Part III. : Surgical treatment => -posibilities – limits – perspectives
In Germany, millions of people suffer from osteoarthritis. As the number of cases of treatment and ongoing efforts to osteoarthritis prevention and the optimization conservative measures, there are also an increase in the “operational” method.
On the tendency of increasing operations with the almost half a million approaching annual number of artificial Gelenksersatzesoperationen, as well as an increasing number of different joint-preserving surgery you can see the efforts of Orthopaedic Surgeons of this widespread disease adequately to oppose.
The “osteoarthritis” describes “the old usual measure biological aging and excess loss of cartilage of a joint.” Problem in the diagnosis basically always represent the definition of staging (grade 1-4 cartilage damage), as well as the creation of correct individual adequate time / Stadiums oriented therapy concept creation.
It just must in future progression of the disease in addition to the conservative, always operational capabilities are included. The following basic setting should always be considered in the decision making between patient and patients. If the conservative treatment methods are no longer sufficiently satisfactory treatment effects reach out to prospects operations improved quality of life must be considered. Persistent pain, severely reduced mobility and limited capacity to increase the risks associated with conservative measures have to be this, the main criteria!
To avoid surgery or after long hesitation possibility out, but should always be the primary goal of doctor and patient. Operations can be used to improve symptoms, to obtain the functionality of a joint, to stiffen a joint or a hinge to replace completely. A distinction is basically two types of procedures with a principal purpose for the surgical treatment of Osteoarthritis: Joint preserving operations before Joint replacement surgery.
Joint-preserving method: A distinction is made between so-called minimally invasive procedures and interventions at the open joint. In the so-called. “Keyhole surgery” in addition to direct local diagnosis is immediately given the opportunity to clean the joint (Gelenkslavage) while dead cartilage and bone cells, but also inflammatory cells from the joint to remove. In the joint toilet (debridement) sick of cartilage (chondroplasty), bony attachments and soft tissue elements by means of careful removal attempts a customized “normal” joint function under anatomical / physiological conditions recover. In other techniques by means of “freshening” of cartilage / bone surface (Pridie drilling / Abrasionstechniken / Mikrofractioning, etc.) tiny bleeding from the bone provoked to win so-called stem cells from the bleeding, which supports to the bone to then to “new” cartilage “convert.
Carbon fiber post-implantation and osteochondral transplantation serve to stabilize the body’s cartilage of the joint or to transplant to a more optimal biomechanical function of the joint gain. In the autologous cartilage cell transplant cartilage parts is taken to be used by an external laboratory chemical Zellkulturvierung in a second surgery again. This powerful new cartilage cells are re-embedded in a “special biological matrix” and then mature into new functional cartilage. In a joint conversion (osteotomy) the mechanical axis and the force curve can be changed so that the healthy parts of the joint burden and the damaged portions are relieved. The operative joint stiffness does not present actual treatment of osteoarthritis, but just about the painless movement restriction merely a symptom of cleanup at the expense of other lost properties. Genetic engineering techniques are still in the experimental procedure and require secure several years of development and then offer even sufficient ethical and moral, economic discussion.
Joint replacement procedure: – The absolute last resort in the treatment of osteoarthritis is the use of an artificial joint replacement (prosthesis). The question of whether a joint replacement is appropriate to decide in addition to the complaints and past course of the disease, especially the suffering of the patient and not (as often) only the X-ray image. The durability of artificial joints, depending on the joint average of the 12-15 years.
New materials and implant procedures are continuously researched and used following increased under the premise of the longest possible service life. Even partial dentures and minimal modern Oberflächenersätze come also increasingly used. Almost all joints can be operated surgical technique and include careful consideration of the risks and successes to the craft of Orthopaedic Surgeons most today. Whether surgery is joint-preserving or replacing, as it is medically always always advise the patient correctly and use the “real” therapy due to age and life-orienting.
The typical behavior measures in daily life (work and leisure) must be brought close to keep the actual operational success in the long term by means of a “training osteoarthritis”. Learn more directly also the author: seita@palma-clinic.com and / or under: http://www.arthrose.de
