In the eyes of people with arthritis disease, surgery is often seen as the last option for the treatment process.
However, with advances in medicine and more options for different procedures, such thinking is actually wrong. While most arthritis in the early stages does not need to involve surgery, early surgical treatment can stop the progression of the disease from mid-stage to advanced. Such surgery is also less complicated, more likely to restore function to the joint, and has a lower complication rate. Locally, the incidence of knee arthritis is six times higher than hip arthritis and 30 times higher than shoulder arthritis.
Arthritis of the knee
There have been several advances in the surgical treatment of knee osteoarthritis.
1. Arthroscopy (endoscopy) and related procedures
2. Cartilage transplantation and replacement surgery
3.Partial knee joint replacement
4, Minimally invasive (small incision) and computer-assisted total knee replacement
1.Arthroscopy and related surgery
Arthroscopy is the most common knee surgery with the smallest incision. During the procedure, various chemical toxins that cause inflammation, pain and swelling are flushed out of the knee joint, allowing for pain relief. However, studies have shown that when performed alone, patients do not improve significantly after 2 years. For better results, arthroscopy must also be combined with other techniques such as subtractive arthroplasty and arthroscopic cartilage surgery to increase the rate of cartilage healing.
2. Cartilage grafting and replacement surgery
Sometimes, after using the above procedures, the cartilage still does not heal. Today, knee cartilage cells or stem cells from the bone marrow can be extracted and grown in the laboratory. Afterwards, a liquid medium containing the chondrocytes is transplanted into the cartilage defect to form a new cartilage layer. This treatment is effective for patients under 45 years of age with small cartilage defects, but is not suitable for older patients with severe arthritis.
3. Partial knee replacement
The normal knee is divided into 3 parts or compartments. Studies have shown that arthritis in the knee always appears in one part first, and then involves the other two parts as it continues to wear. A partial knee replacement, replacing the previously worn out part, has been shown to prevent the knee arthritis from continuing to worsen. This procedure is very advantageous because partial knee replacement requires smaller incisions, preserves undamaged cartilage, ligaments and meniscus, and therefore results in faster recovery, better knee function and lower complication rates after surgery.
4. Minimally invasive (small incision) and computer-assisted total knee replacement
For the past 20 years, patients with severe knee arthritis have been treated with total knee replacement surgery. Today, with the invention of minimally invasive techniques, the incision and muscle dissection are followed by a reduction in size, which can speed up the patient’s recovery and achieve better functioning. With the aid of computers during surgery, the accuracy of knee replacement has increased significantly from 70% to 95%.
Regardless of the type of surgery performed, the goal is always to try to restore the normal function of the knee joint. However, it is important that the patient avoids movements that can aggravate the condition, such as climbing stairs or lifting heavy objects regularly. This will ensure that the good results achieved by the surgery are maintained over time.
Osteoporosis: Etiology, diagnosis and treatment
Osteoporosis has been called the “silent killer” of the elderly. Compared to other notable diseases such as cancer and heart disease, osteoporosis has received much less attention and focus.
In the United States, it is estimated that about 15% of the population suffers from osteoporosis, and it is believed that the figures for people with osteoporosis in third world countries are even higher.
For most patients, the primary symptom of osteoporosis is a fracture. This commonly occurs in the wrist, spine and hip. It is estimated that one in two women and one in four men will have an osteoporotic fracture in their lifetime.
Osteoporosis is caused by a decline in bone density and a decrease in bone strength. The bone becomes thin and brittle, with many holes in it like a sponge, which can easily lead to fractures. This is somewhat different from osteochondrosis, which is triggered by insufficient dietary calcium intake. The older a person gets, the thinner the bones naturally become, but a number of factors can accelerate the loss of bone mass.
Types of osteoporosis
The causes of osteoporosis can basically be divided into two types.
Primary osteoporosis (osteopenia)
This is the most common type of osteoporosis and is age-related. When a person reaches the peak of bone mass at the age of 30, there is a gradual loss of bone mass. However, the risk of fracture is not significant until the age of 55. Women are three times more likely than men to be affected and have problems earlier than men because they have less bone mass to begin with.
Secondary osteoporosis (Secondary osteoporosis)
Secondary osteoporosis is caused by a number of medical conditions, such as kidney failure, excess thyroid hormones or leukemia. Drugs such as steroids can also cause secondary osteoporosis.
Diagnosis of osteoporosis
Before diagnosing osteoporosis, the doctor must obtain a medical history and perform a detailed physical examination of the patient. The patient may complain of frequent back pain, hunchback or loss of height. Osteoporosis can be diagnosed by a bone density scan. The risk of fracture can also be measured based on the results of a bone density scan.
Early diagnosis of osteoporosis is important because fractures can have a significant impact on mortality or patient status. The mortality rate one year after a hip fracture (hip fracture) is 30%, and 75% of such patients will never regain their previous independence and flexibility after a fracture. In the United States, the economic impact of treating osteoporosis and fractures is enormous, as much as $14 billion a year.
The WHO recommends that everyone over the age of 60 should be screened for early diagnosis and treatment of osteoporosis to prevent future fractures.
Treatment of osteoporosis
There are several treatment options for osteoporosis, including.
1. Reversing a variety of risk factors. Basic requirements such as stopping smoking and drinking alcohol can be helpful. Asian patients are encouraged to take daily calcium and vitamin Da supplements because they eat less dairy products in their diet.
2. Currently, there are a variety of treatments and injections that can reduce bone loss and increase bone thickness. The choice of treatment depends on the severity of the osteoporosis and the age of the patient.
3. Treatment of osteoporotic fractures. This may also include bone strengthening to reduce symptoms. Alternatively, surgery may be necessary to repair a displaced fracture.
4. Prevention of future fractures. Fall prevention and training have proven to be effective in reducing fractures in older patients. However, over time, significantly fewer patients will be willing to undergo scheduled sessions.
Osteoporosis is common. Prevention of osteoporosis and fractures has been shown to be more economical than treating osteoporotic fractures. Therefore, the importance of this issue cannot be overemphasized.