Bone and joint diseases are increasingly becoming one of the leading causes of health problems. The American College of Rheumatology classifies joint diseases into ten major categories of more than 200 types, the first three of which are mostly arthritis. The first category is widespread connective tissue disease, such as rheumatoid arthritis; the second is arthritis associated with the spine, such as ankylosing spondylitis; and the third is osteoarthritis. These are fairly common joint diseases in orthopedic clinics. They are also the main cause of loss of joint function in patients. And in order to improve joint function and improve the quality of life of patients, the use of artificial joint replacement is a common treatment. Feng Bin, Department of Orthopedics, Peking Union Medical College Hospital
What is total knee replacement?
Total knee replacement is the removal of the destroyed cartilage and bone fragments on the surface of the femoral condyle, tibial plateau and patella with special precision instruments, and joint surface replacement with titanium or cobalt-chromium-molybdenum alloy and polymer polyethylene. As shown in the figure.
So who can have such a procedure?
Patients with joint pain that is difficult to control and significantly affects function, including the following diseases, are suitable for surgery.
1. severe osteoarthritis.
2, rheumatoid arthritis.
3, traumatic osteoarthritis.
4, hemophilic arthritis.
5, psoriatic arthritis.
6, sequelae of infectious arthritis.
7.Tumor removal involving joint surfaces, etc.
What kind of people cannot have such surgery?
Symptoms of the following diseases are contraindications to artificial joint arthroplasty.
1, local or other parts of the body still have active infection.
2. Poor local skin, soft tissue and blood supply, which may lead to difficulty in closing the incision or soft tissue and skin necrosis at the incision site after surgery.
3.Neurogenic arthropathy.
4.Severe osteoporosis.
5. Paralysis of the muscles around the joint, which makes it difficult to keep the joint stable after surgery or to complete active joint activities.
6. Systemic conditions or concomitant diseases that make it difficult to tolerate the replacement surgery.
What preparations should be made before surgery?
First of all, a detailed medical history and careful physical examination are required. After the indications are established, the specific details of the surgery need to be considered.
1.Take X-ray film to understand the lesion and its severity.
2.Exclude other diseases: such as old fractures.
3.Improve routine blood tests before surgery.
4.Understand the whole body condition and clarify whether it can tolerate the surgical treatment and the risks associated with the surgery. For example: ultrasound, electrocardiogram, cardiac examination, pulmonary function.
5.Strengthen cardiopulmonary function exercise before surgery, such as: do more deep breathing, strengthen coughing exercise, increase lung capacity. Quit smoking and alcohol.
6.Strengthen nutritional support. If you have diabetes, you should actively control blood sugar; hypertensive patients should actively control blood pressure before surgery.
7.Psychological counseling to understand the necessity of surgery and eliminate the fear of surgery.
8.Adapt to defecation in the hospital bed.