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Endoprosthesis replacement of joints
Endoprosthesis replacement of joints in modern medicine by right is considered to recover most efficiently those opportunities of extremities which for certain reasons were lost. Very often this method is unique for elimination of effects of injuries and other damages.
Prosthetics of joints practices if conservative therapy does not yield a positive take, and at the same time the person is disturbed by the severe pain in joints arising at each movement. As a result, constant pain can even break mental balance of the patient.
Endoprosthesis replacement of joints is a process of replacement of the affected joint by an artificial implant. With its help the doctor models own joint of the person. In modern medicine installation of endoprostheses is a guarantee that the person after operation can normally work and fully move 20-30 years.
Important argument for patients is also the fact that recovery after endoprosthesis replacement happens rather quickly. So, already on second day after operation of people shows relative activity, for the fifth days it can be written out from a hospital. On the expiration of the rehabilitation period which proceeds about 1-2 months the person is completely restored to normal life.
If on the expiration of long-term service life replacement of an artificial joint is required, it can be made at repeated operation. It is possible both replacement of a knee joint, and replacement of a hip joint. Besides, it is possible to replace endoprostheses of ankle joints, and also small joints of feet. Operation on replacement of a knee joint, and also intervention for the purpose of repeated establishment of other endoprostheses is carried out after careful diagnosis and the corresponding conclusion of the doctor.
Prosthetics of a hip joint practices at many diseases which lead to damage of this joint. First of all, it is different forms of arthrosis of a hip joint 3 stages (dysplastic, idiopathic, posttraumatic). A prosthesis of a hip joint establish also at a coxarthrosis 2 stages, but only if the patient has strong disturbances of walking. Pain in that case disturbs the person even during standing, the movements in a joint are limited. The endoprosthesis of a hip joint is established at a hip neck fracture which leads to disturbance of a blood-groove of a head of a femur, at tumors of a head and a neck of a hip, Bekhterev's illness, rhematoid polyarthritis and monoarthritis. Often coxofemoral endoprosthesis is an optimal variant for the people who transferred changes of an acetabular hollow, and also other injuries.
Prosthetics of a knee joint is appointed at posttraumatic and idiopathic arthrosis of a knee joint (gonartroza) of the third stage, at a gonatroza of the second stage at people strong disturbances of walking and pain when standing and walking. The endoprosthesis of a knee joint is established to patients with vicious (varus or valgus) installation of an extremity, monoarthritis, rhematoid polyarthritis, Bekhterev's illness. The prosthesis of a knee joint considerably improves a condition of the patient at effects of a number of injuries.
Total endoprosthesis replacement cannot be carried out by the patient at whom the diseases of inflammatory character provoked by influence of specific and nonspecific microorganisms are noted. Also prosthetics is not carried out at a bone anchylosis of a knee joint, to stages of active tuberculosis, in the presence of effects of the infected osteosynthesis, osteomyelitis. The doctor surely defines whether the patient has general contraindications to carrying out operation.
Features of operation
Modern endoprostheses make of different materials which differ in high technological effectiveness. It is steel, titanium, ceramics, etc. Classification of all endoprostheses of joints is carried out taking into account type of their fixing. These are endoprostheses with cement fixing by bestsementny fixing, and also the combined options.
As a rule, bestsementny prostheses are replaced much more simply, than prostheses with cement fixing. Therefore they are preferred to be established to people of rather young age — till 65 flyings.
Endoprosthesis replacement of joints is planned only by the doctor who will perform operation. Before prosthetics of a hip joint or other joints preoperative examination and inspection is performed. Depending on what clinic was preferred by the patient, can vary several necessary inspections. But without fail it is necessary to pass all standard laboratory researches, to consult at the therapist, to carry out sanitation of the centers of persistent infection which are in an organism.
As a rule, the patient defines in what clinic to perform such operation, previously studying About this or that medical institution. The choice of establishment is influenced also by the operation price. However cost depends on several factors: what joint needs to be fitted a prosthesis whether total prosthetics is carried out, whether rehabilitation, etc. is carried out in clinic.
Directly operation continues from 1 to 2 hours. The choice of anesthesia is provided depending on complexity of an operative measure. In the course of operation the patient loses from 200 ml to 1 liter of blood therefore approximately the fifth part of patients the hemotransfusion is carried out.
Endoprosthesis replacement of a hip joint
Endoprosthesis replacement of a hip joint is an exact surgery at which a number of the manipulations directed to returning mobility to a joint is carried out and to eliminate pain. Initially the doctor of clinic advises the patient and selects to him optimum suitable prosthesis taking into account a number of factors (a disease, features of defeat, age of the patient, etc.). In the course of survey and inspection it is necessary to define surely whether there are no contraindications to operation. To the patient appoint carrying out X-ray inspection which results give the chance to learn, the joint is how worn-out, and also to take the necessary measurements. Also during consultation the patient can learn, how much is in general such operation, and also to ask at the doctor what complications can take place whether it is necessary to carry out in the future auditing prosthetics, etc.
Implantation of a hip joint at the normal course of operation is carried out approximately for two hours. During intervention if necessary the loss of blood is made up, the wound is drained not to allow blood accumulation.
Important stage of recovery is the period after operation. At this time to the patient enter antibiotics, analgetics, and also carry out symptomatic therapy. That the operated leg constantly kept in the necessary situation, between legs put the special roller.
It is possible to rise in a bed in the first day after carrying out surgical intervention. For the second day the doctor already recommends to sit down and begin static exercises for training of muscles of an extremity. To a stern of that, course LFK assumes performance of breathing exercises. It is possible to start going on crutches to third day after operation. The removal of sutures is carried out approximately for the 10th day.
The patient to whom replacement of a hip joint is made is written out from a hospital approximately in 10 days after operation. After replacement of a joint in house conditions it is necessary to implement all recommendations of the doctor without fail. If recovery somehow deviates norm, the patient to whom operation on replacement of a hip joint was performed can be defined in the special rehabilitation center where process of rehabilitation will be controlled by specialists. Responses demonstrate what in such centers of people is recovered after prosthetics more intensively.
Nevertheless, within about two months it is necessary to limit loads of the operated leg sharply. These weeks it is worth applying an additional support when walking. At implementation of all recommendations rehabilitation after prosthetics of a hip joint continues not longer than the established span.
Endoprosthesis replacement of a knee joint
Endoprosthesis replacement of a knee joint allows to recover all functions of an extremity by means of prosthetics of the bearing surfaces of a knee joint. Such replacement can be both partial, and full. Total endoprosthesis replacement (there takes place replacement of all joint surfaces) and one-condylar endoprosthesis replacement practices (the prosthesis of one half of a joint is established). Depending on it the cost of such operation is determined. Also the price is established taking into account of what material the prosthesis is made.
First of all, the specialist holds preliminary consultation on which all important points are defined and make a reservation with the patient. The patient can learn not only about that, how much is such procedure, but also what complications are possible after intervention as recovery will be long and whether disability in the future threatens it. An informative method is carrying out a X-ray analysis.
Operation can continue till two o'clock. At full endoprosthesis replacement the joint is replaced with biocompatible prostheses which in the future will provide the natural movement in a joint.
In the course of rehabilitation after operation to the patient course LFK is appointed. When to carry out specific exercises after operation, the attending physician will tell. At first after intervention at the patient joint hypostases, pain can be observed. Later these manifestations completely disappear. It is possible to take a shower for the second day after prosthetics.
After successfully performed operation and the subsequent rehabilitation process the patient completely gets rid of painful feelings in a knee joint, can normally move an extremity and lead a full-fledged life.
Complications after operation
Depending on whether complications after operation take place, duration of the rehabilitation period is defined. After operation on establishment of a hip joint of complication occur rather seldom. Approximately at 2% of patients the infection of a hip joint develops. But most often as complications emergence of clots in veins of legs and a basin is noted.
Features of rehabilitation
Very important point during recovery is the physical therapy. Its use gives the chance not to allow a convergence of joints, to strengthen muscles and to submit to the patient all necessary information concerning the subsequent life with an artificial joint. The convergence of joints occurs owing to emergence of cicatricial fabric near a prosthesis that as a result can limit the movements of a joint.
The physiotherapist surely explains in what poses of people he can injure a joint what load of a prosthesis can be allowed. The specialist also defines all complex of physiotherapy exercises for recovery.
In house conditions the operated patient has to implement all received recommendations surely. It is important to watch that integuments in the replaced joint were dry and pure. At infection of a wound it is necessary to ask for medical assistance at once. Also alarming symptom during recovery is fervescence. Small puffiness can remain in a joint on which operation, for several months was performed. It is sometimes recommended to put several times a day cold to the place of hypostasis and to hold it about 20 minutes.
It is important to remember that at a sharp stethalgia and the complicated breath it is necessary to see doctors as it can be symptoms of blood clot. To prevent it, sometimes to the patient reception of anticoagulants is appointed. Also reception of vitamin complexes, inclusion in a diet of products with high content of iron is recommended. The products containing a lot of vitamin K should be avoided. It is about a liver, onions, cabbage, green beans. It is necessary to limit also amount of alcohol, coffee. It is also important to watch that the patient's weight sharply did not increase.
After establishment of a prosthesis of a knee joint it is necessary to avoid sitting in low chairs, not to cross knees, not to sit in one situation longer than hour. Following all rules, the person is restored to full-fledged life approximately in 2 months.