Welcome to my monthly column on the world of health. This month we’ll be discussing a common part of orthopaedic surgery, or surgery to the joints, bones, ligaments and muscles. One of the most common areas is joint replacement, particularly to the hip or knee joints. Wear and tear to joints can reach a point where pain is consistent and restriction of movement becomes so limited it begins to prevent the individual completing even the most, simple tasks.
At this point they become a candidate for joint replacement surgery. A number of factors will decide whether or not they are eligible for the actual replacement. Age plays an important role, if the person is too young the surgery will be left to the last possible moment as most prosthetic joints have around a 20 year lifespan, and it is best not to have to re-do the surgery. Other factors include, expected usage of the joint, i.e. what tasks the individual is hoping to do post-surgery, weight of the candidate, are they within the strict weight guidelines for surgery patients, and if they currently suffer with any other medical conditions, will they affect the surgery, to name but a few.
Surprisingly many joint replacement operations are now performed while the patient is awake, so surgeons are using a local anaesthetic such as an epidural rather than a general anaesthetic. This is better for several reasons, firstly it allows the surgical team to check the patients status much more efficiently, secondly the risk of a negative reaction to the anaesthetic in older individuals is much less likely, and thirdly recovery time is much faster which allows the patient to be up and moving, which will prevent too much loss of muscle strength in the affected area.
Aftercare of the joint replacement is of great importance for wound healing and also for rehabilitation of the joint area. The program of care should include physiotherapy to strengthen the joint and build confidence with everyday tasks. However, this will generally focus on the joint that has been replaced and not on all of the surrounding joints and how they have been affected. It is perhaps even more important when a patient has a joint replacement to ensure that the rest of the body is performing at an optimum level, as the prosthetic joint will never be as strong or as flexible as the real thing. Therefore any excessive load on that joint may decrease its lifespan, and will increase the chance of a second operation in the future.
For more information on the clinic, to discuss a particular case, or to book and appointment please call Tristan Hill on 01949 839 238