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Auckland DHB Orthopaedics

Public Service, Orthopaedics

Description

What is Orthopaedics?

Orthopaedics covers the diagnosis and treatment of disorders of bones, joints and muscles. Orthopaedic surgeons have special skills in the surgical treatment of these conditions. The medical treatment is often shared by orthopaedic surgeons, rheumatologists, sports doctors and general practitioners (GPs).

Here are some of the most common conditions treated by orthopaedic surgeons in adult patients:

severe osteoarthritis of the hip or knee
fractured bones
torn or inflamed muscles, tendons and cartilage
dislocations of joints
infections in bones and joints
trapped nerves
disorders of the spine.

Where joints have become destroyed by disease, or worn out, orthopaedic surgeons can often replace these joints with artificial ones. This results in marked relief from pain and an increase in mobility and enjoyment of life for patients.

Fractures, except for the most minor ones, are treated by orthopaedic surgeons as they have the expertise to assess the damage around the fracture and ensure the best function is obtained after the fracture is mended.

Most spinal conditions do not need a surgical operation, but a small number do. Your GP will tell you if your condition is one that could benefit from an orthopaedic opinion.

The orthopaedics department at ADHB provides specialist secondary care for the wider Auckland region and tertiary care in a few complex conditions for the whole of New Zealand.

The four nurse specialists working in the orthopaedics department are, Julie Hislop, Katie Moloney Joanne Kalin, and Sowmia Thomas.

Outpatient Clinics

These are held at the Greenlane Clinical Centre. For information about this location please click here.

Consultants

Mr Hugh Blackley

Orthopaedic Surgeon
Mr Clayton Brown

Orthopaedic Surgeon
Mr Andrew Campbell

Orthopaedic Surgeon
Mr Adam Dalgleish

Orthopaedic Surgeon
Mr Angus Don

Orthopaedic Surgeon
Mr John English

Orthopaedic Surgeon
Mr Duncan Ferguson

Orthopaedic Surgeon
Mr Antony Field

Orthopaedic Surgeon
Mr Chris Fougere

Orthopaedic Surgeon
Mr Alastair Hadlow

Orthopaedic Surgeon
Mr Michael Hanlon

Orthopaedic Surgeon
Mr Andrew Johnston

Orthopaedic Surgeon
Mr S Mills

Orthopaedic Surgeon
Mr Paul Monk

Orthopaedic Surgeon
Mr Jacob Munro

Orthopaedic Surgeon
Mr Rupesh Puna

Orthopaedic Surgeon
Dr Helen Rawlinson

Orthopaedic Surgeon
Mr Peter Robertson

Orthopaedic Surgeon
Mr Anand Segar

Orthopaedic Surgeon
Mr Bruce Twaddle

Orthopaedic Surgeon
Mr Mark Wright

Orthopaedic Surgeon

Referral Expectations

Covid ALERT LEVELS 3 and 4 information

Ensure you have received both your COVID vaccinations.

As we prepare to start living with COVID in the community, the hospital is encouraging all patients to get a COVID TEST before their date of surgery.

Where?
Your GP practice/Testing Centre. Please give the testing site the code SURV-GEN. It will speed up their results.

When?

Is the test mandatory for me?
No, the test isn’t mandatory, but it is encouraged. This will speed your journey up on the day of surgery. If you do not get or do not want to get a community test, then this is ok.

For Clinicians:

1. The orthopaedics department is now receiving the majority of their referrals through e-referrals. Please communicate through this medium as much as possible in order to streamline the triage and booking process.

2. Keep in mind that most rejected referrals are due to a lack of information

3. Please include current medications, tests, labs, x-rays (within the last 2 months) and ultrasound reports, all relevant private specialist’s reports and ACC number with your referral. This will expedite the process to have a patient seen and a decision made quickly about the best course of treatment.

4. Spinal patients will get sent a health questionnaire. Unfortunately, if this is not completed and returned then their referral will be suspended.

The questionnaire for NECK pain is https://aucklandregion.healthpathways.org.nz/referral/SpineNeckArmQues.pdf
The questionnaire for LOW BACK pain is https://aucklandregion.healthpathways.org.nz/referral/SpineMidLowBackQues.pdf

For Patients:

1. Referral by General Practitioner

You will need to be assessed by your GP who can then refer you to the Orthopaedic Department at the Auckland Hospital (Greenlane site). During your GP visit, ensure that adequate information is provided to the GP so that they can make an appropriate referral. Kindly, remind your GP to order the necessary investigations and attach them to your referral in order to avoid delays.

2. Contact Details

Please ensure you give your GP your CURRENT CORRECT CONTACT details so that you may be contacted for your appointment. If you have moved house, remember to change your contact details. You will be contacted on your cellphone so please respond to messages on your phone. If we cannot contact you, we are not able to give you an appointment to see the orthopaedic surgeon.

3. Triaging of referrals

There are currently more requests for appointments than we have the capacity to see, therefore, referrals are prioritised according to greatest need. We see the most urgent and the most disabled patients. Patients with lesser levels of disability, whose referral is declined, will need to pay privately see a doctor outside the public hospital system. If you have health insurance, you may be able to consult an orthopaedic surgeon in the private sector in a timely manner.

Many minor orthopaedic conditions are treated well by GPs. Alternatively, your doctor may recommend that you will receive swifter and more effective treatment by referring you to a sports medicine doctor, a rheumatologist, or a physiotherapist. For many minor orthopaedic conditions these are exactly the same health professionals that the orthopaedic surgeon uses to assist in your recovery.

4. Appointment to see an orthopaedic surgeon

There are some conditions that only an orthopaedic surgeon can treat and if your GP refers you to the Orthopaedic Department, you may be given an appointment to see a specialist surgeon. In this case the hospital will write to you giving you an appointment time and date. There may be some delay before you receive one. The current wait time is a maximum of four months.

5. Attend your outpatient appointment in Greenlane Clinical Centre

Sometimes you may be requested to have imaging e.g. CT and MRI prior to seeing the orthopaedic surgeon. The imaging is necessary to help the specialist manage your condition. If you require an MRI and are claustrophobic, please inform your GP so the GP can prescribe medication to help with that for your procedure. MRI and CT are high cost procedures. Please attend your appointments. If you cannot go, make contact with Greenlane Clinical Centre to cancel or change your booking. This way, we can ensure another patient can make use of your appointment time.

If you wish to read more about the process of elective service provision as outlined by the Ministry of Health, please click here

6. What you can do to “GET FIT” for your Orthopaedic surgery:

If you have hypertension and/or diabetes, see your GP to assess and ensure your BP and diabetes is well controlled. Aim for a BP<140/90 and HbA1C is ideally between 50-55.
Participate in rehabilitation as advised by your orthopaedic surgeon and physiotherapist.

Urgent referrals

If you have an urgent orthopaedic condition such as a bone infection, present at the Auckland Hospital emergency department for treatment. If you have a malignant bone tumour, your doctor will mark the referral Urgent.

Injuries covered by Accident Compensation Corporation (ACC)

If you have a condition that was caused by an accident, we are able to treat you at ADHB. Please bring your ACC number with you to appointments if you have been given one. You may also decide to receive assessment and treatment from an orthopaedic surgeon outside the hospital.

Charges

There are no charges for New Zealand citizens or those with permanent New Zealand residency when they are treated in the public hospital. All non-residents and visitors to New Zealand will be billed for the full cost of the consultations and treatment.

The only exception to this is for the treatment of accidents where the cost of treatment can be paid for by the Accident Compensation Corporation (ACC).

Procedures / Treatments

Soft Tissue (muscles, tendons and ligaments)

Orthopaedic surgeons can do operations on tendons to repair them or to improve the muscle balance around a joint.… More
Fracture Clinics

This clinic is for patients who have sustained an injury that has already been treated.… More
General Outpatient Clinics

These are clinics for patients who have been referred by their doctor for an orthopaedic opinion on a specific concern.… More
Specialty Clinics

Some surgeons have special expertise in one area of orthopaedics.… More
Joint Replacement

Joint replacement surgery is sometimes required to treat joints that have been damaged from "wearing out" types of arthritis or from other forms of joint disease including rheumatoid arthritis.… More
Osteotomy

The division of a crooked or bent bone to improve alignment of the limb.… More
Arthroscopy (keyhole surgery)

A large number of orthopaedic procedures on joints can be performed using an arthroscope, where a fiber optic telescope is used to look inside the joint.… More
Bunions

Relief from bunions
Most bunions are treatable without surgery. Prevention is always best.… More