Arthritis

What is osteoarthritis?

It results of the wear of joints. Joints allow the movement. The slow wear of joints (micro-traumas added to the life scale, the most frequent case) or fast wear (following a fracture or certain rheumatic pathologies) causes articular pain during the activities and progressive limbs deformation. In most severe cases, there is a limitation of walking perimeter because of pain.

What is the place of surgical treatment?

When analgesic and anti-inflammatory drugs, joint infiltrations, physiotherapy or external devices fail to provide the level of quality of life you are looking for, it is time to consider surgical treatment.

In early forms with isolated lesion accessible to an effective solution, an arthroscopic treatment may be the solution. 

In many cases, the damage is too great; it is necessary to consider the replacement of the painful joint by a surgical prosthesis. The prosthesis consists of parts designed for maximum safety and longevity, products of a state-of-the-art industry, subject to vigilant regulation. This treatment has proved its effectiveness with a perceived improvement in the quality of life by the patient, sometimes going as far as the complete disappearance of pain and the resumption of moderate physical and sport activities. The results are sustainable, twenty years on average.

What is the approach used by your surgeon to implant a joint prosthesis?

To restore the function of the joint to be replaced, your surgeon needs to carry out the passage of the prosthesis, customized to your measurements (evaluated before or during the operation), from its sterile protective envelope to its future seat in your body. For this, it is necessary to create the surgical approach. This includes a skin incision, division or section of musculo-ligamentous elements protecting the vascular-nervous elements, opening and eventual resection of the articular capsule. This defines the approach, it will be presented to you by your surgeon during the preoperative consultation.

Risks and complications:

There is the inherent risk of any surgical procedure for an adverse event during anesthesia. Their risk of occurrence will be evaluated before the operation with your specialists and some examinations or preventive measures may be necessary.

There are specific risks to joint replacement surgery. There may be a bone fracture during the operation that will require a complementary treatment and may late the return to activities. Fortunately, rare, major vascular injury is still possible and will require vascular surgical treatment. A post-operative infection can be observed from the first days after surgery until years later. Infections require different assessments and treatments depending on their stage, but there is often the need for a new surgical procedure. This risk is evaluated around 1%. There may be a neurological lesion such as the involvement of a sensitive nerve branch; the surgical approach is designed to minimize this risk. Risk of motor neurological deficit (inability to perform some limb movements due to a neurological lesion) is rare but it is a troublesome complication whose recovery is slow and sometimes incomplete. Finally, mechanical problems can occur at the implant: wear of prosthetic parts, loss of contact between them (case of dislocation, which requires urgent reduction by a specialist) or loosening of the prosthesis from the bone walls. Surgical treatment is sometimes necessary for each of these complications.

Postoperative follow-up and expected results

The goal is to help you get back to your daily activities as quickly as possible. Hospitalization will be as short as necessary to relieve postoperative pain. Rehabilitation is considered the day of the intervention when medical conditions allow. The articular function is encouraged: automatic exercises with an arthro-motor, physiotherapy sessions to accompany your return to walking and plan your muscular reinforcement, self-reeducation exercices. The follow-up is closer initially, to ensure the achievement of the preoperative objectives, without complication and your full satisfaction.  Then, follow-up is performed every year.

The primary objective is return to painless and full daily activity, with the ability to perform some physical and sport activities. This objective will be discussed during the preoperative consultation, after your preoperative condition being assessed.