How Long Do I Need To Suffer Pain and Invalidity?

Orthopedics and Rheumatology - Juniper Publishers

                                                   

Editorial

Osteoarthritis in hips, knees and other major large joints is a progressive and chronic debilitating disease characterized by pain and limitation of movements. Worldwide this disease is on the increase due to people living longer and more active lives.

When first symptoms appear, doctors will offer palliative treatments to kill pain, which will help for awhile, and in many cases patients develop health complications due to taking anti-inflammatory or pain killers.

In many countries of the third world and even in the developed world, patients have to suffer pain and limitations for months or years, waiting while their joints are destroyed and in need of the old, dreaded, expensive and not free from severe complications joint prosthesis surgery. By the time patients are operated, their muscles have weakened and lost strength needing prolonged rehabilitation for their limbs to function properly.

Mr. Mc Kee FRCS, and his Assistance Mr. Farrar in Norfolk - England initiated total hip prosthesis replacement as a new era for treating hip osteoarthritis in the 60s., this was improved after Mr. John Charnley introduced plastics and acrylic cement. Total Hip Prosthesis (THP) has helped millions of people worldwide and today there are on the market dozens of different types of hip prosthesis joints.

At the XIX World congress of Surgery of the International College of Surgeons (ICS), in March 1974, the most renowned surgeons of the day; like Mr. Mc-Kee, Mr. Ring, Mr. Wilson from England, together with the very few surgeons performing this surgery in Europe, Latin America and Australia communicated their experiences in this field. The problem of infection, metal rejection, loosening of prosthesis and metallic particles appearing around operated areas were already causing concern, especially in my case, as I was performing this surgery in private hospitals since 1972. After this congress the FDA in the USA allowed the use of acrylic cement in humans, since then very little has changed. We have almost the same complications as 50 years ago as the method of introducing a stiff metallic element (prosthesis) into a constant remodelling bone structure is the same.

Total Hip prosthesis so far has been the treatment for destroyed hip joints, ignoring other solutions for treating the initial lesions in the articular cartilage, that trigger osteoarthrosis that needs replacement by a metallic prosthesis. This kind of surgery is very expensive, not free from complications and by increasing Revision surgery, which is the proof of device failure or surgical procedure, thus creating a huge business and increasing expenditure for patients and society.

We should follow the dental method of treating caries avoiding the destruction and removal of the tooth by resurfacing the decay. By resurfacing lesions in the articular cartilage as soon as diagnosed, it is possible to avoid the rough surface contacting healthy cartilage, which triggers changes in the joint, facilitating its destruction.

New advances in X ray visual devices. Arthroscopy, bio-materials, stem cells therapies, etc, innovative methods to approach joints avoiding puncturing the capsule etc , can make it possible in the near future to resurface initial lesions to save joints and save funds to National Health Authorities and patients. See: biototalhip.com.

We need to mobilize the medical world, research centers, orthopedic manufactures, Governments and Health Authorities to find new methods using new biotechnology to resurface with biomaterials lesions in joints to avoid the appearance of osteoarthritis.

With the economical crisis that societies are facing and worldwide increase of osteoarthritis, it is extremely important to save funds for other diseases. $83 billion will be expend in the next 10 years in the USA in joint prosthesis surgery. This amount of money will increase due to increase of Revision surgery in operated younger patients. Worldwide is the same situation.

The amount of energy consumed to manufacture prosthesis due to materials and metals used, make this production unfriendly to the environment and pollute the soil when patients are buried with them.

We need to open a line of discussion among experts to direct all our resources to find a more modern and biological way of treating osteoarthritis at its different levels of disease.


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