Osteoarthritis (OA) is a common cause of disability and limits every day activities. According to Dr. Shahryar Noordin, Consultant Orthopaedic Surgeon AKUH, initial treatment of knee OA is non-operative, and includes patient education, physical therapy, regular exercise, weight reduction, and use of appropriate medications. Nevertheless if symptoms persist, surgery can be considered as the next treatment option. He was addressing a public health awareness programme organised by AKUH in Lahore for patients suffering from bone and joint related problems.
Sharing his experience at Harvard Medical School, Boston, USA and University of British Columbia, Canada with the audience, Dr. Noordin pointed out that potential surgical treatments for knee OA include arthroscopy, osteotomy, and knee replacement which can be unicompartmental or total. Determining which of these procedures is most appropriate depends on several factors including the location and severity of OA damage, patient characteristics and risk factors. Total knee replacement is the current gold standard for end-stage knee OA. Similarly total hip replacement, known as operation of the century, results in an end to joint pain, an increase in the ability to move around, an improvement in the functionality of the joints resulting in a better quality of life. Recent advances in implant design, metallurgy and surgical techniques means that most patients requiring hip and knee implants will be able to use their joint replacements for as long as 15 to 20 years, he added.
Describing the hip and knee replacement procedure, Dr Noordin informed the audience that modern knee replacements offer patients much more stability and greater flexibility with increased range of motion. In addition, the material used in modern implants is significantly wear-resistant, prolonging the life of the surgical implants. Currently, about one million total hip and total knee replacement surgeries are performed worldwide each year and by 2030, these numbers are projected to increase three- to four-fold.
People use their hands extensively to accomplish daily basic tasks and activities said Dr Haroon Rashid, Consultant Orthopaedic Surgeon, AKUH. When a problem occurs in our hands, care must be given to all the different types of tissues that make functioning of the hand possible. He mentioned that there is a well-developed hand and microsurgery service at AKUH which provides 24-hour coverage for emergencies involving hand-related problems.
Dr Rashid also talked about the Ilizarov method - a low-invasive technique to lengthen limbs and mend fractures. In this procedure, surgery is done through small cuts that result in minimal damage to soft and bone tissues. An Ilizarov apparatus, an external device, is fixed to the limb and removed at the end of the treatment. Complications are very rare and if they do occur, they are temporary and do not influence the final result since the doctor can make corrections during the course of treatment.
He added that most orthopaedic surgeons in the country are not familiar with the Ilizarov technique and treat orthopaedic problems in the ‘conventional’ way. Two orthopaedic surgeons at AKUH have been trained abroad in Ilizarov techniques and are running a joint clinic. They examine each patient together to assess and plan the surgery and to date have performed more than 500 procedures successfully.
The results are very encouraging and AKUH is receiving patients with hip and knee problems from all over the country.
Rasool Sarang, Assistant Manager Media, Department of Public Affairs, Aga Khan University, Stadium Road, Karachi, on +92 21 3486 3920 or firstname.lastname@example.org