Orthopedics
The signs of a worn-out locomotor system are considered to be the most frequent illnesses of modern times caused by excessive strain, inadequate biomechanical stress, lack of activity, inadequate diet and metabolic disorders. Further risk factors develop with aging, such as artrosis and the loosening of hip joints, and some of the problems are caused by genetic factors.
The symptoms often cause pain and include regular movements. In some cases, it is no longer possible to lead a normal life.
Orthopaedic procedures treat structural changes and diseases of the bones, joints, muscles and sinews:
-artificial joint replacement of the knee
-hip replacement
-shoulder joint replacement
-spinal disk replacement
-vertebroplasty
Artificial joint replacement of the knee
Your posture and ability to walk depends on the knee joint. It enables optimum movement and optimum stability. Over time, the joint wears out and the inborn deficiencies and damages created by injuries cause limited functioning of the joint: less mobility, pain and, eventually, a poorer quality of life.
Today, advancements in medical knowledge in the field of orthopaedics enable partial or complete replacement of the knee joint, which completely or partially restores mobility: the replacement of the damaged part of the joint, usually the inner one, a complete replacement of the worn out surface of the joint or complete replacement of the entire joint that has been destroyed due to wearing out or injury.
The level of injury and type of procedure are determined on the basis of the radiograph and the blood sample.
Patients who are on anticoagulant therapy should terminate it 2-3 weeks before the surgery. Nicotine and alcohol should also be avoided.
The procedures are performed under general anaesthesia, sometimes local, and last 1.5 -2.5 hours. The final results and stability depend on the care after the procedure when the patient learns how to use the implant and gradually apply pressure.
Hip replacement
Factors such as age (over 65 years), diet, professional stress and personal life, along with genetic factors, can cause a weakening of the hips. By means of hip arthroplasty the painful and damaged hip is replaced with a highly functional prosthetic device.
The prosthesis consists of 3 parts: the stem, the cup and the ball. Individual parts are available in different sizes and materials and adapt to the body as much as possible. The stem is made from metallic polyethylene.
The entire device can be fixed to the bone with cement, but some prosthetic devices are fixed without cement. Fixed prostheses accelerate recovery time and the time it takes to return to normal activities. Prostheses that are fixed without the use of cement enable forming of the new bone structure so the recovery takes longer. These implants are used with younger patients who have stronger bone substance.
The materials are biocompatible and will not corrode, degenerate or erode over time.
The method of fixing the prosthesis determines the choice of the surgical procedure: the traditional, or the least invasive surgical procedure is performed through two small incisions, it is less destructive to the surrounding tissue, the recovery is faster and the person can leave the hospital earlier.
Before the procedure, the usual tests are run: blood, urine, ECG and orthopaedic tests, in order to determine the best type of prosthesis. There must be no inflammations in the surrounding tissue. The anticoagulant therapy should be terminated. If the person is considerably overweight, he/she might be advised to lose weight so that the access to the hip would be easier.
Home recovery implies help around the house, from keeping the household to maintaining hygiene, due to reduced mobility which lasts for several weeks after the surgery.
Shoulder joint replacement
Considering that we use hands in nearly every moment of our daily lives, many activities, if not all, will become painful if the shoulder joint cannot function properly.
Old age, increased stress or disease can cause wearing out of the joint (artrosis), inflammatory rheumatic diseases or necrosis of the head of the humerus (upper arm bone) and limited functioning of the shoulder joint.
Modern orthopaedics offers the possibility of replacing the shoulder joint with an artificial one in order to restore function, mobility and ability to play sports, or to eliminate pain.
The shoulder joint consists of two parts: the joint head and the cup. The surgery involves replacement of the worn out, inflamed or necrotized parts of the joint and sometimes the whole joint. Depending on the solidity of the bones, the procedure is performed with or without the use of cement.
The decision about the method of surgery is made on the basis of preparatory tests which include: a blood test, a radiograph and ECG. The patient must be in good physical shape, quit smoking and stop taking anticoagulant medications.
The procedure is performed under a local or general anaesthesia, depending on the difficulty or the type of the procedure, and lasts 2-3 hours. The patient remains in the hospital for 2-5 days. During the first 4-6 weeks of post surgical recovery, the patient wears a special bandage and activities such as driving are not possible. Returning to work is possible after 3-6 weeks, if the person does not have a physically demanding job.
After the surgery, the pain disappears or gradually decreases in the recovery process. The mobility of the shoulder increases in proportion to the amount of physical therapy. Full results are visible after 3-6 months.
The spinal disk replacement
The spinal disks enable stability and maximum mobility of the entire backbone. Simultaneously, they protect the spinal nerve that connects the upper and lower part of the body.
Pain in the spine caused by the disk herniation due to degenerative changes or sudden injury develops when the disk pressures the spinal nerve in the vertebral canal or toward the root of the nerve in the back. The nerve affected with compression causes pain in the neck or the lower part of the back, stiffness, motor activity problems, reduced reflexes, and can also cause loss of bladder control.
When the symptoms cannot be improved with traditional methods, surgery of the spinal disk is considered. This procedure can reduce the pain and restore mobility of the spine.
The procedure is performed under a local anaesthesia: the spinal disk is removed and replaced by a prosthetic implant composed of metal and plastic, and affixed to the surrounding vertebrae.
Prolapsed disc in only one vertebra and otherwise healthy backbone are important requirements for the installation of an artificial spinal disk. The vertebrae should not manifest any degeneration. The person should not be overweight or suffer from osteoporosis or scolitis. These requirements are determined by preliminary tests such as the radiograph and the magnetic resonance imaging. Two weeks prior to the surgery, the patient must not use anticoagulant medications, alcohol or nicotine because they interfere with the process of recovery.
The surgery lasts 3-6 hours, and the patient remains in the hospital for 2-5 days. In most cases, the mobility already returns on the same day. If the implant is inserted in the neck part of the spine, it is recommended to wear a soft cervical collar during the first 6 months following the procedure, or a lumbar corset for 6 weeks.
Recovery further includes regular physical therapy to strengthen the backbone, stretching exercises and walking. The patient can resume regular activities in 6-8 weeks.
Vertebroplasty
Osteoporosis is a common disease in old age that is characterized by reduced bone substance and its further decay. The disease might cause the breaking of certain bones, even of the whole skeleton. The fractures are particularly dangerous for the backbone because of damaged stability and pain.
When several requirements are fulfilled, the procedure called „percutaneous vertebroplasty” can be performed. The technique is minimally invasive, stabilizes the fractures of the backbone and reduces the pain. If performed immediately after the fracture it is 80-90% successful, and it is possible to eliminate the pain entirely.
Stabilization of the vertebral column is achieved by injecting the bone cement into the bone with a fine needle which is penetrated into the vertebra using the image guidance. After the injection, the bone is solidified with heating and the bone hardens from the inside. Up to 3 vertebrae can be treated in one procedure.
The procedure requires the use of a local anaesthetic in the area of penetration of the needle or, alternatively, a mild analgesic or a sedative. After the procedure, the patient will need bed rest, and will be advised to stay in the clinic for a day. After the procedure, the patient should have a CT at regular intervals and continue with the treatment of osteoporosis.
During preparation for the procedure, it is necessary to analyze the patient’s blood sample and blood coagulation, but also the patient’s allergies in order to avoid an allergic reaction to the injected substance. The patient must not have any bone or spinal disk inflammations, and the magnetic resonance should eliminate the possibility of a tumour.
The symptoms often cause pain and include regular movements. In some cases, it is no longer possible to lead a normal life.
Orthopaedic procedures treat structural changes and diseases of the bones, joints, muscles and sinews:
-artificial joint replacement of the knee
-hip replacement
-shoulder joint replacement
-spinal disk replacement
-vertebroplasty
Artificial joint replacement of the knee
Your posture and ability to walk depends on the knee joint. It enables optimum movement and optimum stability. Over time, the joint wears out and the inborn deficiencies and damages created by injuries cause limited functioning of the joint: less mobility, pain and, eventually, a poorer quality of life.
Today, advancements in medical knowledge in the field of orthopaedics enable partial or complete replacement of the knee joint, which completely or partially restores mobility: the replacement of the damaged part of the joint, usually the inner one, a complete replacement of the worn out surface of the joint or complete replacement of the entire joint that has been destroyed due to wearing out or injury.
The level of injury and type of procedure are determined on the basis of the radiograph and the blood sample.
Patients who are on anticoagulant therapy should terminate it 2-3 weeks before the surgery. Nicotine and alcohol should also be avoided.
The procedures are performed under general anaesthesia, sometimes local, and last 1.5 -2.5 hours. The final results and stability depend on the care after the procedure when the patient learns how to use the implant and gradually apply pressure.
Hip replacement
Factors such as age (over 65 years), diet, professional stress and personal life, along with genetic factors, can cause a weakening of the hips. By means of hip arthroplasty the painful and damaged hip is replaced with a highly functional prosthetic device.
The prosthesis consists of 3 parts: the stem, the cup and the ball. Individual parts are available in different sizes and materials and adapt to the body as much as possible. The stem is made from metallic polyethylene.
The entire device can be fixed to the bone with cement, but some prosthetic devices are fixed without cement. Fixed prostheses accelerate recovery time and the time it takes to return to normal activities. Prostheses that are fixed without the use of cement enable forming of the new bone structure so the recovery takes longer. These implants are used with younger patients who have stronger bone substance.
The materials are biocompatible and will not corrode, degenerate or erode over time.
The method of fixing the prosthesis determines the choice of the surgical procedure: the traditional, or the least invasive surgical procedure is performed through two small incisions, it is less destructive to the surrounding tissue, the recovery is faster and the person can leave the hospital earlier.
Before the procedure, the usual tests are run: blood, urine, ECG and orthopaedic tests, in order to determine the best type of prosthesis. There must be no inflammations in the surrounding tissue. The anticoagulant therapy should be terminated. If the person is considerably overweight, he/she might be advised to lose weight so that the access to the hip would be easier.
Home recovery implies help around the house, from keeping the household to maintaining hygiene, due to reduced mobility which lasts for several weeks after the surgery.
Shoulder joint replacement
Considering that we use hands in nearly every moment of our daily lives, many activities, if not all, will become painful if the shoulder joint cannot function properly.
Old age, increased stress or disease can cause wearing out of the joint (artrosis), inflammatory rheumatic diseases or necrosis of the head of the humerus (upper arm bone) and limited functioning of the shoulder joint.
Modern orthopaedics offers the possibility of replacing the shoulder joint with an artificial one in order to restore function, mobility and ability to play sports, or to eliminate pain.
The shoulder joint consists of two parts: the joint head and the cup. The surgery involves replacement of the worn out, inflamed or necrotized parts of the joint and sometimes the whole joint. Depending on the solidity of the bones, the procedure is performed with or without the use of cement.
The decision about the method of surgery is made on the basis of preparatory tests which include: a blood test, a radiograph and ECG. The patient must be in good physical shape, quit smoking and stop taking anticoagulant medications.
The procedure is performed under a local or general anaesthesia, depending on the difficulty or the type of the procedure, and lasts 2-3 hours. The patient remains in the hospital for 2-5 days. During the first 4-6 weeks of post surgical recovery, the patient wears a special bandage and activities such as driving are not possible. Returning to work is possible after 3-6 weeks, if the person does not have a physically demanding job.
After the surgery, the pain disappears or gradually decreases in the recovery process. The mobility of the shoulder increases in proportion to the amount of physical therapy. Full results are visible after 3-6 months.
The spinal disk replacement
The spinal disks enable stability and maximum mobility of the entire backbone. Simultaneously, they protect the spinal nerve that connects the upper and lower part of the body.
Pain in the spine caused by the disk herniation due to degenerative changes or sudden injury develops when the disk pressures the spinal nerve in the vertebral canal or toward the root of the nerve in the back. The nerve affected with compression causes pain in the neck or the lower part of the back, stiffness, motor activity problems, reduced reflexes, and can also cause loss of bladder control.
When the symptoms cannot be improved with traditional methods, surgery of the spinal disk is considered. This procedure can reduce the pain and restore mobility of the spine.
The procedure is performed under a local anaesthesia: the spinal disk is removed and replaced by a prosthetic implant composed of metal and plastic, and affixed to the surrounding vertebrae.
Prolapsed disc in only one vertebra and otherwise healthy backbone are important requirements for the installation of an artificial spinal disk. The vertebrae should not manifest any degeneration. The person should not be overweight or suffer from osteoporosis or scolitis. These requirements are determined by preliminary tests such as the radiograph and the magnetic resonance imaging. Two weeks prior to the surgery, the patient must not use anticoagulant medications, alcohol or nicotine because they interfere with the process of recovery.
The surgery lasts 3-6 hours, and the patient remains in the hospital for 2-5 days. In most cases, the mobility already returns on the same day. If the implant is inserted in the neck part of the spine, it is recommended to wear a soft cervical collar during the first 6 months following the procedure, or a lumbar corset for 6 weeks.
Recovery further includes regular physical therapy to strengthen the backbone, stretching exercises and walking. The patient can resume regular activities in 6-8 weeks.
Vertebroplasty
Osteoporosis is a common disease in old age that is characterized by reduced bone substance and its further decay. The disease might cause the breaking of certain bones, even of the whole skeleton. The fractures are particularly dangerous for the backbone because of damaged stability and pain.
When several requirements are fulfilled, the procedure called „percutaneous vertebroplasty” can be performed. The technique is minimally invasive, stabilizes the fractures of the backbone and reduces the pain. If performed immediately after the fracture it is 80-90% successful, and it is possible to eliminate the pain entirely.
Stabilization of the vertebral column is achieved by injecting the bone cement into the bone with a fine needle which is penetrated into the vertebra using the image guidance. After the injection, the bone is solidified with heating and the bone hardens from the inside. Up to 3 vertebrae can be treated in one procedure.
The procedure requires the use of a local anaesthetic in the area of penetration of the needle or, alternatively, a mild analgesic or a sedative. After the procedure, the patient will need bed rest, and will be advised to stay in the clinic for a day. After the procedure, the patient should have a CT at regular intervals and continue with the treatment of osteoporosis.
During preparation for the procedure, it is necessary to analyze the patient’s blood sample and blood coagulation, but also the patient’s allergies in order to avoid an allergic reaction to the injected substance. The patient must not have any bone or spinal disk inflammations, and the magnetic resonance should eliminate the possibility of a tumour.