One of the most important functions of the human body is its ability to move itself. The interaction of muscles and joints is essential for this function. Along the continuous increase of life expectancy in industrialized countries, there is an increasing incidence of degenerative diseases of the joints (arthritis). Articular arthritis initiates with a reduced thickness of the articular cartilage. At more advanced stages the articular bone is progressively deformed.
When study in gosteoarthritis there is another interesting aspect according to it’s etiology. In our technologically developed society, we are witnessing an increase in secondary osteoarthritis that is subsequent to a previous trauma. In fact, each of us goes by cars and / or motorcycles (traffic-based trauma); exercises and practices one or more sports activities (sportive trauma); or is exposed to situations of mechanical strain at work (occupational trauma) etc.
Joins that are typically affected by arthritis are the hips, knees and shoulders. The arthritic disease is characterized by a continuous increase in the joint’s pain and an ever advancing limitation of the joint’s mobility.
Osteoarthritis and its progression can be decelerated- yet not prevented- by certain measures such as:repetitive axial movement (walking, swimming, cycling) and reduction of the load (weight). In case of a progression of the degenerative process, conservative therapies such as physical therapy, spa treatments as well as intra-articular injections with anti-inflammatory drugs or chondro-protective agents may yield another treatment option.
For the more advanced cases with important functional limitations, there are modern surgical techniques through the worn joint replacement with artificial implants (arthroplasty). These interventions guarantee, after a brief period of rehabilitation, a normal function without any pain.
Due to the complexity of the diverse treatment option, we have established the ASGroup with the precise intention of preventing and especially treating osteoarthritis using the most advanced state-of-the-art surgical techniques.
How to treat osteoarthritis
For early and middle stages the treatment is strictly conservative.
- Anti-inflammatory drugs
- Intra-articular infiltration
- Intramuscular infiltrations (cortisone, hyaluronic acid, ACP)
In advanced stages, treatment is exclusively surgical and involves the replacement of the articular heads with an endoprosthesis.
Represent the different artificial joints with different subtypes:
Type of material
- Chromium, cobalt, etc.
Method of fixation
- Biological fixation
- Indirect fixation
Implants with an biological fixation do not require any chemical element that acts as a bonding agent (cement). They are able to fully integrate into the bone that holds them through a direct contact between bone and the special implant’s surface. These prostheses are very durable and require only few revisions.In contrast, prostheses with an indirect fixation need a chemical that acts as an adhesive (cement) to allow the fixation of the prosthesis to the bone.These prostheses are characterized by a smooth or almost smooth (microporous) surface and their duration is much shorter than those with a biological fixation.
L’Arthro Surgery Group utilizza prevalentemente protesi a fissazione biologica.
Osteoarthritis: The surgery
The surgery lasts on average 45 minutes and is conducted in epidural anesthesia. There are exceptions in which the patients receives a general anesthesia. This is individually decided by the anesthesiologist.Blood transfusions from external donors are no longer required as the patient donates his own blood several weeks before the intervention.This autologous technique is perfected by single-use special blood-cell savers that support a faster peri-operative recovery. It is generally known that breathing generates an intense circulation of germs normally present in the airways; until now the only way to reduce this problem during surgery was to wear surgical masks worn by surgeons and medical and paramedical staff in the operating room. It was shown that the absorption of germs and safety of these surgical masks are limited by several factors:
• Time of use (the filtration power is inversely proportional to the duration of surgery)
• Improper dressing (too loose lacing can squeeze out the nose with the total loss of barrier function) etc.
Therefore. the ASG has adopted a protective ultra-sterile system that is used in the United States of America for the operations on infected wounds. This system is consisting of helmets for air filtration with sterile coating, that are worn by the entire surgical team (surgeons and scrub nurse) and guarantees a maximum of sterility. This significantly reduces the risk for wound infections.
Osteoarthritis: Rehabilitation and Recovery
The day after surgery, the patient is verticalized (set up) and mobilized.
Two days after surgery, the patient will start to take its first steps using two crutches.
At the third or fourth day after surgery, the patient is able to walk up and down stairs, always helped by two crutches.
The rehabilitation program then continues with the phase of muscular strengthening and physiotherapy. The patient will be able to walk without the help of crutches no later than two to three months after surgery.