Overview
Artificial joints
Osteoarthritis, or degenerative arthritis, has a high morbidity rate in the aging population. At the primary stage, conservative treatment is the major strategy. At the secondary stage, artificial joint replacement surgery, or joint arthroplasty, is the most successful and effective solution. At present, people receiving artificial joint replacement are increasing every year, and it has since become one of the most common surgeries in orthopedics.
Being the first to introduce the minimally invasive surgery (MIS) for partial knee joint implant, over the past year or so Show Chwan Memorial Hospital has helped more than a dozen patients ease the pain of being unable to walk, and was the first to apply MIS to artificial joint replacement. The advantages of MIS include small sutures about 7cm long, minimal removal of bone, minimal bleeding, short surgery time, fast recovery etc. Therefore, patients can usually be discharged from the hospital about 3-5 days after the surgery.
Artificial joints are made with metals and high-density plastics according to the structure, shape and functions of human joints. These metals include titanium and cobalt-chrome, and high-density and durable polyethylene (PE) is the most common plastic material.
In an MIS joint implant, the damaged surface of a joint is removed before an artificial joint is implanted like a brace to recover the normal smooth surface of the damaged surface. Most importantly, this helps to prevent aging people from falling, particularly in the bathroom or when getting up in the middle of the night. This way, we can reduce the incidence of bone facture.
The thigh bone, or femur, is the longest bone in the human body. Its top, which looks like a small baseball and is called the femoral head, forms with the hip joint with the pelvis. As it is a spherical joint, it has great flexibility, allowing us to stretch, bend and internally and externally turn the lower limb in a great range of motions.
Vessels on the femoral neck underneath the femoral head supply most part of the blood for the femoral head. When the femoral neck is broken, e.g. when old people suffering osteoporosis fall, these vessels are damaged and cause the ischemic necrosis of femoral head. This case, we must replace it with an artificial hip joint.
Indications
Congenital developmental dysplasia of the hip, degenerative hip arthritis, ischemic necrosis of femoral head, displaced femoral neck fractures, and joint wears of different causes.
Specialists
Treatment course
- An orthopedist first prescribes the patient an X-ray examination of the joint at the outpatient clinic before deciding on the artificial joint surgery together with the evidence shown in the clinical symptoms.
- The physical condition of the patient is assessed before the surgery. For example, patients 60 or older must receive the cardiac ultrasonography; patients suffering from chronic diseases, e.g. hypertension and diabetes, must take medication as instructed and followed up. Basically, as far as the condition is stable and in control, surgery can be very successful.
- At present, a set of standard procedures for hospitalization has been established for patients receiving an artificial joint surgery. The duration is usually 4-8 days, depending on the recovery condition.
- A drainage tube will be placed inside the joint after the surgery, to drain the blood and fluid to reduce swelling. In general, the tube will be removed in about 2-3 days.
- During the hospitalization, medical staff will show patients how PT exercise and post-operative care. A knee bender can help patients bend the knee with a replacement joint for early rehabilitation.
- In post-operative pain control, in addition to general pain relievers, either oral or injection, the PCA implanted by the anesthetist can help to relieve pain dramatically. However, it is not covered by the NHI, and the cost is about $4000-$5000.
- Patients are advised to use crutches for 6 weeks after the surgery to protect the post-operative limb; wait for 3 months to begin normal walking and 6 months minor exercise.
