Choosing the Right Specialists for Your Knee Replacement Surgery
Since the earliest and surprisingly effective efforts of the physicians of Ancient Egypt, and the subsequent rise of the bonesetters during the 16th to 18th centuries, the role of the orthopaedic practitioner has evolved almost beyond recognition. No longer confined to the reduction of fractures of the long bones, or even to the correction of spinal deformities in children upon which the name of this discipline was actually based, many of the orthopaedic specialists of today are engaged in far more intricate procedures, such as the repair and replacement of knee, shoulder and even entire hip joints with prosthetic components.
It is not only the scope of this discipline that has changed so dramatically, but the technology and techniques involved in both the basic and more complex procedures employed in orthopaedics have also advanced by leaps and bounds, and are continuing to do so. While much of the research carried out in this field is purely clinical in nature, inevitably, a portion will translate into alternatives for use in current procedures. Typically, these might be a more effective or safer approach for use with certain patients, or could perhaps lead to the development of new materials for the manufacture of prosthetic joints.
This, of course, means that the learning process for these practitioners does not end on the day that they receive a master’s degree, but that the pressure on an orthopaedic surgeon to remain abreast of the latest trends in his or her field is both intense and ongoing. Many of the top men and women in the field choose to participate in research projects of their own, in parallel with their practice duties. In the light of such observations, it should be clear that it can be important for anyone who may need a knee replacement to take care when choosing their specialists.
Academic prowess and even research achievements alone are still not sufficient grounds on which to base your trust in the individual upon whose skills your future comfort and mobility could possibly depend. You will also need to set your sights on finding an individual with an established track record of success in the practical application of the relevant subject knowledge and research findings. It is often claimed by those engaged in other practical occupations that a teaspoon of experience can be worth a bucketful of knowledge. It is certainly the case that when conducting any type of surgery, there can be no real substitute for hands-on experience.
The insertion of an artificial joint to replace a damaged one is a procedure known as arthroplasty. The title applies equally, whether it is the joint in the shoulder, in the hip or in the knee that may be targeted for replacement by a specialist in orthopaedic surgery.
The earliest known substitute for a damaged joint was made from ivory. Unfortunately, it proved to be insufficiently durable to provide a long-term solution. Since then, a number of stronger materials have been used for this purpose in the attempt to promote optimum mobility between the joint surfaces, while ensuring the minimum of wear.
Today, a typical, complete artificial knee joint consists of a flat metal plate attached to a stem, and implanted into the tibia that articulates, via a polyethylene bearing surface, with a contoured metal implant fitted over the head of the femur. The metals used include stainless steel, cobalt-chromium alloys, titanium and its alloy, with aluminium and vanadium and tantalum. The latter, along with titanium alloys, are biocompatible in nature. Tantalum, in the form of trabecular metal, is ideal for un-cemented implants in which attachment is achieved through bone in-growth. On the other hand, titanium alloys provide a more natural joint action, but require the use of a bio-active surface agent to promote bone in-growth.
Knee replacement specialists must be familiar with the relative merits, the cost and physical circumstances that will influence the choice of prosthetic material, and any special requirements or contraindication that may apply to its use for a given implantation.
To ensure the services of a knee replacement specialist with all of the knowledge, experience and expertise described above, many doctors both in South Africa and overseas, are now referring patients in need of arthroplasty, and even general orthopaedic surgery, to Dr Jan De Vos, a leading Pretoria-based practitioner in the field of hip, knee and shoulder surgery.