Arthroscopic Knee Surgery Hospital Pablo Tobón Uribe

Knee arthroscopy is a surgical procedure that allows doctors to view the knee joint without making a large incision. (cut) through the skin and other soft tissues. Arthroscopy is used to diagnose and treat a wide range of knee problems..

During knee arthroscopy, your surgeon inserts a small camera, called arthroscope, in the knee joint. The camera displays images on a video monitor, and your surgeon uses these images to guide miniature surgical instruments..

Arthroscopic Knee Surgery Hospital Pablo Tobón Uribe

Knee arthroscopy is a surgical technique that can diagnose and treat problems in the knee joint. . During the procedure, your surgeon will make a very small incision and insert a tiny camera, called arthroscope , on his knee. This allows them to see the inside of the joint on a screen.. Later, the surgeon may investigate a problem with the knee and, if required, correct the problem using small instruments inside the arthroscope.

Arthroscopy diagnoses various knee problems, such as a torn meniscus or kneecap (ball joint) misaligned . It can also repair the ligaments of the joint . The risks of the procedure are limited and the prognosis is good for most patients.. Your recovery time and prognosis will depend on the severity of the knee problem and the complexity of the required procedure..

Because the arthroscope and surgical instruments are thin, your surgeon may use very small incisions, instead of the larger incision needed for open surgery. This results in less pain and stiffness in patients' joints and, often, shortens the time needed to recover and return to your favorite activities.

Arthroscopic Knee Surgery bogota
Arthroscopic Knee Surgery

Arthroscopic Knee Surgery Hospital Pablo Tobón Uribe

Arthroscopic knee surgery may be a treatment option for certain types of knee pain . Arthroscopic surgery is a procedure that involves inserting a small camera into the joint. Through other small incisions, instruments can be inserted to repair or remove damaged structures. Arthroscopic knee surgery is often referred to as “knee reach” or knee arthroscopy.

Not all causes of knee pain can be effectively treated with an arthroscopic procedure. Some of the reasons to perform arthroscopic knee surgery include: 1

    • Torn cartilage surgery / meniscus : Meniscectomy is the official name for surgery that involves the removal of a part of the cartilage from the meniscus of the knee joint. The meniscus is a shock-absorbing cartilage wedge that sits between the ends of the bone to provide cushioning and support.. The smallest meniscus tears can usually be trimmed to relieve symptoms of a torn meniscus.
    • Meniscus repair : a meniscus repair is a surgical procedure done to repair the damaged meniscus. Meniscus repair can restore normal knee anatomy and has a better long-term prognosis when successful. However, meniscus repair is a major surgery. Recovery is longer and, due to limited blood supply to the meniscus, meniscus repair is not always possible.
    • ACL Reconstruction : he Anterior cruciate ligament , o LCA, is one of the four main ligaments of the knee. The ACL is essential for the stability of the knee, and people who injure their ACL often complain that their knee sags under them. Thus, many ACL tear patients choose to undergo surgical treatment of this injury. Most ACL surgeries are performed arthroscopically.
    • Escrow split: a plica is a remnant of tissue left over from fetal development. In early development, his knee was divided into separate compartments. Compartment dividers are gradually lost over time, but there are some remains. When this remnant tissue is most prominent, it is called escrow. When the escrow is irritated, is named plica syndrome . A plica resection is performed to remove this irritated tissue. 2
    • Lateral release : the kneecap moves up and down the end of the femur in a groove of cartilage. The kneecap can be pulled out of this groove, or it can even dislocate from the groove, causing pain when bending the knee joint. A lateral release is performed to loosen the ligaments that pull the patella out of the groove. 3
    • Microfracture : the microfracture is a treatment used to stimulate the body to develop new cartilage in an area of ​​damaged cartilage. 4 In a microfracture procedure, the firm outer layer of the bone is penetrated to expose the inner layers of the bone where marrow cells exist. These cells can access the damaged area and fill the space with cartilage..
  • Implantation of autologous chondrocytes : in this procedure, arthroscopic surgery is used to identify areas of cartilage damage and collect cartilage cells. 5 The person's own cells are then grown in the laboratory and reimplanted into the joint in a separate procedure., which is open surgery rather than arthroscopic surgery.
  • Cartilage transfer / OATS : Cartilage transfer involves moving cartilage from healthy parts of the joint to damaged areas. Small cartilage plugs are removed, with a portion of underlying bone, and are transferred to the damaged area. Plugs are taken from areas of the joint where the cartilage surface is not needed.

Why is knee arthroscopy used??

  • Diagnose injuries: knee arthroscopy looks closely for any sore or swollen areas. The camera shows images of soft tissue and damaged bone. The images help your healthcare provider diagnose injuries (or confirm a diagnosis) and plan treatment.
  • Repair of soft tissues and injured bones: if you need surgery to repair tendons, ligaments or cartilage, Specially designed tools are used. The camera displays real-time images that guide your healthcare provider through the procedure. Your health care provider uses tiny tools to repair and rebuild soft tissues by sewing them together. They can also suture (to sew) the bones.
  • Remove damaged or inflamed tissue: some tiny tools help shave off damaged bone and cartilage or inflamed tissue (like the synovial membrane). They use tools to remove these tissues from the knee.

You may need knee arthroscopy if you have:

  • injuries soft tissue: soft tissues include ligaments (connect bones to bones) and tendons (connect muscles to bones). Some of the most common knee injuries are bursitis , meniscus tear , the patellar tendinitis , anterior cruciate ligament tear (ACL tear ) and medial collateral ligament tear (MCL tear) .
  • Fracture: bones may break or chip inside the knee. Sometimes, pieces of cartilage (rubbery tissue that helps bones move against each other smoothly) They can detach when fracture bone .
  • Inflammation : the synovial membrane within a joint can become inflamed (swell and irritate). The synovium is soft tissue inside a joint.. Health care providers call this condition synovitis..

Arthroscopic Knee Surgery Procedure Hospital Pablo Tobón Uribe

Your knee is the largest joint in your body and one of the most complex.. The bones that make up the knee include the lower end of the femur (thigh bone), the upper end of the tibia (shin) and the kneecap (ball joint).

Other important structures that make up the knee joint include:

  • Articular cartilage. The ends of the femur and tibia, and the back of the patella are covered with articular cartilage. This slippery substance helps the knee bones glide smoothly over each other as you bend or straighten your leg..
  • Synovial. The knee joint is surrounded by a thin lining called the synovial membrane.. This lining releases a fluid that lubricates the cartilage and reduces friction during movement..
  • Meniscus. Two wedge-shaped pieces of meniscal cartilage between the femur and tibia act as shock absorbers. Unlike articular cartilage, the meniscus is tough and rubbery to help cushion and stabilize the joint.
  • Ligaments. Bones are connected to other bones by ligaments. The four main ligaments in the knee act like strong cords to hold the bones together and keep the knee stable..
    • The two collateral ligaments are located on either side of the knee..
    • The two cruciate ligaments are found within the knee joint. They cross to form an X with the anterior cruciate ligament in front and the posterior cruciate ligament in back..

Knee Type Joint Replacements

Performing arthroscopic knee surgery

Arthroscopic knee surgery is one of the most common surgical procedures performed by an orthopedist.. A variety of surgical procedures can be performed arthroscopically, using small incisions and minimizing soft tissue damage. Not all surgical procedures can be performed through small incisions, and there are some procedures that can be done better through direct visualization than through an endoscope. Having said that, arthroscopy has tremendous benefits for many types of knee surgery and can help people get back to sports and daily activities much sooner than they used to.

Most knee arthroscopies are outpatient procedures., which means he goes home the same day. They usually take about an hour. Sometimes, knee arthroscopy requires hospitalization (hospitalization procedure).

When you're ready to go home, you'll need someone to drive you. After surgery, will feel some pain. While you recover the first few days after your procedure, must:

  • don't stand up: avoid putting weight on the knee for a few days. You may need crutches or a walker to help you get around.
  • raise the knee: to reduce swelling and relieve pain, rest with leg elevated. Try to keep your knee above your heart.
  • take painkillers: your health care provider may recommend nonsteroidal anti-inflammatory drugs (AINE) over-the-counter or prescription pain relievers. Be sure to follow your health care provider's instructions when taking pain relievers.. You may also need medicine to reduce swelling or prevent blood clots..
  • Keep your incisions covered. Make sure the bandage stays on your knee and keep the area clean. Ask your health care provider when you can remove the bandage, showering or bathing after your procedure.

After you have had time to recover from the procedure, your health care provider may recommend physical therapy (PT). A personalized physical therapy program can help you gain strength and mobility. Your physical therapist will show you special exercises to increase flexibility, strengthen the muscles that support the knee and prevent another injury.

Knee arthroscopy can be performed under anesthesia general , regional o local . After adequate anesthesia, your surgeon will create “portals” to access the knee joint. Portals are placed in specific locations to minimize the chance of nerve injury, surrounding blood vessels and tendons. Through a portal, a camera is placed in the joint and, through others, small instruments can be used to address the problem. Patients who have arthroscopic knee surgery under regional or local anesthesia can often watch their surgery on a monitor to see what is causing their problem..

The length of the knee arthroscopy procedure varies depending on what your health care provider needs to accomplish.. After surgery , your knee will be wrapped with a soft bandage. Depending on the type of surgery performed, your doctor may or may not allow you to put weight on the affected leg. 1 Most patients will work with a physiotherapist to regain movement and strength of the joint. The length of rehabilitation will also vary depending on the procedure being performed at the time of surgery..

Bogota Knee Fracture

Arthroscopic Knee Surgery Procedure Hospital Pablo Tobón Uribe

Knee arthroscopy is a minimally invasive surgical procedure. Healthcare providers use knee arthroscopy to diagnose and treat a variety of knee injuries.. Your health care provider makes a small incision, and then inserts a long, thin tool with a camera on the end. The camera shows images of the inside of your knee, which helps your healthcare provider make a diagnosis of your injury.

Knee arthroscopy is a very common minimally invasive surgical procedure. Minimally invasive procedures require incisions (cortes) smaller than traditional surgery. The incisions are the size of a keyhole.

To treat injuries or structural problems, your health care provider inserts tiny instruments through another incision. They use the tools to repair or remove damaged tissue.

minimally invasive procedures, such as knee arthroscopy, generally require less recovery time than traditional surgery (open). Since you only need a few small dots, you are more likely to recover more quickly than with traditional surgery. You may also have less pain and a lower risk of infection.

Reasons to perform arthroscopic knee surgery

Not all causes of knee pain can be effectively treated with an arthroscopic procedure.. Some of the reasons to perform arthroscopic knee surgery include:

  • Torn Meniscus/Cartilage Surgery : Meniscectomy is the official name of the surgery that involves the removal of a portion of the cartilage of the meniscus of the knee joint.. The meniscus is a shock-absorbing wedge of cartilage that sits between the ends of the bone to provide cushioning and support. The smallest meniscus tears can usually be trimmed to relieve symptoms of a torn meniscus.
  • Meniscus repair : a meniscus repair is a surgical procedure done to repair the damaged meniscus. Meniscus repair can restore normal knee anatomy and has a better long-term prognosis when successful. However, meniscus repair is a more significant surgery. Recovery is longer, due to limited blood supply to the meniscus, meniscus repair is not always possible.
  • ACL Reconstruction : The Anterior cruciate ligament , o LCA, is one of the four main ligaments of the knee. The ACL is essential for the stability of the knee, and people who injure their ACL often complain that their knee fails. Thus, many ACL tear patients choose to undergo surgical treatment of this injury. Most ACL surgeries are performed arthroscopically.
  • Escrow split: a plica is a remnant of tissue left over from fetal development. In early development, his knee was divided into separate compartments. Compartment dividers are gradually lost over time, but there is some remnant. When this remnant tissue is most prominent, it is called escrow. When the escrow is irritated, is called plica syndrome . A plica resection is performed to remove this irritated tissue.
  • Liberacifrom the lateral : the patella rides up and down the end of the thigh bone in a groove of cartilage. The kneecap can be pulled out of this groove, or may even dislocate from the groove, causing pain when bending the knee joint. A lateral release is performed to loosen the ligaments that pull the patella out of the groove.
  • Microfracture : Microfracture is a treatment used to stimulate the body to grow new cartilage in an area of ​​damaged cartilage.. In a microfracture procedure, the firm outer layer of the bone is penetrated to expose the inner layers of the bone where the marrow cells are located. These cells can then access the damaged area and fill the space with cartilage..
  • Autologous Chondrocyte Implantation : in this procedure, arthroscopic surgery is used to identify areas of cartilage damage and harvest cartilage cells. Later, the person's own cells are grown in the lab and reimplanted into the joint in a separate procedure, which is open surgery rather than arthroscopic surgery.
  • Cartilage transfer/OATS : Cartilage transfer involves moving cartilage from healthy parts of the joint to damaged areas. Small cartilage plugs are removed, with a portion of underlying bone, and are transferred to the damaged area. Plugs are taken from areas of the joint where the cartilage surface is not needed.

Arthroscopic Knee Surgery Hospital Pablo Tobón Uribe Bogota Medellin Colombia Cali Pereira Manizales

Your knee is the largest joint in your body and one of the most complex. The bones that make up the knee include the lower end of the femur (thigh bone), the upper end of the tibia (shin bone) and the kneecap (ball joint).

Other important structures that make up the knee joint include:

  • Articular cartilage. The ends of the femur and tibia and the back of the patella are covered with articular cartilage. This slippery substance helps the bones of the knees slide smoothly against each other while bending or straightening the leg..
  • Sons. The knee joint is surrounded by a thin lining called the synovium.. This coating releases a fluid that lubricates the cartilage and reduces friction during movement..
  • Meniscus. Two wedge-shaped pieces of meniscal cartilage act as “shock absorbers” between the femur and the tibia. Unlike articular cartilage, the meniscus is tough and rubbery to help cushion and stabilize the joint.
  • Ligaments. Bones are connected to other bones by ligaments. The four main ligaments in the knee act as strong cords to hold the bones together and keep the knee stable..
    • The two collateral ligaments are found on either side of the knee.
    • The two cruciate ligaments are found within the knee joint. They intersect to form a “X” with the anterior cruciate ligament in front and the posterior cruciate ligament in the back.

Frequently Asked Questions about: Arthroscopic Knee Surgery Hospital Pablo Tobón Uribe

Common Questions and Answers about Arthroscopic Knee Surgery Hospital Pablo Tobón Uribe

It may be recommended that you have knee arthroscopy if you have knee pain. Your doctor may have already diagnosed the condition causing your pain., or they may order arthroscopy to help find a diagnosis. In any case, an arthroscopy is a helpful way for doctors to confirm the source of knee pain and treat the problem.

Arthroscopic surgery can diagnose and treat knee injuries, including:

torn anterior or posterior cruciate ligaments
torn meniscus (the cartilage between the knee bones)
ball joint that is out of position
torn pieces of cartilage that are loose in the joint
removal of a Baker's cyst
knee bone fractures
swollen synovium (the lining of the joint)

This surgery is not very invasive. For most people, the procedure takes less than an hour, according to the specific procedure. You will likely return home the same day to recover. You must wear an ice pack on the knee and a dressing. Ice will help reduce swelling and minimize your pain.

At home, you must have someone to take care of you, at least for the first day. Try to keep your leg elevated and put ice on for a day or two to reduce swelling and pain. The bandage will also need to be changed. Your doctor or surgeon will tell you when to do these things and for how long.. You will probably need to see your surgeon for a follow-up appointment a few days after the procedure..

Your doctor will give you an exercise regimen to follow at home to help your knee heal., or recommend a physical therapist to see you until you can use your knee normally. Exercises are necessary to help restore your full range of motion and strengthen your muscles.. With proper care, your prognosis after this procedure is excellent.

Knee arthroscopy can be used when making or confirming a diagnosis and performing surgery:

  • Make a diagnosis: if a patient has knee pain, a doctor may order an x-ray or other imaging tests. However, The provider may need more information before going ahead with a treatment such as surgery.. In this case, the doctor may use the scope of the knee for a diagnosis or to confirm a treatment. To do this, a doctor makes a small incision, then insert the tiny arthroscope into the knee and the images can be viewed on a video screen. An example of how this could be used is when a surgeon wishes to view a meniscus tear to assess the extent of damage..

  • Performing the surgery: if arthroscopy is used for surgery, small incisions are made at different points around the knee joint, in addition to the opening made for the arthroscope. These additional openings allow the physician to insert small surgical tools into the area as needed.. Using arthroscope images as a guide, the surgeon can repair torn ligaments, remove a torn or damaged meniscus, remove loose bone fragments or perform other treatments.

Knee braces after simple arthroscopic knee surgery are rarely used. However, if your surgery involves more than the removal of a torn cartilage or meniscus, for example, if you have a meniscus repair, a brace may be placed on your knee after surgery. If you have a neoprene knee sleeve that you used before surgery and want to use it after surgery, do not start using it until your wounds have completely stopped draining. If you use a neoprene sleeve, be sure to take it off for several hours a day to allow your skin to breathe.

Can shower 48 hours after surgery if there is no drainage from your incisions. Do not rub directly on the incisions and pat them dry after showering.

Many patients are referred to physical therapy after knee arthroscopy, and this is usually decided on the first postoperative visit. Some patients regain movement very quickly and have minimal swelling, so they may not need therapy. Or they may only have to go once or twice to learn a home program.. Your surgeon will decide what is best for you.

It is recommended that you bend and straighten your knee as much as pain allows immediately after standard knee arthroscopy.. However, remember that your knee may be swollen and full movement may be difficult for the first few days. You can tighten your quadriceps muscle immediately after surgery and we recommend that you lift your leg straight if it doesn't hurt too much. Massaging the kneecap is also beneficial (ball joint) with straight leg. With the fingers, push the ball joint in all four directions (above, under, left and right) and hold it down for 10 seconds in each direction. This helps prevent scarring and tension around the kneecap during the recovery period..

You can put as much weight as is comfortable on your leg immediately after surgery. One more time, the usual need for crutches or a walker is about two to three days. Riding an exercise bike, using a treadmill or elliptical machine or just walking are good exercises to start once the knee is less sore. Don't be surprised if your knee tends to swell after such activities.; remember to apply ice and then elevate the knee.

After surgery, You will be transferred to the recovery room and you can go home in 1 The 2 hours. Make sure you have someone with you to drive you home and check on you that first night.

While recovery from knee arthroscopy is faster than recovery from traditional open knee surgery, it is important to follow your doctor's instructions carefully after you return home.

minimally invasive procedures, such as knee arthroscopy, generally require less recovery time than traditional surgery (open). Since you only need a few small dots, you are more likely to recover more quickly than with traditional surgery. You may also have less pain and a lower risk of infection.

While recovery from knee arthroscopy is faster than recovery from traditional open knee surgery, it is important to follow your doctor's instructions carefully after you return home.

minimally invasive procedures, such as knee arthroscopy, generally require less recovery time than traditional surgery (open). Since you only need a few small dots, you are more likely to recover more quickly than with traditional surgery. You may also have less pain and a lower risk of infection.

While recovery from knee arthroscopy is faster than recovery from traditional open knee surgery, it is important to follow your doctor's instructions carefully after you return home.

Everyone responds to surgery differently. Ask your health care provider when you can return to your daily activities, even drive and walk unassisted. Your health care provider may recommend waiting several weeks before doing more physical or strenuous activity.

Sometimes, people need to make changes to their lifestyle and activity level. Some sports (especially those that require running or jumping) can damage the knee. Talk to your health care provider about choosing low-impact sports and activities that are easier on your knee..

  • An arthroscopy is a type of minimally invasive surgery to check or repair the joints.. Minimally invasive surgery is where only small cuts are made in the body.
  • Arthroscopy is most commonly used on the knees. Can also be used on ankles, hips, shoulders, wrists and elbows.
  • It can help find the cause of the pain, the swelling and stiffness of the joints.
  • Your doctor may recommend that you have knee arthroscopy if you experience knee pain.. Your doctor may have already diagnosed the condition causing your pain., or may order arthroscopy to help find a diagnosis. In any case, an arthroscopy is a useful way for doctors to confirm the origin of the knee pain and treat the problem.

    Arthroscopic surgery can diagnose and treat knee injuries, between them:

    • anterior cruciate ligaments rear torn
    • torn meniscus (the cartilage between the knee bones)
    • ball joint that is out of position
    • pieces of torn cartilage that are loose in the joint
    • removal of a Baker's cyst
    • knee bone fractures
    • inflamed synovial (the lining of the joint)
  • This surgery is not very invasive. For most people, the procedure takes less than an hour depending on the specific procedure. You will likely go home the same day to recover. You must use a bag ice on the knee and a bandage. Ice will help reduce swelling and minimize pain..

    At home, you must have someone to take care of you, at least for the first day. Try to keep your leg elevated and ice it for a day or two to reduce swelling and pain.. You will also need to change your bandage. Your doctor or surgeon will tell you when to do these things and for how long.. You will probably need to see your surgeon for a follow-up appointment a few days after the procedure..

    Your doctor will give you an exercise regimen to follow at home to help your knee heal., or refer you to a physical therapist to see until you can use your knee normally. The exercises are necessary to help restore your full range of motion and strengthen your muscles.. With proper care, your outlook after undergoing this procedure is excellent.

Knee arthroscopy can be used to make or confirm a diagnosis and perform surgery.:

  • Make a diagnosis: if a patient has knee pain, a doctor may order an x-ray or other imaging tests. However, the provider may need more information before proceeding with a treatment such as surgery. In this case, the doctor may use the knee scan for diagnosis or to confirm treatment. To do this, a doctor makes a small single incision, then inserts the small arthroscope into the knee and the images can be viewed on a video screen. An example of how this could be used is when a surgeon wants to view a meniscus tear to assess the extent of the damage..
  • Performing the surgery: if arthroscopy is used for surgery, small incisions are made at different points around the knee joint, in addition to the opening made for the arthroscope. These additional openings allow the doctor to insert small surgical instruments into the area as needed.. Using arthroscope images as a guide, the surgeon can repair torn ligaments, remove a torn or damaged meniscus, remove loose bone fragments or perform other treatments.

after the procedure, the surgeon will close the incision. Sometimes, only small strips of tape are needed. Other times, one or two small dots will be required.

Following, the patient rests in a recovery room for several hours. At home, the patient will follow the doctor's instructions, which may include taking certain medications, raise the knee, get enough rest and, finally, do exercise. In general, a patient can return to light activity in a few weeks, although each patient is different.

Learn more about arthroscopy from the American Academy of Orthopedic Surgeons.

Diagnosis of a joint injury will always begin with a complete medical history., a physical exam and x-ray studies (X-rays, magnetic resonance, computed tomography, etc.). through the arthroscope, a final diagnosis is made that is often more accurate than through surgery “open” traditional, X-ray studies or MRI alone.

Some of the more common reasons knee arthroscopy is performed in pediatric orthopedics include:

  • Internal meniscus (cartilage inside the knee)
  • Menisco lateral discoideo (abnormally formed meniscus)
  • Loose bodies in the knee joint
  • Fractures at or near the knee joint (although these will often require an approach “open”)
  • Repair of torn ligaments (may require open surgery)
  • Persistent knee pain with failure of conservative therapy (diagnostic knee arthroscopy)
  • Removal of the inflamed lining (son) in the knee

Arthroscopic surgery is performed in the operating room or in the operating room under general anesthesia. Although the procedure can be performed under local lockdown (regional anesthesia), in the pediatric population it is usually performed under general anesthesia. A small incision will be made (about the size of a buttonhole) to insert the arthroscope into the knee joint. are often needed 2 The 3 additional buttonhole incisions to examine other parts of the joint or to insert other instruments. when indicated, corrective surgery is performed with specially designed instruments that are inserted into the joint through the accessory incisions. Many common knee injuries can now be treated arthroscopically.

After arthroscopic surgery, the small incisions will be covered with a bulky dressing and knee immobilizer. You will be moved from the operating room to the recovery room. Some patients will need little or no pain medication, although it is not uncommon to feel pain if an injury was treated. The surgeon will usually place novocaine in the knee at the time of surgery to relieve pain after surgery.. This will often last around six to eight hours after surgery.. Pain relievers should be used as needed for the first few days after surgery. After the effect of novocaine wears off, it is not uncommon to have knee discomfort. Pain should be well controlled with ibuprofen (Motrin) and/or Tylenol with Codeine (tablets the liquid). The dose will depend on the weight of the patient.

Once I'm awake, tolerate eating and drinking, and the pain is well controlled, you will be discharged home.

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After playing competitive soccer for several years, I broke my anterior cruciate ligament and meniscus. I was very nervous about the long process of surgery and recovery really is a life changing process, I thought I would lose everything since sport is my life and my passion, but Dr.. Danilo Velandia was very helpful, informative and reassuring, he really knew how to handle the situation. My surgery went smoothly and my recovery went according to plan. The doctor. Danilo was present every step of the way and showed his medical competence, as well as his natural compassion, Thank you very much and very grateful, I have been able to continue with my day to day.

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