Knee replacement and rehabilitation
Knee replacement, or any other – is one of the types of arthroplasty, which involves replacing damaged joint surfaces with artificial ones. This allows you to eliminate pain and restore the functioning of the entire limb. Replaced with the articular surface are called by the term «endoprosthesis». Term of its functioning in 90% of cases is 20 years, that speaks about its durability. And if the prosthesis will wear out, you can spend a replacement.
These operations have become the gold standard for the treatment of various chronic diseases such as arthritis and arthrosis III severity. The endoprosthesis has superseded all other options of arthroplasty due to the short recovery period, increase the functioning of the joint and significant improvement in the quality of life of patients. After it the person can once again restore their work capacity and social significance. Also in this case surgical intervention rarely any complications. The only drawback of replacement is high cost of the prosthesis.
Indications and contraindications for surgery
Endoprosthesis is indicated for osteoarthritis, aseptic necrosis, rheumatoid arthritis and tumors that are located in the periarticular tissues. For cancer total joint replacement necessary for complete removal of the tumor and prevent the development of metastasis is a secondary tumor that arose as a result of migration of tumor cells from the primary tumor. If the patient is under 50 years, it is also shown holding the prosthesis in diseases that are accompanied by multiple lesions of the joints, such as ankylosing spondylitis and juvenile rheumatoid arthritis.
Hold the endoprosthesis is contraindicated in the presence of aggravated thrombophlebitis, infection, inability of the muscles to hold the extension in the joint and chronic foci of infection (carious teeth, chronic tonsillitis, etc.). This is due to the possible development of complications such as infection of the prosthesis when the foci of infection.
Thrombophlebitis can lead to very dangerous complications of thromboembolism. It arises due to separation of the clot from the vascular wall, migration through the blood and subsequent clogging of the smaller vessel of any organ, leading to partial necrosis (death of cells and tissues). The highest risk of this complication when a blood clot enters the lungs, the heart and brain, leading to myocardial infarction, stroke and pulmonary embolism. These cases are often fatal.
Remember that joint replacement is performed only after when treatment gives no result. If the patient feels improved after a course of drugs, you should not hurry with the operation. But we should not delay the conduct of endoprosthesis failure of drug therapy: the better preserved the function of the joint before surgery, the greater the effect after the intervention.
Lately for the poor has become possible to obtain endoprosthesis according to the quota. As conditions are constantly changing and often have features for each region, you should contact the local health Department to find out all about this quota.
Replacement of joints of the lower limbs on artificial
Knee replacement is one of the most common surgical interventions. This is due to the high frequency of lesions it chronic diseases. The types of arthroplasty of the knee:
- replacement of the articulation between the femur and patella.
Total joint replacement is indicated for all damage to the articular surfaces, while other types are used in local or limited damage. Odnodiskovyh knee replacement replaces the inner or outer joint between the femur and tibia. It is also possible endoprosthesis of the articular surfaces forming the femoral-patellar joint. Choosing the right kind of replacement always depends on the extensiveness of damage to the articular surfaces.
The prosthesis is carried out under spinal anesthesia, thus reducing the risk of thromboembolism. Anesthetic injected into the subarachnoid space and blocks the conduction of pain impulses to the spinal cord. After processing the surgical field produced an incision that starts at 3-5 cm above the patella and ends at 4 cm below the articular gap. Separated the surrounding muscles, exposing the capsule of the joint, cross the ligament holding the patella and remove it. Next, separate the surrounding tissue from the bones and perform the resection (removal) of the bone above the injured surface with subsequent polishing, thereby forming a surface for implants. The implants are fixed to bone using special bone cement.
Rehabilitation will not take more than two months, despite the fact that walking with crutches is possible within two days, and with a cane in 2 weeks.
Ankle joint replacement is a quite rare operation in connection with low frequency of damage to this area. The principle and stages of operation are similar to knee replacement. Patients undergoing joint replacement of the ankle joint, after surgery was noted complete disappearance of pain or a significant reduction, increase mobility in ankle joint and a decrease or disappearance of crunching during movement.
Surgical treatment of joints of the upper limb
Most often shoulder replacement is performed at mnogomillionnyj comminuted fractures. Shoulder replacement is performed on a special table, which gives a V-shaped position of the patient. As with any surgery, shoulder replacement start with the formation of access, which allows you to allocate the tendons of his hands, which are located in this area. Then spend the removal of the humeral head and implanted two parts of the prosthesis: shoulder and scapular.
Completed shoulder replacement by restoring the integrity of the muscles of the hand are necessary to carry out movements in the shoulder. With such phasing of the operation shoulder replacement provides maximum recovery of hand function.
After end of immobilization (immobility) of hand applied plaster or bandage for 14 days. If shoulder replacement is accompanied by suturing the muscles directly to the implant, the period of immobilization is increased by 1 week. Rehabilitation after shoulder replacement surgery less than two months.
Prosthetic elbow joint produce under local anesthesia. Anesthetic is injected above and below the brachial plexus. Stages of the operation the same as for the shoulder. Prosthetic elbow joint is dangerous because there is a high risk of damage to the ulnar nerve, because even with a rough or careless touch to it may cause movement disorders in the hand and fingers.
Prosthetic joints of the hand is often in rheumatoid arthritis. Depending on the location of the damage of the brush there are the following types of replacement:
- wrist joint;
- the metacarpophalangeal joints.
Make access, and then carried out selection of the large vessels and nerves of the hand. Further, in the bones and drill the holes. Formed in the bone channels enter the bone cement or other liquid fixers and instantly having locking rods implants brush.
Complete the operation by juxtaposition of parts of the prosthesis between them, strengthening his muscles, ligaments and suturing the skin of the hand.