Destructions of the joints’ cartilage surface occur due to calcification, infections, rheumatic diseases, trauma or congenital structural abnormalities and may progress and cause serious pain and movement restrictions. This situation may decrease patients’ life quality and it may be converted to chronicle unhappiness.
In the condition which is not possible to control pain or remove movement restriction with drugs, intra-articular injections and physical therapy, in the patients whose daily life activities are limited, and for patients who has advanced stage of cartilage destruction, total joint prosthesis is the most appropriate treatment option. Total joint prosthesis aims to provide functionality and stability again to the joint and it also aims to eliminate current pains via replacing defective joint surface with artificial materials. Joint prosthesis application rates are increasing in our country as well as all around the world. Prosthesis are mostly applied to are knee and hip joints. However, shoulder, elbow, fingers, ankle and wrist prosthesis can also be applied.
Total joint prosthesis generally consists of two pieces of joint surface and a piece of intermediate material. As defective joint surfaces are removed, replaced metallic portions are fixed via compressing to bone or bone cement.
Favourable results for patients are achieved with a well applied prosthesis application. Informing patients ahead of prosthesis application is crucially important for success of the operation. If you will undergo prosthesis surgery, ask your doctor and learn about the application method, and the things you must do before and after operation.
Deep vein thrombosis: It is formation of blood clot depending on the slowed blood flow in your leg. To prevent, protective treatment is applied after surgery with blood thinner drugs. This treatment may be extended up to 20 days if it is necessary. To start exercise in early stages after operation and to avoid being immobile will decrease the risk of thrombosis.
Prosthesis infection may be seen between 0.1% and 2%. Infection at another side of the body (e.g. urinary, teeth), diabetes mellitus or existence of another chronicle disease may increase this risk. It is necessary to treat infections at other sides of the body ahead of the operation. Due to this fact, blood and urine tests, dental examination, ear nose and throat and gynaecological infection investigations are must applied before operation. Protective antibiotic treatment is done during operation to reduce infection risk. Using special cloths like space-helmets during surgery is another way to reduce risk. One of the most important risks regarding infection is hospital and operating theatre conditions. Infection risk may substantially increases at prosthesis applications done in operating theatre which does not have modern air flow or cleaning facilities such as laminar flow or HEPA filters. Due to this fact, search conditions of the hospital and operating theatre where your operation will take place.
You must use antibiotics if you will undergo a dental or urinary operation in two years after prosthesis surgery. In case of infection; some interventions may be necessary such as recurrent operations, removal of the prosthesis and antibiotic treatment.
Loosening may be seen in early or late stages after surgery. Early stage loosening generally occurs because of wrong application of prosthesis or infections. Late stage loosening happens ten years after operation and it occurs due to abrasion. Pieces which form the total prosthesis are eroded in time because of friction during movement. As a result of body response to the small metallic pieces which come out with erosion, prosthesis pieces may leave and loosen from the bone they fixed. This time is improved up to twenty years with modern production technologies and development of prosthesis materials.
Other rare complications which can be seen after prosthesis operation are nerve and vessel injuries, dislocation of some pieces of the prosthesis, fracture formation at bone around the prosthesis or at prosthesis itself.
Both knee and hip prosthesis operations can be performed under general anaesthesia or regional (spinal and/or epidural) anaesthesia. This is up to joint choice of patient and doctor. Patient is generally got up and started to walk in 48 hours after operation. Putting load may prolong up to 3 to 6 weeks after operation in some special cases of hip prosthesis. Length of hospitalization is between 3 to 6 days.
After hip replacement, some movements, such crossing legs or sitting to short places like old-fashioned toilets, should not be preferred.
Most of the modern prosthesis are produced from MR safe materials. Therefore, there will not be any problem about taking MRI scan to another body region. It will be appropriate to take a document showing you were operated in case of signals emerging from metal detectors.