The incidence of painful and swollen joints is growing worldwide, creating a steadily increasing need for arthroscopy and replacements of the affected joints. Disorders that affect the joints, causing pain, swelling and hindering mobility, have always been relatively common.
In the past, these symptoms were often a manifestation of tuberculosis, an infection which is not confined to the lungs as often believed but can also affect joints and other organs like the kidneys and brain. Today, apart from traumatic injuries, the most frequent explanation for joint pain is osteoarthritis, a condition in which the protective layer of cartilage on one or more of a joint’s articulating surfaces is gradually eroded.
Once, this condition was seen almost exclusively in patients aged 65 or more. However, average life spans have increased in most developed countries, and the poor diet and lifestyle choices associated with obesity have led to a marked increase in the incidence of osteoarthritis and the subsequent demand for investigative and remedial surgery.
The Nature of Arthroscopy and Replacements
Whether employed individually or in combination, the impact of these procedures on the tasks of the orthopaedic surgeon has been transformative. Let’s examine them in more detail:
- The arthroscope: Almost all surgical disciplines welcomed and applied instruments to view the interior structure of body cavities, like the lungs, bladder, womb and colon, following the development of the first endoscope in 1895. However, orthopaedic surgeons rejected this option until a breakthrough by a Japanese professor who used a converted cystoscope to explore the interior of a knee joint.Although initially used solely for diagnostic purposes, in the late ‘60s, a Canadian became the first to employ an arthroscopic procedure to perform knee surgery. Today, many orthopaedic surgeons favour this minimally invasive approach, combining arthroscopy and replacements.
- Joint replacements: The earliest attempt to perform total knee replacement occurred in the early 1860s when a German surgeon successfully implanted an iron hinge joint. However, his technique was more effective than the prosthesis, which deteriorated rapidly. Other materials proved to be either insufficiently durable or bio-incompatible until the introduction of a metal-on-polyethylene prosthesis by a British surgeon in the 1960s.While Dr John Charney employed open surgery to fully expose the joint, total knee arthroplasty (TKA) is frequently performed arthroscopically. This minimally invasive procedure reduces infection and blood loss risk, produces less scarring and enables shorter recovery times.
The Growth of Arthroscopy and Replacements
Since their introduction, these invaluable advances in orthopaedic surgery have changed the lives of millions. A survey sets the number of total knee replacements performed in 2022 in the United States alone at around 1,37 million and suggests this figure could reach 3,48 million by the end of the decade. While hip replacements were markedly fewer at about 511 000 in 2020, predictions for 2030 suggest a growth of 71% by 2030.
Regardless of these statistics, specialists worldwide agree that arthroscopy and replacement of diseased or damaged joints are the most successful interventions in orthopaedic history.
Arthroscopy and Replacements in Pretoria
The state capital is home to one of South Africa’s leading orthopaedic surgeons. If analgesics no longer relieve your joint pain, it will pay you to contact Dr De Vos at the Wilgers Life Hospital in Lynwood Ridge.