For patients
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Knee Replacement-Causes,Symptoms,Treatment
Knee replacement is a surgical procedure that involves removing damaged or diseased parts of the knee joint and replacing them with artificial components. It is typically done when other treatments, such as physical therapy or medication, have failed to relieve knee pain and improve mobility.
Causes: The most common reasons for knee replacement are:
- Osteoarthritis: A degenerative joint disease that causes the cartilage in the knee joint to wear down over time, leading to pain and stiffness.
- Rheumatoid arthritis: An autoimmune disorder that causes inflammation in the joint lining, leading to pain and stiffness.
- Post-traumatic arthritis: Arthritis that develops after a knee injury, such as a fracture or ligament tear.
- Avascular necrosis: A condition where the bone tissue in the knee dies due to a lack of blood supply.
Symptoms: The most common symptoms that may indicate the need for knee replacement include:
- Persistent knee pain that limits daily activities
- Stiffness and swelling in the knee joint
- Difficulty walking or climbing stairs
- A decrease in knee mobility
- Knee deformities, such as varus or valgus
Treatment: The knee replacement surgery involves replacing the damaged parts of the knee joint with artificial components made of metal and plastic. The procedure typically takes a couple of hours, and most patients stay in the hospital for a few days to recover.
After the surgery, patients are advised to rest and gradually increase their physical activity with the help of a physical therapist. Pain medication and anti-inflammatory drugs may be prescribed to manage discomfort and swelling.
Prevention: While knee replacement cannot be prevented in all cases, there are some measures that can help reduce the risk of knee damage and delay the need for surgery, such as:
- Maintaining a healthy weight to reduce stress on the knees
- Engaging in regular low-impact exercise, such as swimming or cycling, to strengthen the muscles around the knee joint
- Avoiding high-impact activities that can put excessive strain on the knees
- Wearing appropriate footwear to support the feet and knees.
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Hip Replacement-Causes,Symptoms,Treatment
Hip replacement is a surgical procedure that involves removing damaged or diseased parts of the hip joint and replacing them with artificial components. It is typically done when other treatments, such as physical therapy or medication, have failed to relieve hip pain and improve mobility.
Causes: The most common reasons for hip replacement are:
- Osteoarthritis: A degenerative joint disease that causes the cartilage in the hip joint to wear down over time, leading to pain and stiffness.
- Rheumatoid arthritis: An autoimmune disorder that causes inflammation in the joint lining, leading to pain and stiffness.
- Avascular necrosis: A condition where the bone tissue in the hip joint dies due to a lack of blood supply.
Symptoms: The most common symptoms that may indicate the need for hip replacement include:
- Persistent hip pain that limits daily activities
- Stiffness and swelling in the hip joint
- Difficulty walking or climbing stairs
- A decrease in hip mobility
- Hip deformities, such as leg length discrepancy or hip dislocation
Treatment: The hip replacement surgery involves replacing the damaged parts of the hip joint with artificial components made of metal, plastic or ceramic. The procedure typically takes a few hours, and most patients stay in the hospital for a few days to recover.
After the surgery, patients are advised to rest and gradually increase their physical activity with the help of a physical therapist. Pain medication and anti-inflammatory drugs may be prescribed to manage discomfort and swelling.
Prevention: While hip replacement cannot be prevented in all cases, there are some measures that can help reduce the risk of hip damage and delay the need for surgery, such as:
- Maintaining a healthy weight to reduce stress on the hips
- Engaging in regular low-impact exercise, such as swimming or cycling, to strengthen the muscles around the hip joint
- Avoiding high-impact activities that can put excessive strain on the hips
- Wearing appropriate footwear to support the feet and hips.
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Total Shoulder Arthroplasty
Total shoulder arthroplasty (TSA) is a surgical procedure that involves replacing the damaged or worn-out parts of the shoulder joint with artificial components. During the procedure, the surgeon will make an incision in the shoulder and remove the damaged parts of the joint, including the humeral head (upper arm bone) and the glenoid (shoulder blade). These parts are then replaced with artificial components made of metal, plastic, or ceramic.
The benefits of TSA include:
- Reduced pain and stiffness in the shoulder joint
- Improved range of motion in the shoulder joint
- Improved function and strength in the arm and shoulder muscles
- Improved quality of life and ability to perform daily activities
ΤSA is a major surgery and requires a significant amount of rehabilitation and recovery time. Patients will typically need to undergo physical therapy and follow a strict rehabilitation program to regain strength and range of motion in the shoulder.
Shoulder arthritis is a common condition that can cause pain, stiffness, and reduced range of motion in the joint. In cases where conservative treatments are no longer effective, total shoulder arthroplasty (TSA) may be recommended as a treatment option. While TSA can provide significant benefits in terms of pain relief and improved function, it is important to understand the risks and benefits of the procedure and to work closely with a healthcare provider to ensure a successful outcome.
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Diabetic Foot
What is a diabetic foot?
Diabetic foot is a condition that is caused by diabetes mellitus and is caused by a disorder of the blood supply to the limbs, resulting in various complications such as ulceration, tissue infection or diabetic arterial disease.
What are the symptoms?
The main symptoms that should alarm the patient are:
- Leg ulcer
- Swollen and irritated foot
- Blisters and dry skin
- Bruised foot
How is it treated?
Proper treatment of diabetic foot requires the involvement of physicians of various specialties, with the primary role of the vascular surgeon. First, the blood sugar must be regulated and then the existing arterial lesions must be treated with modern surgical techniques. At the same time, the existing ulcers must be meticulously treated with appropriate dressings and negative pressure therapies. Neglecting and mishandling an ulcer can lead to limb amputation.
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Hallux Valgus
Hallux valgus, commonly referred to as a bunion is an anatomical deformity of the big toe. This is the most common deformity of the foot, in which the big toe deviates from its anatomical position and turns around its axis, while the first metatarsal head protrudes creating the so-called bunion, that causes medial big toe pain and difficulty with shoe wear.
The condition appears to have genetic predisposition and is more common in women. Aggravating factor is the narrow shoes, especially with high heels, which force the big toe to change its angle in relation to the other toes, while the constant pressure and friction causes redness, pain and osteophytes.
In most cases the problem is addressed surgically. The purpose of the surgical intervention is to correct the deformity, through corrective osteotomy. This means that the bone will be incised, its orientation will be corrected, and it will be held in its final position with special osteosynthesis implants.
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Osteoarthritis
What is osteoarthritis?
Osteoarthritis is a degenerative disease that affects the joints. It mainly affects older people, however, it can also be caused by an injury. It is the most common form of arthritis and occurs in people all over the world. It is also known as degenerative arthropathy.
What causes osteoarthritis in the joints?
Osteoarthritis is due to the gradual degeneration of the joints of the body. Cartilage is a tissue that facilitates the movement of the joint without friction. If it wears out completely, then the bones rub against each other and thus, the entire joint is damaged. Thus, the bone changes, the tissues that hold the joints together and attach to the bone wear out, causing inflammation in the area.
Risk factors that increase the risk of osteoarthritis include age, previous injuries, gender (more common in women), obesity, heredity and certain metabolic diseases.
The symptoms of osteoarthritis?
- Pain
- Stiffness
- Swelling and inflammation
- Feeling that the joint is rubbing
- The range of motion is reduced
What is the treatment for osteoarthritis?
Different forms of treatment are recommended for each stage of osteoarthritis with the aim of relieving the symptoms.
In the first stage of acute osteoarthritis, anti-inflammatory drugs and cold compresses are given. Muscle-strengthening exercises and physiotherapy are also recommended.
In the second stage, injections of hyaluronic acid and chondroitin are applied. These are substances that reduce bone friction and help partially regenerate damaged cartilage.
Finally in the third stage, when the wear is great, the patient undergoes total arthroplasty surgery.
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Total Hip Arthroplasty
The invention of total hip arthroplasty (THA) was the most radical treatment, addressing the various hip diseases and contributed significantly to the improvement of patients' quality of life, as they are given the opportunity to live an almost normal life. The pioneer surgeon of this operation was Sir John Charnley who, about 70 years ago, started the systematic treatment of osteoarthritis of the hip with total hip arthroplasty. Today we have reached the point where the number of total hip arthroplasties performed worldwide exceeds 1.3 million patients per year.
The evolution of THA went through various stages. It was preceded by hemi-arthroplasty, i.e., replacement of the femoral head only, which is still used today to treat subcapital fractures of the femur.
The first attempt is described around 1890 when Gluck in Germany replaced a femoral head with a spherical ivory head. More recently (1943) Austin Moore in England applied a femoral prosthesis that was fixed to the femur with screws, with a spherical head at the edge. In 1946 Judet in France made a prosthesis consisting of a femoral stem and a chrome-cobalt alloy head. A few years later (1950) Austin-Moore placed the femoral prosthesis inside the femoral canal with much better mechanical results. In 1951 Mckee performed THA which used a Thompson-type femoral prosthesis with a head fixed in the femoral stem and a metal acetabular cup with pegs for stable fixation.
Sir John Charnley, in the 1950s, used Teflon for the acetabular implant and replaced the femoral head with a steel stem. For the stabilization of the two implants was used biological (methylmethacrylate) cement. Muller from Switzerland followed approximately the same technique. However, because of some problems that were observed with the cement, research turned to materials that would be stabilized without cement, with the so-called press-fit technique.
Since the 1980s the trend has been to place prostheses without the use of cement. Today we use femoral and acetabular prostheses with a porous surface. The acetabular insert is either made of high molecular weight polyethylene (UHMWPE) or ceramic material (AL2 O3) and the femoral heads are also made of ceramic material for reduced wear.
There is much discussion currently for the surgical approach which is still evolving. The predominant trend is small incisions of minimal invasiveness, such as the technique of anterior approach AMIS (Anterior Minimally Invasive Surgery) which avoids injury to muscles and nerves in the area, resulting in faster recovery of the patient.
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Total Knee Arthroplasty
The goal of total knee arthroplasty (TKA) is to restore knee joint mobility and improve the function of the muscles, ligaments, and other soft tissues around the knee. Clinically, it also aims to reduce pain and improve patients' quality of life after ineffective conservative treatment.
Total knee arthroplasty is not a modern operation, as the first attempt at arthroplasty was reported in 1860 by Fergusson. In 1890, Gluck first proposed the complete excision of the articular surfaces of the joint and the creation of an ivory prosthesis on the principle of the hinge.
The first attempts to create a total knee replacement, roughly as we know it today, were done in the 1940s by Judet.
Still, the design of the prosthesis as a hinge allowed only flexion and extension of the knee and not rotation and sliding, which caused loosening due to the strong forces applied. To address the loosening problem, Freeman and Swanson invented in 1974 the independent prostheses of the femur, the tibia and the patella with a polyethylene insert between the metal prostheses, made of stainless steel at first or chrome-cobalt alloy afterwards. It was the first time that the knee was not reconstructed as a "hinge", but its normal anatomy was preserved, while the collateral ligaments and (in some cases) the posterior cruciate ligament was preserved.
A famous pioneer was Insall, who along with Burstein designed in 1978 the famous Insall-Burstein Posterior Stabilized Knee, a special prosthesis that provided stabilization needed when the posterior cruciate ligament was sacrificed.
Since then, there has been a constant evolution in the design of prostheses, as research has led to impressive achievements making TKA one of the most successful procedures today.
One of the most modern techniques is individualized total knee arthroplasty. It is a surgical procedure tailored to the patient as it allows the surgeon to acquire a three-dimensional preoperative image of the bones and the prostheses, based on the patient's CT (or MRI) scans, and subsequently to design personalized cutting guides. The latest development is the use of computer-assisted navigation systems that help the surgeon to achieve optimal placement of the prostheses.
The above techniques have benefits for both the surgeon and the patient as intraoperative and postoperative complications are reduced and the quality of life of patients is improved.