Dr Jason Ward

Arthritis is a general term that refers to joint degeneration and inflammation. Arthritis can affect any joint, however the knee, hip, shoulder and ankle are often affected. Arthritis encompasses a group of more than 100 different types of joint disorders and related conditions.

Arthritis affects people of all ages and backgrounds. Its impact can range from mild to severe discomfort and include reduced mobility. Treatment options vary depending on the type of arthritis and may include medications, lifestyle changes (including weight management), or surgery.

Ankle Surgery - Dr Jason Ward - Adelaide Ankle Surgeon

Types of Arthritis

Osteoarthritis (OA) is a degenerative joint disease that can affect the knee, hip, shoulder, and ankle joints. It occurs when the protective cartilage that cushions the ends of bones wears down over time. This leads to pain, stiffness, and reduced mobility. Several factors can contribute to the development of osteoarthritis. These include patient age, family history (genetics), previous joint injury, and obesity.

Rheumatoid arthritis (RA) is an autoimmune disorder that primarily affects joints. It causes inflammation, pain, and joint damage. While rheumatoid arthritis typically involves small joints of the hands and feet, it can also affect larger joints, including the knee, hip and shoulder. In rheumatoid arthritis, the synovial lining of the joint becomes inflamed. This leads to pain, swelling, stiffness and eventually erosion of the joint.

Psoriatic arthritis occurs in some people with a chronic skin condition called psoriasis. This is characterised by red, scaly skin patches. Psoriatic arthritis can affect various joints and can affect the knees, hips, shoulders, and ankles, leading to pain, swelling, and stiffness.

Post-traumatic arthritis (PTA) is a type of arthritis that develops in a joint following an injury or trauma. This could be due to a fracture, dislocation or other significant joint injuries. The trauma causes damage to the joint cartilage and over time this damage can result in arthritis symptoms. The joint often becomes painful, swells, and stiffens, despite the initial injury healing.

Gout is a metabolic disorder caused by the buildup of uric acid crystals in the affected joints. Uric acid is a waste product normally found in blood and excreted through the kidneys. In people with gout, uric acid levels become elevated, and this can lead to the formation of joint crystals which in turns causes pain, swelling, and inflammation. Gout very commonly affects the joint at the base of the big toe, but it can also be found in the knee and less frequently in the ankle, hip and shoulder.

Anterior knee pain, also known as patellofemoral pain, refers to pain felt at the front of the knee, usually around or behind the kneecap (patella). It is common in young women due to softening of the cartilage behind the patella, and eventually can result in longer-term arthritis at the front of the knee. Anterior knee pain is often aggravated by activities that involve bending the knee. These include climbing stairs or squatting, and walking or running up and down hills. Appropriate early management of anterior knee pain can help in preventing early onset of arthritis.

Rotator cuff tear arthropathy is a condition that occurs when severe and longstanding rotator cuff tears occur in the shoulder. The rotator cuff is a group of muscles and tendons that surround the shoulder joint and provide stability for the joint but still allow a wide range of motion. When a rotator cuff tear is extensive and longstanding, it can lead to changes in the shoulder joint that result in arthritis, causing pain and limited function.

Treatment Options

Treatment for arthritis aims to alleviate pain, improve joint function, and thereby enhance overall quality of life. Specific treatment options will depend on the type of arthritis, the affected joint, and the severity of the condition. Here is a list of common treatment options:

Medications

Dr Ward will discuss with you:

Pain and Inflammation Reduction: Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment in reducing joint inflammation and managing pain.
Joint Injections: Dr Ward will discuss the appropriate use of corticosteroid injections and platelet-rich plasma (PRP) injections which can help alleviate pain and inflammation.

Your GP or Rheumatologist will discuss with you:

If you have gout, you may be prescribed medications that can either help lower uric acid levels or help the kidneys eliminate uric acid more effectively.
If you have rheumatoid arthritis, you may be prescribed specific rheumatoid arthritis treatment, which can include disease-modifying antirheumatic drugs (DMARDs).

Lifestyle Changes

Weight Management: Maintaining a healthy weight can reduce the load on the affected joint and decrease pain. Low-impact activities like swimming and cycling can help improve joint flexibility and strengthen the surrounding muscles. These activities can also help in maintaining a healthy weight.
Physiotherapy: A physiotherapist can provide an exercise program to improve joint mobility, strengthen muscles, and enhance overall function. A Physiotherapist may also recommend joint support with taping to help with symptoms.
Rest and Activity Modification: Avoiding activities that worsen pain and incorporating periods of rest can help reduce the stress on a joint.
Walking Aids: A walking stick or cane, crutches or a frame may be recommended to help maintain mobility which reduces joint stress and improves biomechanical issues.

Surgery

Joint Surgery: Dr Ward will discuss the different types of surgical procedures available to help with your case.
- In the knee, joint preservation or cartilage-preserving surgeries may be a possibility. In more severe cases, partial or total joint replacement surgery may be considered to replace the damaged joint with an artificial prosthesis.
- Dr Ward has particular expertise in Anterior Hip Replacement.
- Specific to the shoulder, if rotator cuff function is severely compromised, a Reverse Total Shoulder Replacement (RTSR) may be considered.

Arthritis is a common condition, however, it can be managed effectively. If you’re concerned about potential arthritis, contact Dr Jason Ward for a diagnosis and access to the latest treatment options.

Dr Jason Ward is pleased to announce that he is expanding his practice locations to provide greater access for patients in the eastern suburbs.

Dr Ward is one of Adelaide’s busiest and most experienced orthopaedic surgeons. He has an established and successful practice, consulting and operating at several locations around Adelaide and country South Australia.

“I’m really pleased to be able to expand my practice and start operating and consulting at Burnside hospital” Dr Ward said. “This will provide more convenient access for patients in the surrounding areas and the Adelaide Hills.”

Dr Ward is looking forward to using the orthopaedic robotic technology at the Burnside hospital. “I can use this on-site technology to assist with knee replacement surgery in some cases” Dr Ward said.

Dr Ward uses various technologies to optimise outcomes and recovery for his patients. This includes options such as customised 3D printed instruments, patient-matched implants and robotic-assisted surgery.

“Each patient is an individual and presents unique biomechanical challenges. Having access to robotic technology at Burnside hospital will allow me to provide the best solution for each patient” Dr Ward said.

Patients who have a knee replacement procedure using the ROSA knee robot at Burnside hospital will have access to a free digital interactive care plan. This will allow them to connect with their surgeon and care team via a mobile app, and allow digital monitoring of their post-operative progress.

More information on the ROSA orthopaedic knee robot or the MyMobility patient program can be accessed using these links.

If you are considering driving after surgery, it is worth noting that after most orthopaedic surgical procedures, you will experience challenges that affect your ability to drive. There are no specific regulations for driving after surgery, but returning to safe driving is dictated by your individual situation. This includes the type of surgery, your physical and mental capacity, and your individual recovery.

Before returning to driving after surgery, aim for:

Minimal pain experienced during driving motions
No use of an arm sling or leg splint
Adequate range of motion of the shoulder
Reasonable upper limb strength
Un-compromised reaction time
Not using crutches for mobilisation

Questions to ask yourself before recommencing driving:

Will my recovery be negatively affected by my driving?
Can I control my vehicle in an emergency?
Am I physically able to perform driving manoeuvres, or is my capacity restricted?
Has my surgery and recovery affected my driving judgement? For example, am I taking pain medication which disrupts my judgement and reaction time?

Returning to driving after surgery also depends on:

Your vehicle type (transmission and power steering)
Driving conditions (lighting, road quality and weather)
Journey length
Your current medication intake
Your post-surgery pain level
Your physical ability
Your judgement and decision-making capacity

Driving and opioid pain medication

It is likely that you will be consuming pain relief medication after your surgery. Typically, these medications (opioids) are also sedatives, which mean they have similar effects to alcohol, and will impair your ability to drive a vehicle. Your reaction time, concentration and judgement will be affected by these strong pain medications. Do not drive when under the influence of opioid medicines.

Testing your post-surgery driving abilities

It is a good idea to test your driving abilities in a safe environment like an empty car park before recommencing driving on the road. Here, you should practice all manoeuvres required for safe driving (including emergency stops), and should only think about recommencing road driving after you can perform all actions comfortably.

Insurance Considerations

After surgery, you may not be covered by your normal car insurer if:

you are wearing a brace or cast when driving and are involved in an accident
you are under the influence of strong pain relief (including opioids) and your judgement and concentration is deemed to be affected
a reasonable time has not passed since your surgery

Speaking directly to your insurer regarding limitations imposed following surgical procedures is strongly advised.

Guidelines for specific types of surgery

Each surgery may have different post-procedure driving recommendations. This discussion relates to your individual situation and guidelines may not be the same for each patient. Talk to Dr Jason Ward about your specific condition if you have any questions.

Driving After Shoulder Surgery

Most shoulder procedures will require a sling to be worn for 4-6 weeks. Driving is not permitted during this time. Reducing use of the sling and building strength in the arm can take 3 to 6 months, and caution with driving needs to be taken during this recovery period. Expect to begin with short, low intensity trips and then slowly return to your usual driving habits over this period.

Driving After Hip or Knee Replacement Surgery

Lower limb joint replacement surgery is a major procedure and will impact your ability to drive. Patients are generally unable to drive for a minimum of 6 weeks after lower limb joint replacement. Return to driving may take longer, depending on your progress with rehabilitation. It is a very common goal of rehabilitation to build up adequate strength and mobility to facilitate driving and regain independence.

Driving After Arthroscopic Surgery

You are able to return to driving when your physical ability allows it. Patients may be able to return to driving in the days after surgery, however if a more complex procedure has been undertaken it may be up to 4-6 weeks before driving capability returns.

Please ask Dr Jason Ward any questions regarding your individual return to driving.

When you are considering flying after surgery, then you need to remember that simple things like walking around the airport, sitting in a chair for an extended period or experiencing turbulence may be uncomfortable after orthopaedic surgery.

BEFORE you plan travel or board a flight, it is important that you think about the issues outlined below.

Flying after specific orthopaedic surgeries

In general terms, consider the timeframes below before flying after your orthopaedic surgery.

Surgery	Wait Time
Arthroscopic (keyhole) surgery	1-2 days
Simple open surgery	3-5 days
Complicated open surgery	7-14 days
Joint replacement	1-2 weeks

These time frames are a general guide. Talk to Dr Jason Ward about your specific case if you are planning to travel to ensure your recovery is not affected.

Check Airline Regulations before Flying

It’s important when booking your flight to consider the individual regulations of your chosen airline. Restrictions can vary by carrier.

Travel Insurance

It is vital that you read over your travel insurance policy as you may need to notify them about your surgery. Your travel insurance can be affected by surgical procedures.

Airport Security

It is common for metal implants including joint replacements to activate the metal detectors used in airports. You will need to notify airport staff that you have had surgery and have joint replacements or other metal in place.

Flying with Splints

After a procedure where a splint is applied, flying may cause swelling which can impact circulation. Please talk to Dr Ward about managing your splint if you are flying, as it may need to be loosened for travel.

Your Plane Seat

You shouldn’t have any trouble sitting in a standard seat if you are wearing a sling, or have a brace which allows for knee bending. However, you may need to organise alternative seating if your knee brace does not allow knee bending. This may require extra room or an upgraded seat.

Wheelchair Assistance

Talk to your airline when scheduling your travel, as often a wheelchair can be arranged at the airport and for boarding. In Australia, wheelchair access is readily available at most airports.

Using crutches

Notify your airline if you are using crutches or a frame. Normally, you will be allowed to take them on the plane with you, and they will be stored during the flight.

Medication Regulations

After orthopaedic surgery, you may require various medications. There are rules surrounding medication and travel. Make sure you research what your specific airline regulates in the cabin, and the rules of your travel destination. Some countries regulate the quantity and type of medications that you can bring with you when travelling. You should be aware of these rules before travelling, and if travelling overseas you may want to contact the embassy of the country to which you are flying.

Travelling with Medicines

When travelling with medicines, make sure you keep them in their original packaging with the correct labels. If available, also bring a copy of your medication prescription. It’s a good idea to pack a spare medicine supply in case you lose the first. Make sure your medication does not expire during your travel period. Some medicines may have a required storage temperature. Talk to your pharmacist about how to store your medicine during travel.

Risk of Deep Venous Thrombosis (DVT)

After your procedure, you may have an increased risk of a deep vein thrombosis (DVT) developing when flying. If you are already predisposed to developing DVT, speak to your GP for the best course of action. When flying, regular movement around the plane and keeping well hydrated will decrease the risk of DVT.

Have Questions?

If you have further questions about after flying after surgery, please talk to Dr Jason Ward or your GP.

Dr Jason Ward is a specialist Knee, Hip, Shoulder and Ankle Surgeon.

Dr Ward graduated from Flinders University in 1996 and in 2005 obtained a Fellowship at the Royal Australasian College of Surgeons.

Dr Ward continues to stay abreast of contemporary practice and keeps up to date with the latest in leading edge surgical techniques, including specialising in anterior hip replacement, and being accredited to undertake robotic surgery.

Dr Jason Ward has been in practice as an orthopaedic surgeon for 13 years, and always strives for the best outcomes for his patients.

Dr Ward is an avid sailor, competing in keelboat racing at a national level, he loves and collects fine wines, and enjoys travelling and spending time with his family.

There are usually two presentations of a Rotator Cuff Tear. There is a traumatic tear, where a patient might have had a fall, injured their shoulder and require immediate attention. The second presentation of a Rotator Cuff Tear is the more common form; this is typically from wear-and-tear. The patient might start to suffer from pain in the shoulder or upper part of the arm, and these symptoms may be intermittent or more constant.

Two out of three patients presenting with these symptoms will normally improve with a Physiotherapy-guided exercise program. Dr Ward will attend to those patients who aren’t seeing any improvement from their Physio program.

Of the patients who opt for surgery, a large majority will enjoy relief from their symptoms and will regain function of their shoulder.

Surgery is likely to be keyhole surgery, and the patient will spend the night in hospital. While recovering from the surgery, the patient will see the Physiotherapist, and a rehabilitation program will be discussed.

After surgery, the patient’s arm will be in a sling for 4-6 weeks, and in most cases should see recovery after 4-5 months. By the 6-month mark, 90% of patients would have recovered from the surgery. Some patients might need additional Physiotherapy to aid recovery.

A patient is typically suitable for a partial knee replacement when they are experiencing localised symptoms and when the arthritis is limited to one part of the knee. This presents an option for younger patients, normally in their 50s or 60s, who are not ready for a full knee replacement.

The recovery time of a partial knee replacement is roughly half the time of a full knee replacement. The aim of this treatment is to allow the patient to be active again, for example to play golf or tennis more comfortably.

Patients can expect to be off work for up to 4 weeks and resuming walking without any aids at approximately 6 weeks.

Robotic-assisted orthopaedic surgery can be used for both hip and knee joint replacements.

Dr Ward will review each patient and discuss suitable options. Dr Ward utilises robotic-assisted surgery for all partial knee replacements. He will discuss with you the option of robotic vs traditional methods in your case.

Dr Jason Ward will consider multiple factors in determining the right method of treatment.

Robotic-assisted surgery is helpful in planning the joint replacement. Another benefit of using robotic surgery is to assist in the alignment of the existing bone with the new components.

Read more about robotic assisted surgery.

Dr Jason Ward is dedicated to giving people back their quality of life, their ability to be free to move and to re-engage with life.

The aim of treatment is to restore function to the joint, giving you back your confidence and reducing pain.

It is good to know that there is an alternative to living in pain and discomfort and that within months, you could be out-and-about with improved function and reduced pain.

The decision to undergo joint replacement surgery lies squarely with the patient. If your quality of life is affected, if you can’t sleep because of the pain, if you can't do the activities you want to do, then it is probably time to consult Dr Ward and discuss your options.

Dr Jason Ward is an orthopaedic surgeon with extensive experience and a special interest in joint replacement surgery.

Key indicators that you need to consider surgery:

You can no longer do everyday tasks.
You have a lot of pain. Pain that keeps you awake, with little reprieve from medication.
You have tried non-surgical treatments without success.
You have arthritis and it is taking a toll physically, mentally and emotionally.
Tests show advanced joint damage or arthritis.

Recovery after surgery depends on a variety of issues, including your age, general health, and physical fitness. Dr Ward recommends that you consider and discuss the pros and cons of joint replacement surgery with him, to tailor a solution that suits you best.