- Arthroplasty - if conservative treatment fails
- The total
Joint diseases can dramatically change a person's lifestyle. Because of the severe disorders of the limbs lost the ability to self-service. When this disturbed patient persistent pain, where the conservative treatment is ineffective. Arthroplasty - the only way in most of these situations.
What is total joint replacement
Arthroplasty - a surgical procedure during which the affected parts of the joint are replaced with artificial elements. The operation is performed on the hip, knee, shoulder, elbow and interphalangeal joints.
Prostheses are made from high-strength materials that do not react chemically with the surrounding tissues and harmless to humans. These properties are plastics, ceramics, and metals (stainless steel, titanium and titanium alloys).
If the prosthesis is replaced only part of the joint, this type of joint replacement
Endoprosthesis - when the most durable fabric fail
It called unipolar or incomplete. With full (total) to replace the entire joint arthroplasty.
Implants are attached to the bones of two ways: cementless and cemented. In the first case part of an artificial joint fixed by means of bone cement - durable polymeric material which hardens quickly. This method is often used in elderly people with low physical activity, and in patients with osteoporosis
Osteoporosis - he threatens you?
With cementless prosthesis mounting surface covered with a porous material, which further grows bone and fixes the parts of the artificial joint. This method is suitable for young people who lead an active lifestyle. If you follow all the doctor's recommendations, the prosthesis will last about fifteen years. Then, it must be replaced, while cementless attachment to do a lot easier.
When cemented arthroplasty in rare cases, possible separation of the prosthesis. Sometimes there is a degradation of the cement particles, and because of this there is a loosening of joints. Cementless implants do not have this drawback.
After replacement of the affected joint cemented endoprosthesis reduces pain in the early postoperative period, and joint function recovered very quickly. In patients with cementless endoprostheses it takes longer. Bone tissue needs time to grow into the material, which is covered by the endoprosthesis.
Indications and contraindications
Arthroplasty is indicated for lesions of the musculoskeletal system, in which the conservative treatment does not help. Such conditions include:
- Degenerative-dystrophic diseases of the joints;
- Post-traumatic arthritis and dysplastic;
- Ankylosing spondylitis;
- Rheumatoid arthritis
Arthritis - a variety of forms and complications
- False joints of the shoulder or hip;
- Intra-articular fractures, which are not properly fused;
- Aseptic necrosis of the femoral head.
For this surgery, there are contraindications. Endoprosthesis is not carried out if the patient has any of the following conditions:
- Acute or chronic osteomyelitis;
- Severe chronic diseases of the cardiovascular or respiratory system;
- Severe liver or kidney failure
Kidney failure - when treatment is vital
- Neuropsychiatric diseases;
- Endocrine diseases that are difficult to treat;
- Poliallergiya (an allergic reaction to some allergen);
- Hemiparesis (weakening of voluntary movements on one side of the body) on the side where the affected joint.
An elderly patient's age is not a contraindication to surgery. But if you are patient with the severe comorbidities, the surgical procedure is not carried out.
As the operation is performed
Before the surgery, the patient must undergo a full clinical examination, which includes a laboratory and instrumental research, consulting various doctors and inspection of the anesthesiologist, since the surgery is performed under general anesthesia. One day before the joint replacement patients arrive at the hospital.
Before the surgery and after the patient administered antibiotics. This avoids the infectious complications of the surgical wound.
With total hip replacement acetabulum (impression of the pelvis, which, together with the head of the hip joint forms) processed cutters (tool with a large number of blades). During this procedure, the articular cartilage is removed. Then, into the cavity of the prosthesis is implanted in the form of a cup. Hip crossed and then removed together with the head. The second part consists of a prosthesis stem and a head. The femur forms a channel in which the fixed leg and the head of the implant is inserted into the cup. Thereafter, the joint capsule is reduced. When hemiarthroplasty replaced with only the head of the femur. The operation lasts for two to three hours.
Endoprosthesis of the knee, shoulder, elbow and finger joints are also the same shape as healthy joints. This allows you to fully restore the range of motion in the affected limb. Deleted and changed articular surface of the bone, and in their place establish the prosthesis.
At the site of the surgery fixed drainage tube. Thanks to her surgical wound does not collect blood.
After surgery, the patient is administered pain relievers and blood-thinning drugs. The latter is necessary in order to avoid the formation of clots.
The recovery period
Immediately after surgery in the operated joint movement must be limited. When hip replacement is placed between the legs of the roller, which holds the limb in the correct position.
Already in the first day after surgery, the patient is allowed to move in bed. On the second day, you can sit down. The patient should perform breathing exercises and static exercises (contraction and relaxation of certain muscle groups operated limb), it shows that the doctor on physiotherapy exercises. On the third day of walking can be a load on the operated limb, with additional support should be used, such as crutches.
The patient was discharged from the hospital about the tenth day after the arthroplasty. The loads on the operated limb should be limited to two months after surgery, and complete the recovery period is about a year.
Arthroplasty - a modern operation that can completely restore the function of the affected limb. If you comply with all recommendations of the physician and surgeon for physical therapy, the artificial joint will last a very long time.