Many older people will recall a grandparent with severe joint pain and only painkillers for relief. Today, joint surgeons can replace damaged hips and knees. The branch of medicine we now know as orthopaedics has been practised for millennia. Indeed, the earliest evidence supporting this can be traced as far back as the New Stone Age, when Neolithic healers used splints to treat fractured limbs and performed amputations.
Later, the Egyptians adopted and continued to refine these practices. However, it was the superior anatomical knowledge of the ancient Greek and Roman physicians that contributed most to the early development of orthopaedics. At that time, the Greeks, in particular, focussed mainly on correcting spinal deformities in children, using bandages and splints to straighten their misaligned posture.
Although this term was not coined until the mid-eighteenth century, the word orthopaedics was derived from the union of two Greek words: “orthos”, meaning “straight or correct”, and “paedion”, meaning “child”.
This discipline’s focus remained confined to treating conditions affecting the spine and long bones until the late 19th century when the first, albeit unsuccessful, attempts to perform joint surgery were made.
Since then, progress has been steady rather than meteoric. Nevertheless, today, joint surgeons routinely perform procedures that early pioneers would have considered miracles.
The Role of Modern Joint Surgeons
Frequently, a physician and physiotherapist can deal successfully with joint injuries like sprains, strains and dislocations without recourse to surgery. A combination of manipulation, compresses, painkillers, rest and mild exercise will usually do the trick. However, some conditions can only be treated by a joint specialist. For example:
- Reconstruction of a damaged anterior cruciate ligament (ACL), a major ligament in the knee.
- Repairs to a torn meniscus, a C-shaped pad of cartilage in the knee forming a shock absorber between the femur and tibia.
- Repairs to a torn rotator cuff, the group of muscles and tendons responsible for stabilising the shoulder joint and enabling its rotary movement.
- Removal of bone fragments and debris from a damaged joint.
These procedures alleviate pain and swelling and allow patients to resume normal activities. However, sometimes, the damage to a joint cannot be repaired, and the only viable solution is to replace it. Today, in the United States alone, around 450 000 total hip replacements and 790 000 total knee replacements are performed annually, and the demand for shoulder replacement is increasing.
Joint Surgeons Specialising in Arthroplasty
Joint replacement or arthroplasty is more demanding than most other forms of joint surgery. It requires an experienced specialist, particularly in its minimally invasive form. For example, when replacing a knee joint, the damaged heads of the femur and tibia must be replaced with prosthetic parts and a suitable cushion inserted between them before perfectly aligning the new components.
Rather than exposing the entire joint, a suitably experienced joint specialist will often adopt a less invasive approach, using three or four tiny incisions to operate whilst monitoring the process on a video screen with the aid of an arthroscope.
One such joint surgeon is Dr Jan De Vos, head of orthopaedics at Pretoria’s Wilgers Life Hospital and a leader in joint replacement and arthroscopic surgery. If you require a joint replacement, contact him to discuss how he can help you.
