Dr. Enric Castellet Feliu is a leading expert in pathologies knee orthopedic surgeon with over 25 years of experience in different hospitals and private centers of Barcelona. Member of the optional body COT Creu Blanca de Barcelona.
& iquest, consisting in a knee prosthesis?
The knee prosthesis is a metal implant that replaces the joint surfaces are damaged by disease. These implants reproduce the anatomy of the knee being fixed to the bone by cement.
& iquest;By standing?
The prosthetic knee joint is placed when suffering from an advanced stage of deterioration. This deterioration causes pain and creates a loss of mobility of the patient's knee. In most cases the causative disease is osteoarthritis, which is a loss of cartilage that covers the surfaces of the joint and that is what allows the function to be optimal and painless.
& iquest;What challenges currently facing knee osteoarthritis?
The current challenge is the problem that arises in middle age of life. We are a generation of patients has made an intense sport in his youth and has injuries osteoarthritis formerly of older people own more advanced. Somehow they have altered traditional patterns and this requires a very personalized attention to each case as a function of lifestyle demanded by the patient.
& iquest;There are solutions for these cases?
Some are. But the complexity of the knee requires evaluating each case in a personalized way. Not only the level of injury but also the needs and expectations raised by the patient should be evaluated to provide the best solution in each case.
Describe which can be effective.
First, we must insist on the importance of maintaining good muscle tone. At the moment the only possibility to delay the deterioration of the knee is to maintain muscle tone. However, to achieve the necessary activity to be well targeted for certain activities can be detrimental. Also, the daily habits also influence the course of the affectation of the knee. Acting on them is very important. Second, the biological treatment involved. Injections of hyaluronic acid and growth factors may help in some cases.
& iquest;And when these measures are not enough?
That's when you should consider the possibility of surgical treatment. In middle-aged patients and affectation when confined to a compartment is when we can offer the possibility of partial dentures. Partial dentures replace only part of the joint ligaments and thus respecting respecting the biomechanics of the knee and getting proper function.
& iquest: and in the most advanced cases?
In these cases total prosthesis is indicated. The total prosthesis designs are continually evolving. At present not only get good results with these prostheses but satisfactory results hold for many more years.
& iquest;do you think about the evolution of prosthetic knee surgery?
The prosthetic surgery represents a revolution in surgery of the past few years but has not had sufficient recognition. When there existed the possibility of placing a prosthesis patients left their physical activity, and this represented the dependence on others and loss of social life. And with the lack of activity health is deteriorating: aparecian decompensation of other systemic diseases such as hypertension, diabetes... Thanks to the prosthesis patients return to be active and well being recovered.