A artrose, uma doença que degenera progressivamente as estruturas do joelho, atinge 4% da população brasileira. O implante elimina a dor e devolve a mobilidade

Arthroplasty: the ‘saving’ knee surgery – 09/17/2022 – News – Tribuna do Norte

Tádzio França
news reporter

When the knee starts to hurt non-stop and the movements become more and more difficult, it’s time to pay attention to the bases. Osteoarthritis, a disease that progressively degenerates the structures of the knee, affects 4% of the Brazilian population, and in its most severe forms, may require a procedure in addition to common treatments. Arthroplasty is the most suitable resource for the problem: it consists of a surgery that replaces the worn cartilage of the knee with a prosthesis. The implant eliminates pain and restores mobility and quality of life to the patient.

Alex Regis

Osteoarthritis, a disease that progressively degenerates knee structures, affects 4% of the Brazilian population. The implant eliminates pain and restores mobility

Arthroplasty is considered by specialists as a “salvation” surgery, according to Márcio Rêgo, an orthopedist and specialist in this type of procedure. “We always try conservative treatment at first, with physical therapy, medication and infiltration, but when there is nothing else to do, we recommend surgery. The main symptom for this is disabling and very severe pain,” he explains. Because the surgery is performed only when it is absolutely necessary, the results are usually very satisfactory, says the doctor.

Knee prosthesis consists of replacing the worn joint surface with artificial metal and polyethylene components, specially designed to restore knee function. Prosthetic surgery does not remove the entire knee, but only the surface within the joint. Therefore, most of the original knee is preserved. Total arthroplasty replaces the entire surface of the femur and tibia. Partial arthroplasty, on the other hand, replaces only one of the compartments of the knee, when wear is limited to only one part.

Prosthesis surgery is indicated for very characteristic cases and profiles. Osteoarthritis, which leads to the procedure, is closely related to advancing age. According to the World Health Organization (WHO), between 70% and 80% of the population over 65 years old has the disease. Márcio Rêgo points out that the surgery is performed in most people over 60, with rare exceptions.

“Obviously, if you have patients a little younger, between 50 and 56 years old, who are losing their quality of life due to the disease, we are already sensitive to having the procedure done. But only if there is no improvement with clinical treatments”, explains the orthopedist. It is worth mentioning that more and more precocious cases have been observed. Therefore, recommendations for surgery are based on the patient’s pain and limitation of movement, not just age.

cases among young people

A survey by the Brazilian Society of Orthopedics and Traumatology (SBOT) points out that, among the young adult population, about 20% of individuals in their 30s were diagnosed with the disease by 2017. These are cases in which joint wear is not associated with advancing age, but the excess of high-impact and repetitive physical exercises, and also obesity. There are rheumatological diseases such as rheumatoid arthritis and gout, which also cause osteoarthritis.

The orthopedist explains that the prosthesis is usually the same for any knee, but may vary depending on the existence of deformities in the knee with arthrosis. “Arthrosis sometimes deforms the knee, and when there are very prominent deformities, we need different prostheses. But as a rule, in the vast majority of cases, it is the conventional prosthesis that is used. We call it primary knee prosthesis,” he says.

The duration of the prosthesis, on average, is fifteen years. “I have already received patients in my office who have had prostheses for twenty years, this varies greatly from person to person. But on average fifteen years. It is when the prosthesis loosens that a revision surgery is indicated, in which we need to change the prosthesis. It is a more complex surgery”, explains the specialist.

The greatest benefit of implant surgery, emphasizes Márcio Rêgo, is the absence of pain and the normal range of motion in the knee. “For the patient to be able to bend the knee after this surgery to at least one hundred degrees, we are already satisfied”, he says. Surgeries have been successfully performed on all ages, from teenagers with juvenile arthritis to elderly patients with degenerative osteoarthritis.

The advancement of technology, through robotic medicine, started to help surgeons to have maximum precision in total knee arthroplasty procedures, allowing a faster recovery of the patient, as well as the return to the routine of daily activities, in the post-operative period. operative.

resuming the plumb

Civil engineer Celso Veiga, 69, underwent the surgical procedure for a knee implant earlier this year. For nine months, he considers himself in a state of comforting relief – despite all the necessary post-surgery adaptation process. Celso says that he has always been an enthusiastic practitioner of sports activities, something that has made him live with ailments in his knees since he was 30 years old.

Celso Veiga, 69, underwent knee implant surgery

Celso Veiga, 69, underwent knee implant surgery

A basketball and tennis player, Celso underwent meniscus surgery in 1984, a very common injury among sportsmen. “At the time, I was cured of knee stability, but the surgical techniques of that time were more radical, and the consequences came later,” he says. The engineer explains that when the meniscus is extracted, the cartilage that protects the bones is compromised, facilitating the wear process and the appearance of arthrosis. That’s what happened to him after he was 50 years old.

The pain has gotten a lot worse in the last five years. “I was no longer able to get around properly. The knee swelled and the pain was constant. I wouldn’t stop taking pain medication, which didn’t solve the problem,” she says. Celso had to resort to arthroplasty to return to normal life. He underwent the procedure in January of this year, and considers that the benefits are evident. “The pain is gone, and I have a normal life from the mobility point of view”, he says.

The post-surgery was relatively quiet, “The knee is swollen for about 15 days, after all, there is an artificial material in your body, adaptation is necessary”, he says. He then underwent at least 60 days of intense physical therapy to normalize leg movement. He points out that he intends to return to some physical activities as soon as he can, such as swimming, cycling, and maybe even tennis – but all very light, low-impact. No sudden shifts.

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