Orthopedics Division

The Division of Orthopedics includes two inpatient departments, Orthopedics A and Orthopedics B, where patients are hospitalized according to their medical needs and stage of treatment.

Each department has approximately 32 inpatient beds.

The medical teams consist of senior orthopedic physicians and residents, supported by a multidisciplinary team that includes a head nurse, deputy head nurses, a clinical education coordinator, registered nurses, a social worker, and experienced physiotherapists.

• Orthopedics A: Primarily admits patients before and after joint replacement and hand surgery.

• Orthopedics B: Primarily admits patients before and after shoulder surgery, orthopedic trauma procedures, sports-related surgery, and minimally invasive orthopedic procedures.

Patients Admitted to the Departments

• Patients scheduled for elective surgery or treatment: These patients have generally undergone a preoperative evaluation by an orthopedic physician and an anesthesiologist and have received an explanation of the planned procedure. Their surgery is performed according to a predetermined surgical schedule.

• Emergency patients admitted through the Emergency Department: These include patients injured in various types of accidents. Some are transferred to the inpatient department following surgery, while others are admitted for observation and preoperative preparation. Surgical priority is determined primarily by medical urgency rather than order of arrival. Patients may be required to fast for at least six hours before surgery while awaiting operating room availability, as more urgent procedures may take precedence throughout the day and night.

• Patients referred from outpatient clinics: Patients who have been evaluated in the outpatient clinics and require hospitalization for further diagnostic evaluation or surgical treatment.

The Foot and Ankle Unit at Tel Aviv Sourasky Medical Center is a leading specialized unit providing diagnosis, treatment, and advanced surgical care for complex foot and ankle conditions.

The unit combines extensive surgical experience, advanced biomechanical expertise, and innovative technologies to achieve optimal treatment outcomes and improve patients' quality of life.

Treatment is individually tailored to each patient, based on a comprehensive understanding of foot anatomy, load distribution patterns, and functional needs. Treatment planning takes a holistic approach, combining conservative and surgical options according to the patient's clinical condition and treatment goals.

The unit's clinical activities focus on three main areas: hindfoot and ankle disorders, forefoot conditions, and diabetic foot care and limb preservation.

The unit follows an integrated approach that combines accurate clinical diagnosis with an advanced biomechanical understanding of the foot and ankle.

Each patient undergoes a comprehensive evaluation, including assessment of limb alignment, weight-bearing patterns, and functional performance. An individualized treatment plan is then developed.

Treatment combines conservative approaches with surgical intervention when necessary, emphasizing restoration of function, maintenance of stability, and prevention of progressive deformities and disease.

Areas of Expertise

Hindfoot and Ankle

This field encompasses a wide range of conditions affecting ankle stability and walking function.

Conditions treated include progressive collapsing foot deformity, chronic ankle instability, tendon disorders such as Achilles tendinopathy, cartilage injuries, and joint degeneration.

Treatment requires a thorough biomechanical understanding of the foot and ankle and is tailored to each patient according to the severity of the condition and functional level.

Forefoot Conditions

The forefoot bears significant loads with every step, and deformities in this area may cause pain, functional impairment, and difficulty wearing shoes.

Common conditions include hallux valgus, hammertoes, and metatarsalgia.

Treatment options include appropriate footwear, custom orthotic insoles, and, in advanced cases, surgical correction to restore proper biomechanical alignment.

Diabetic Foot and Limb Preservation

Diabetic foot complications are complex conditions resulting from a combination of nerve damage, reduced blood flow, and structural changes in the foot.

These conditions may lead to chronic wounds, infections, and an increased risk of amputation if not treated promptly.

The unit focuses on early diagnosis, wound management, pressure offloading, and limb preservation.

Traumatic Injuries and Anatomical Reconstruction

Foot and ankle injuries require accurate diagnosis and meticulous anatomical reconstruction to preserve normal joint structure and function.

Injuries may include intra-articular fractures, ligament damage, and complex injuries involving multiple anatomical structures.

Treatment includes conservative immobilization or surgical fixation, depending on the complexity of the injury, with an emphasis on precise anatomical restoration.

Following treatment, patients undergo a gradual rehabilitation program aimed at restoring function and preventing complications such as secondary joint degeneration.

Sports Injuries and Rehabilitation

Sports-related foot and ankle injuries include tendon and ligament tears, recurrent sprains, and stress fractures.

These injuries are common among physically active individuals and may cause significant functional limitations if not properly treated.

Diagnosis is based on clinical examination and, when necessary, imaging studies.

Treatment is tailored to the patient's condition and activity level and may include rehabilitation, load management, and surgical intervention when indicated.

The goal is not only to heal the injury but also to enable a safe return to activity and reduce the risk of recurrence.

Advanced Surgery and Technological Innovation

The unit performs advanced surgical procedures and incorporates innovative technologies, including:

• Joint Fusion (Arthrodesis): Performed in cases of advanced joint degeneration, deformity, or instability.

• Total Ankle Replacement: A surgical procedure designed to replace a damaged ankle joint while preserving joint motion.

• Advanced Technologies: Use of innovative surgical technologies, including 3D printing, to support surgical planning and treatment.

The hip and knee joints may be affected by a wide range of conditions and diseases, including infections, post-traumatic degenerative changes, rheumatic joint diseases, and other conditions that cause joint degeneration and destruction, resulting in pain and severe limitations in mobility and function.

Joint replacement surgery has become increasingly common in recent decades, with more than 6,000 procedures performed annually in Israel. Most patients requiring joint replacement are older adults, although younger patients may also develop conditions involving severe joint damage.

Joint replacement surgery requires a high level of technical skill and extensive experience. Alongside the increasing number of primary joint replacement procedures, the number of patients requiring revision surgery due to implant wear has also risen.

The complication rate associated with these procedures is very low, and more than 95% of patients return to normal, full function.

The Joint Replacement Unit at Tel Aviv Sourasky Medical Center (Ichilov) is recognized in Israel and internationally for the quality of its surgical procedures, the use of advanced implants, and their individualized selection for each patient.

The unit provides training for orthopedic residents and fellows from Israel and abroad and participates in the development and clinical evaluation of innovative implants.

Types of Joint Replacement Surgery

Hip Replacement

Hip replacement surgery involves replacing damaged or worn components of the hip joint with artificial implants when conservative treatment fails to provide sufficient relief.

The type of implant and fixation technique are selected according to the patient's medical condition, age, functional level, and bone quality.

Total Knee Replacement

Total knee replacement surgery involves replacing worn or damaged joint surfaces with artificial implants.

The unit performs total knee replacement procedures using the VELYS Robotic-Assisted Solution, which enables precise surgical planning and personalized adjustment of implant size, positioning, and joint balance.

Partial Knee Replacement

Partial knee replacement is intended for patients with cartilage degeneration limited to a single compartment of the knee, allowing preservation of the healthy parts of the joint.

The procedure is also performed using the VELYS Robotic-Assisted Solution, which supports precise implant positioning, personalized alignment, and maximum preservation of healthy joint structures.

The hands are among the most essential parts of the human body for everyday functioning. Nearly every daily activity involves the use of our hands, from basic tasks such as eating and dressing to complex activities such as writing, playing musical instruments, and painting.

Normal hand function relies on an exceptionally complex anatomical system consisting of numerous bones, joints, tendons, muscles, nerves, and specialized soft tissues, all working together in precise coordination.

Hand surgery is a specialized field dedicated to the diagnosis and treatment of conditions affecting the upper extremity, from the arm to the fingertips. These include disorders involving bones, joints, muscles, tendons, nerves, blood vessels, and soft tissue coverage.

The Hand Surgery Unit operates within the Division of Orthopedics and includes three specialist physicians. The unit treats a wide range of conditions affecting upper extremity function, including:

• Injuries and fractures of the hand, forearm, and elbow

• Nerve compression syndromes, including carpal tunnel syndrome and cubital tunnel syndrome

• Inflammatory and degenerative conditions affecting the elbow and hand joints

• Hand and elbow contractures

• Paralysis and other nerve injuries

• Tendon entrapment disorders, including trigger finger and De Quervain's tenosynovitis

• Congenital and acquired upper extremity disorders in children

The unit performs a broad range of surgical procedures, including advanced arthroscopic and microsurgical techniques. Its comprehensive approach to the upper extremity enables the treatment of complex conditions involving bones, nerves, blood vessels, and soft tissues.

The medical team works closely with the hospital's Occupational Therapy Service and maintains an active weekly schedule that combines extensive clinical care with academic research and teaching activities.

The Sports Injuries and Arthroscopy Unit specializes in the diagnosis and surgical treatment of sports-related injuries in professional and recreational athletes of all ages and across a wide range of sports.

The unit performs minimally invasive arthroscopic procedures involving the hip, knee, and ankle joints.

In addition to its clinical activities, the unit participates in international research projects, including the research and development of cartilage scaffolds for implantation, as well as studies focusing on the rehabilitation and reconstruction of sports-related injuries.

Main Procedures Performed

• Knee Arthroscopy and Meniscus Repair: Arthroscopic repair and reconstruction of torn meniscal tissue to preserve its function and improve knee stability and mobility.

• Cruciate Ligament Reconstruction: Arthroscopic reconstruction of a torn cruciate ligament using a tendon graft, aimed at restoring knee stability and enabling a gradual return to sports activities.

• Cartilage Injury Repair: Advanced treatment of cartilage defects, including the implantation of laboratory-cultured autologous cartilage cells to restore damaged areas and preserve joint function.

Most patients with orthopedic trauma, including fractures, blunt injuries, and lacerations, are hospitalized in the Division of Orthopedics.

In some cases, patients with fractures may be temporarily admitted to other hospital departments due to bed availability while awaiting surgery. These patients continue to receive daily evaluation and treatment from the Orthopedic Trauma Unit.

Patients Treated by the Unit

The unit treats patients with complex fractures of the extremities or pelvis that require specialized surgical expertise and advanced fixation techniques, including plates, screws, and intramedullary nails.

The unit also treats patients referred due to complications following previous fractures or injuries, including delayed union, malunion, and infection at the injury site.

In these cases, treatment may involve bone grafting, replacement or revision of fixation devices, and other specialized surgical techniques.

A significant part of the unit's activities is carried out in close collaboration with the hospital's Trauma Unit.

Many of these patients have sustained severe multiple injuries, including life-threatening trauma. In such cases, the Orthopedic Trauma Unit initially performs damage control procedures aimed at preserving the injured limb. Definitive orthopedic surgery is performed once the patient's overall medical condition has stabilized.

Complex Pelvic Fracture Surgery

One of the unit's areas of particular expertise is the surgical treatment of complex pelvic fractures.

These injuries frequently occur in younger patients involved in road traffic accidents and are often part of severe multiple trauma.

Surgical treatment of complex pelvic fractures requires highly specialized expertise and is performed at a limited number of medical centers in Israel.

Due to the unit's extensive experience and favorable surgical outcomes, patients are referred to Tel Aviv Sourasky Medical Center from other hospitals for these complex procedures.

The Shoulder Unit at Tel Aviv Sourasky Medical Center (Ichilov) is the largest of its kind in Israel. The unit includes approximately six senior orthopedic specialists who provide comprehensive care for even the most complex shoulder conditions.

The unit welcomes patients seeking initial treatment as well as those who have undergone unsuccessful treatment elsewhere, with the aim of providing the most appropriate medical and surgical solutions.

The Shoulder Surgery Unit serves as a national referral center, treating patients from across Israel, including those with highly complex conditions requiring multidisciplinary evaluation and treatment.

These cases may involve collaboration with neurosurgeons specializing in peripheral nerve disorders and plastic surgeons.

Multidisciplinary surgical procedures are routinely performed, enabling patients to receive coordinated treatment from specialists in different fields within a single medical center.

This integrated approach allows the medical team to develop comprehensive, individualized treatment plans without requiring patients to consult multiple specialists independently.

Advanced and Complex Shoulder Surgery

The unit performs a wide range of highly complex surgical procedures, including:

• Complex revision shoulder replacement surgery, using advanced patient-specific 3D-printed surgical instruments and technologies

• Tendon transfer procedures, requiring highly specialized surgical expertise

• Surgical treatment of complex shoulder fractures

• Treatment of shoulder conditions associated with nerve injuries

• Surgical management of severe infections

• Complex revision procedures following previous unsuccessful shoulder surgeries

The unit is committed to clinical excellence and consists of orthopedic specialists who have completed advanced fellowship training.

The physicians work collaboratively, holding daily professional discussions and making treatment decisions through a transparent, multidisciplinary process.

For particularly complex cases, patients may be presented at a multidisciplinary team meeting involving all the unit's physicians to enable comprehensive evaluation and joint decision-making.

Preoperative team discussions are also routinely conducted for less complex cases, ensuring coordinated surgical planning and individualized patient care.

The Multidisciplinary Amputee Clinic provides comprehensive, advanced medical care for individuals with limb amputations, including both civilians and military personnel, bringing a wide range of specialized services together under one roof.

Tens of thousands of people in Israel live with limb amputations and require complex, multidisciplinary medical care.

The need for comprehensive, coordinated treatment became particularly evident during the Swords of Iron War, when many soldiers and civilians sustained severe injuries requiring extensive rehabilitation.

The clinic operates as part of an initiative to establish a national Center for Amputation and Reconstruction, designed to provide advanced, integrated care for individuals with limb loss and complex reconstructive needs.

The clinic offers both surgical and nonsurgical treatment options, with the shared goal of helping patients regain mobility, independence, and the highest possible level of function.

Treatment is provided through a multidisciplinary approach, with surgical care coordinated among the Department of Orthopedics, the Department of Plastic Surgery, and the Rehabilitation Department.

This integrated model emphasizes comprehensive and early rehabilitation as an essential part of the overall medical treatment process.

Patients attending the clinic receive coordinated medical and allied health services in a single location, eliminating the need to navigate multiple clinics and healthcare providers independently.

Shoulder fractures are usually caused either during simple forward falls onto the hands while attempting to break the fall, or as a result of a direct injury. During impact, the head of the bone breaks and the tendons tear from the bone. It is very important to repair the break anatomically, to return the bone’s ball structure and prevent joint degeneration, which if not restored properly, can heavily limit function. Because shoulder fractures are common in the senior population, it is important to restore shoulder function to promote independence.

These types of fractures are treated with innovative, surgically affixed metal plates designed specifically for this purpose or with special screws that facilitate successful healing and return of joint movement. In more elderly patients shoulder replacement should be considere.

Torn shoulder tendons are common in seniors, resulting from falls or sharp pulling on the bone. However degenerative tears are also very common. The area typically injured is the rotator cuff, the tendons set into the shoulder socket. Repairing this area and returning it to functioning is done by stitching the tendons under arthroscopic surgery, which does not require large incisions into the joint.

Recurring Dislocations, surprisingly common in young patients, are often caused by an acute motion that pulls the joint out of place. This is extremely painful and requires a skilled orthopedist to reset the bones in place (routinely performed in the emergency department). However, typically in young patients, when the joint is dislocated, there is also a tear in the joint capsule or fracture of the socket. As a result, the shoulder becomes unstable and shoulder dislocation can recur during routine activity, even during sleep.
Arthroscopic surgery is ordinarily performed to treat the injury—to repair the damage and to strengthen the joint capsule. Most tendon and joint repair surgeries are now done on an ambulatory basis in the day hospital.

Additional surgeries conducted by the unit include shoulder replacements—both total and partial—including unique prosthetic implantation, and procedures to treat function-limiting joint degeneration or severely torn tendons.