diagnosis. Radiographic and ultrasound images are often used to confirm this diagnosis and/ or to exclude other possible reasons for the pain. In most cases the appropriate treatment can be initiated immediately, which could be anti-inflammatory medication in form of tablets, direct infiltration of the inflamed nerve or epidural injection. Physiotherapy, osteopathic mobilizations, massage techniques and acupuncture are frequently added.

Surgical procedures like nerve decompression or removal of a herniated disc are rarely needed, but would be performed by orthopaedic surgeon Dr. Alf Neuhaus in a nearby private hospital. Please click here to make an appointment.

Arthritis

The degeneration of a joint – arthritis – is part of the aging process and can, if left unattended, result in a completely worn out joint, leaving surgical replacement or fusion of the effected joint as the only treatment option. But if treated in the beginning or only moderate stage of arthritic changes, several approaches can help to reduce the pain and increase mobility. Special exercise program, developed and supervised by our UK trained physiotherapist, lymph drainage to reduce swelling. Furthermore anti-inflammatory medication either as tablets or direct joint infiltration can help to reduce the pain. Another option is joint aspiration, and infiltration with Hyaluronic Acid – comparable with a WD40 for joints – which is often and very successfully used by orthopaedic surgeon Dr. Alf Neuhaus. Whenever needed these injections would be done guided by either radiological or ultrasound images.

If the conservative treatment seems ineffective a surgical procedure might be indicated, which could be arthroscopic clean out, partial or even total joint replacement of the joint. The appropriate procedure would be discussed with you and performed in a nearby private hospital.

Read a recent article about Arthritis by orthopaedic surgeon Dr. Alf Neuhaus in our Health News section. If you wish to make an appointment please click here.

Osteoporosis

One in two women, and one in five men, over 60 will, statistically, suffer from osteoporosis. Of those 1 in 5 will sustain a bone fracture due to this disease. It silently makes the bone structure thinner, become fragile and eventually give way without any adequate trauma (sneezing, coughing, etc.). The only way to detect osteoporosis is performing a bone density measurement – available at Clinica SANDALF – and start treatment accordingly. If treated in time the disasters outcome of osteoporosis can be prevented. The bone most often effected are the spinal vertebrae, and the result could be the unpredictable and complete collapse of one or even more of those effected vertebrae. In most cases proper pain killing medication and very gentle exercises and mobilization can keep those patients going. But in some cases it might be necessary to perform a special type of  back surgery (Cyphoplastic), in which the collapsed vertebra would be filled up and stabilized with a special bone cement. If you would like to know more about the treatment of osteoporosis please get in touch with us.

Rheuma – Gout

Rheumatoid Arthritis (‘Rheuma’) and Gout are, besides the osteoarthritis, two of the most common diseases that affect joints in general. They can, if untreated, lead to the complete destruction of the joint. Both diseases are hereditary, ‘rheuma’ effecting both men and women almost equally, meanwhile gout statistically is found 5 times more often in men than in women over the age of 50. Many external factors like smoking, alcohol consume, diet, life style and lag of exercises play an important role in how severe the disease might turn out. Being a genetic problem they unfortunately cannot be cured. But modern medicine has found ways to control them and make life with them much more enjoyable. The different treatment options would be discussed by orthopaedic surgeon Dr. Alf Neuhaus with you, a long term treatment schedule will be developed and frequent check- ups and tests would confirm the success of the treatment or indicate the need to readjust it. Special physiotherapeutic exercises, massage and osteopathic mobilization techniques might be used to mobilize those joints. Furthermore other cooperating medical specialist would be consulted to elaborate the best treatment options. Should you have any questions regarding rheuma or gout please contact us.

Key Hole Surgery / Arthroscopy

Arthroscopy – key hole surgery – is a surgical procedure that has developed rapidly in the last 20 years or so, allowing the surgeon to look inside a joint (usually knee, hip, ankle, shoulder, elbow) using a probe attached to a camera/ screen. Most of the arthroscopies can be done as day case surgery, meaning that you would be admitted by orthopaedic surgeon Dr. Alf Neuhaus to a private hospital in the morning and be ‘back on your sofa’ in the evening. The most often performed arthroscopic procedure is done on the knee to repair meniscal defects, remove cartilage damage or wash the joint out. Similar procedures are performed at other major joints like the hip, ankle or shoulder. The obvious advantage is that the joint is cleaned from any damaged parts, the patient would go home the same day and be able to use the operated joint fully weight bearing. The small skin cuts to introduce the instruments and the very short hospital stay reduce the possible infection rate dramatically.  The results of the surgery will be discussed with you during the post- operative consultations in our out- patient clinic. Further treatment consequences will be planed and initiated. Please contact us for more information regarding arthroscopic procedures.

Joint Replacements

Joint replacement is a major orthopaedic surgical procedure and therefor usually ‘the end of the line’ of treatment of a painful and worn out joint. Sometimes, when all other treatment options like standard medication, physiotherapy, special massage techniques and alternative approaches like Yoga don’t deal with the pain caused by the worn out joint, or the pain simply gets unbearable, the only solution might be the replacement of the arthritic joint by an artificial one. The by far most often replaced joints are the knees and hips, followed by shoulder and ankle. Orthopaedic surgeon Dr. Alf Neuhaus would perform a joint replacement procedure in a nearby private hospital, either under general or epidural anaesthetics. Rehabilitation by our UK trained physiotherapist would start sometimes even in the afternoon of the day of surgery. Hospital stay should be no more than 3 – 4 days. Four to six weeks later you should be back to normal daily activities, pain free. And you should even be back to sports activities like playing a round of golf or similar within three month.

For more information about joint replacement please click here. 

Spine – Surgery

The outcome of spinal surgery, at the neck or the back, has improved significantly in the last 20 years or so, due to more sophisticated imaging devices (MRI scans), new surgical techniques, better surgical equipment and, probably the most important, appropriate selection of patients who might benefit from this type of surgery. The most often performed surgical procedure at the spine is a so called decompression, meaning taking away structures that might ‘press’ on the nerve responsible for the pain. In rare occasions it might be necessary to even fuse a small part of the spine.

Spinal surgery should only performed if all other treatment options – physiotherapy, medication, infiltration including epidural, massage techniques, osteopathic treatments – have failed to improve the symptoms. The exception could be fractures of a vertebra, due to osteoporosis or trauma, in which case an immediate surgical procedure might be indicated to stabilize the broken vertebra. Another reason to initiate this surgical procedure rather sooner then later would be the existence of neurological symptoms, like not being able to hold the urine. Orthopaedic surgeon Dr. Alf Neuhaus would perform this surgical procedure under general anaesthetics, and hospital stay would be 2-3 days. You might have to wear a protective lumbar corset for a few weeks, but would be allowed to mobilize full weight bearing from day one on. The post- operative rehabilitation and wound care would be done in the facilities of Clinica SANDALF following discharge from the hospital. Total recovery, including initiation of gentle sports like swimming, stationary bike or golf, would be achieved by 10-12 weeks after the surgery. Please don’t hesitate to get in touch with us should you have any further questions or to make an appointment.

Hand Surgery

Carpal tunnel syndrome and ‘trigger finger’ are two very well-known and frequent medical conditions of the hand. The first one causing numbness and pain in some of the fingers. The later one making a finger get stuck in flexion when trying to open the fist. In the early stages of a carpal tunnel, when there is no pain yet and the numbness only appears in certain positions of the hand or at night, orthopaedic surgeon Dr. Alf Neuhaus would initiated the treatment with a night splint for the wrist and an injection with local anaesthetics and Cortisone into the effected carpal tunnel. In case of a ‘trigger finger’ injections are not recommended as they are baring the risk of damaging the tendon. ‘Trigger finger’ and the advanced stage of carpal tunnel are treated surgically under local anaesthetics. Orthopaedic surgeon Dr. Alf Neuhaus is performing these procedures using the facilities of Clinica SANDALF, no hospital stay is needed and the patient would be back home within a couple of hours. The symptoms are usually gone immediately after the surgery, the hand can be used almost normal and stitches would be removed after 10-12 days.

More complicate conditions like Dupuytren’s disease or severe arthritis of finger joints, would be operated by orthopaedic surgeon Dr. Alf Neuhaus, who had been trained in hand surgery, in a nearby private hospital. It would require a 1-2 days hospital stay. All the follow up consultations for wound care, suture removal and hand therapy would be done in the facilities of Clinica SANDALF. 

Please don´t hesitate to get in touch with us for more information or to make an appointment with orthopaedic surgeon Dr. Alf Neuhaus.

Foot Surgery

Some ‘minor’ conditions like ingrown toe nail or hammer/ claw toe can be very uncomfortable, but can be dealt with by a small surgical procedure done under local anaesthetics. Orthopaedic surgeon Dr. Alf Neuhaus would use the facilities available in Clinica SANDALF and the patient would walk out within a couple of hours, although obviously not able to drive a car. All follow up consultations regarding wound care and suture removal would be done in Clinica SANDALF. You should be ‘back to normal’, including sport activities, within 2-3 weeks. Other medical conditions like the tarsal tunnel syndrome or Morton’s neuroma, both involving nerve inflammations, can often be treated conservatively with anti- inflammatory medications, or direct infiltration with Cortisone, temporary splinting or insoles, special massage techniques and physiotherapeutic gait education. Should these pathologies need surgical attentions, the procedure would be performed by orthopaedic surgeon Dr. Alf Neuhaus in a nearby private hospital, as a day case or including 1-2 days hospital stay.

Hallux valgus is another very common problem of the foot, with the big toe ‘moving’ towards the other toes, sometimes even crossing over the next one. A surgical re- alignment, involving a bone procedure for re- positioning and re- alignment, is usually needed. The foot will be immobilized in a special boot for 6 weeks, allowing partial weight bearing for the first three weeks, and fully weight bearing for the following three weeks. Total hospital stay should not be longer then 2 days. Returning to normal gait immediately following removal of the Aircast boot, including none- running sports like walking or playing golf. Please get in touch for further information.

The Private Hospital

The private hospital used by UK-trained orthopaedic and trauma surgeon Dr. Alf Neuhaus is about 10 minutes’ drive away from his out- patient clinic Clinica SANDALF. This modern and fully equipped private hospital has all facilities needed, 4 state of the art operating theatres, intensive care unit and 24h on-call medical staff and physicians. All rooms are equipped with TV (Spanish, English, German), WiFi and an on-suite bathroom.

The friendly and helpful staff speaks English, and orthopaedic surgeon Dr. Alf Neuhaus and his UK-trained physiotherapists will come in every day of your stay to look after you (wound control, pain medication, arranging further tests if needed, joint mobilization, etc.) until discharge. All further follow up consultations would be performed in the facilities of Clinica SANDALF.