"Joint Replacement surgery is a very common operation performed in the West. Joint replacement simply means replacing a diseased and painful joint with an artificial joint. A joint can be destroyed either by disease or by injury," informed Dr. Mirza Rahman Beg, Consultant Orthopaedic Surgeon, Associate Professor and Chief of Orthopaedics at Aga Khan University Hospital (AKUH) while addressing the 'Signs, Symptoms and Care' health awareness programme held on April 5, 2003.
Dr. Beg informed, "In Pakistan, the common disease, which destroy a joint, are infections caused by bacteria and disease such as tuberculosis, rheumatism and osteoarthritis (worn out joint). Other common causes of joint destruction are injury in traffic accidents and fall from heights."
"A joint is formed when the ends of two bones come together. Friction is reduced by the smooth cartilage that lines the bone ends. The joint also secretes oily fluid, which further reduces the joint friction. Any condition, be it a disease or an injury, which destroys this smooth cartilage will lead to pain and joint stiffness. Unfortunately, science has not yet developed any treatment for restoring the joint surface with smooth cartilage, though research is under way. When the joint cartilage is destroyed we have no option left but to replace it with an artificial joint. The artificial joint consists of two parts: one is made of metal (steel or titanium), and the other is of high-density polyethylene. This combination of metal and polyethylene reduces the friction to nearly zero. These metals and polyethylene (also called implants) do not cause any harm to the human system and can stay in the body for life," explained Dr. Beg.
There are many factors, which influence the longevity of artificial joints. Some common factors, which reduce the life of an implant, are obesity, overuse such as in sports, and poor quality of material used. "The major factor, which can ruin this operation and negatively affect the result, is infection. This is usually caused by operating rooms which are not properly sterilized, poorly sterilized instruments and of course, the technique of the surgeon who may not be properly trained. Once infection sets in, it is very difficult to eradicate it and usually the implant has to be removed leaving the joint flail. This flail joint has to be fused later when the infection clears up. To clear this infection, expensive antibiotics have to be used in addition to surgical procedures. All this means that the patient is worse off than what he/she was before the operation," emphasised Dr. Beg.
"Joint replacement is a major operation and requires properly sterilized instruments, modern operating rooms, expert anaesthesia service and of course, an experienced and trained surgeon. When done properly, the new joints can last up to 25-30 years enabling the patient to walk normally without pain. Most commonly replaced joints are the hip joint, the knee joint, the shoulder joint and the finger joints in rheumatic patients. Hospital stay on average is about seven to ten days. In case of a hip or knee replacement a patient can start walking after four or five days of surgery," concluded Dr. Beg.
The speaker and the panellist, which included Dr. MAWajid and Dr. Riaz Hussain Lakdawala, participated in the question and answer session at the end of the programme.
