The Star – Fixing Ailing Joints
Interview with Dr. Lim Li Aik and Dr. Gopinath Mathavan, Consultant Orthopaedics and Trauma Surgeons
Minimally Invasive (keyhole) surgery uses a few small incisions rather than one large incision and has been associated with better outcomes than open surgery, including reduced risk of surgical site infections and less post-operation pain, which translate to faster recovery time and shorter hospital stay.
Total Knee Replacement
Arthritis of the joints is very common in Malaysia and often involves the knees. The goal for treatment is to relieve pain and improve quality of life. “When my patient complains of severe knee pain, I know that it is hard if not impossible for them to perform their daily activities. Medications and walking support are often used first but when their effectiveness has reached a limit, knee replacement surgery can become the answer,” says Dr. Lim, Consultant Orthopaedic and Trauma Surgeon at Oriental Melaka Straits Medical Centre.
Total knee replacement surgery (TKR) is safe and effective procedure to relieve pain, restore limb alignment with good range of motion and improve overall quality of life. This procedure involves removing all diseased portions of bone and tissue on the ends and replacing them with metal and high-density polyethylene implants. These implants create a new joint that approximates the anatomical and physiological function of a human knee joint. In most cases, the replacement knee can last for about 15 to 20 years.
“The overall success of TKR depends on appropriate patient selection, proper implant choice, meticulous and appropriate surgical technique and post-surgery rehabilitation,” says Dr. Lim. “The availability of computer-assisted navigation in TKR surgery helps orthopaedic surgeons achieve proper soft tissue balance, correction to within one to two degrees of the neutral mechanical axis and minimal or zero error during the implant placement,” says Dr. Lim. With the combination of navigation technology and minimally invasive surgical technique, this advancement has resulted in better post-operation results.
Patients can move the day after their surgery and can usually be discharged four days after the procedure. Early mobilization reduces hospital stay by reducing the risk of post-operation complications such as deep vein thrombosis and this is psychologically empowering for the patient, which translates to improved results during rehabilitation after the operation.
Arthroscopy is a surgical procedure where the surgeon uses specialized cameras and equipment to diagnose and treat a variety of joint problems through just a small incision in the skin.
“Arthroscopy can only be undertaken after obtaining a complete medical history and examination of the affected joint, often supplemented by further investigations such as X-rays or MRI scans. Following this, a decision will be made whether or not to proceed with surgery,” says Dr. Gopinath Mathavan, Consultant Orthopaedic and Trauma Surgeon at Oriental Melaka Straits Medical Centre.
Common problems within the joint that can be dealt with using arthroscopic methods include:
- Synovitis (Inflammation of the joint lining)
- Damaged joint surfaces
- Loose fragments of bone or cartilage
- Bone spurs or impingement
- Ligament reconstruction procedures
“Arthroscopy is generally safe and can often be performed as a day procedure. Because of the smaller incision needed, there is less discomfort and risk, which allows for quicker recovery. Most patients can return to work and resume sporting activity as early as two to six weeks post-surgery,” says Dr. Gopinath.
Furthermore, complications from arthroscopy are rare. These include pain, infection and swelling of the joints.
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