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Orthopedist-traumatologist Tomas Sveikata says that not only medicine, but also the Lithuanian approach to health has improved enormously in recent decades: “Today we consider the 60th anniversary as still young patients who want to travel, play tennis or attend dances.” .
In a press release, the doctor talks about the causes of joint problems and the treatments that help to return to a life without pain.
It is more common in overweight women.
The main disease that causes joint pain and damage is osteoarthritis. It is a degenerative disease caused by the wear and tear of the joint surface with age, which is why osteoarthritis is common in the elderly. However, this is not the only cause of the disease. T. It is said that health is affected by genetics, sports injuries, too much or too little exercise, congenital deformities of the axis of the legs, dysplasia, inflammatory and rheumatic diseases (rheumatoid arthritis, psoriatic, gout, etc.).
Another factor is gender. An orthopedic traumatologist says that osteoarthritis is more common in women. This is explained in medicine by the fact that the structure of women’s connective tissue is different. The doctor identifies being overweight as one of the main risk factors.
Joint diseases.
“Patients often come with a high BMI (body mass index) and complain of severe joint pain. On examination, we see changes in the joint, but they are not large, and joint replacement surgery is not necessary. Generally, these patients request surgery because they experience great discomfort and want to lead an active life. From a surgeon’s perspective, being overweight is a risk factor: there is a higher probability of infection and these patients have a shorter duration of joint implants ”, he says.
T. Health tells us that patients often say that if the joint no longer hurts, they could move more and lose weight. But practice shows otherwise.
“A study in the United States compared two groups of patients. One group of overweight patients underwent knee replacement surgery and another underwent gastric reduction surgery. The first group not only did not lose weight a year later , but also gained weight. And patients with a reduced stomach were asked to postpone joint replacement surgery. Basically, the joint itself did not heal and the changes remained the same. However, when losing weight, several people experience less stress and pain, ”shared the doctor.
The biggest myth is that it is better to suffer with your joint
Conservative treatments are used in the early stages of osteoarthritis: exercise, anti-inflammatory drugs, dietary supplements, hyaluronic injections, advanced autologous protein therapy. If conservative treatments are ineffective and the disease progresses, joint replacement surgery is required.
Joint problems
According to the doctor, the problems occur when patients present late cases or want to postpone surgery due to the myths of society.
“These patients say they have been sick and in pain for many years. The natural question arises as to why they did nothing for so long. I often hear the answer that they have been discouraged by family doctors, ambulatory orthopedists or neighbors. , telling them how much you need that joint here, an old man can suffer. “There has been a myth since ancient times that his joint is better, even if it hurts, that an elderly person has to suffer, that he does not need an active life,” he explains.
T. Health recommends immediate surgery: in the later stages of osteoarthritis, joint damage can be very severe, deformities occur for which a normal implant is no longer sufficient, and surgery cannot guarantee such a good result. She suggests taking into account that with age, health deteriorates, additional diseases occur, and the postoperative period lengthens. Timely surgery can not only help you return to a normal pain-free life, it can also ensure better results in surgery.
Lithuania is equated with western countries
Asked about changes in joint treatment, T. Health identifies a change in patients’ attitudes as the main difference. If in the past people consulted the doctor when they could barely walk or were slow to change the joint to the end, now they are more responsible, consult when they notice a slight pain or change in the joint.
“There are more and more younger patients whose expectations for surgery are much higher: they want to return to an active life as soon as possible, the joint receives a greater load from the first days after surgery. In addition, patients come to us already knowing which market trends, which joint implants are better. This not only makes doctors happy, but also encourages them to expand their field of medicine, seek better solutions and please the patient, ”she says.
Speaking of joint surgery, the doctor says that Lithuania has lagged the West for some time. “We have free access to information, surgeons can learn from the best specialists in the world. Sometimes I even think that we have been in the post-Soviet shadow not long ago, and now we use state-of-the-art implants, we communicate with foreign colleagues and find that We solve the same problems and use the same tools. In the past it seemed incredible and now we are all the same, “says the orthopedic surgeon.
The choice of joint implants is increasing
Another important change identified by your doctor is the choice of joint implants. He says there used to be an implant on the shelf and all the joint problems were solved with it. Manufacturers can now offer many more sizes and implants to fit the human anatomy.
“The joint is not just bone and cartilage. These are all the soft tissues: tendons, ligaments, muscles that are needed for their function. “Our goal is not to change the joint, we want to restore what the patient had, so the material and size of the implant must match the physiological characteristics of a person,” he says.
T. Health says there are at least some implant variants that are reimbursed solely from health insurance funds. If a person wants to buy an implant for themselves, they have even more options.
Tom Health
© Personal album
“Increasing life expectancy, the younger age of patients undergoing surgery, and their rising expectations are driving the development of better implants. As a result, custom knee replacements have emerged and are rapidly gaining popularity in the marketplace. used in the best clinics in the world and are gradually changing the standard knee replacement systems, we have been using these implants in Lithuania for several years. Customized knee replacement systems are characterized by better materials, abrasion resistance, a selection wider sizes and better adaptable anatomically shaped components of the right and left tibia, ”he says.
T. Health says surgeons now have more work and preparation before the operation: they draw, they model, what size, what design, what properties the implant will fit the patient.
“Due to the wide range of sizes and anatomical shapes, custom implants allow for more efficient surgery, reduce the risk of complications, and resolve postoperative pain or inflexibility. In addition, a precisely selected implant can better restore joint function, mobility and ensure the longest possible life span. “
Wants to dance and climb mountains
“A 60-year-old patient comes in and complains that he can’t dance. She says:” I changed my husband, he wants to dance at night and I can’t; I make a roulette and it hurts. If I still lived with my first husband, I would have been able to do without surgery, he didn’t want to dance. “Or patients are afraid of not being able to play tennis or golf,” the doctor tells stories from his daily work.
Endoprotezavimas.
According to him, older people see their way of life differently than they did a few decades ago – they want to live an active, high-quality life in this way. “I remember when I interned in the United States in 2000, I was very surprised that the doctors referred to the 67-year-old patient as a young man. At the time, it seemed strange and now we are saying the same thing. We change joints for 90 and 100 year old patients, we understand that age is just a number. Look, most gyms or parks are now in their 50s and 60s. Modern joint implants provide the opportunity to live perfectly: travel, move, spin on the dance floor. Some patients say that they even forget to live with an artificial joint after stenting. If there is such an opportunity, why suffer and not seize it? ”- thinks the traumatologist-orthopedist T. Sveikata.
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