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Wednesday, February 8, 2023
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New methods of knee and shoulder arthroplasty

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The developments in arthroplasty are important as new surgical techniques allow more precise planning of operations, offering great safety to patients.

Unicompartmental knee arthroplasty

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It is a minimally invasive technique that reduces morbidity, complications and length of hospital stay, ideal for those suffering from osteoarthritis in one part of the knee. It is not suitable for all patients with osteoarthritis, so the decision to choose the type of operation is made after discussion with the surgeon.

“This particular method does not disturb the biomechanics of the knee. Preservation of the medial and lateral collaterals, anterior and posterior cruciate ligaments and external meniscus, as well as the preservation of the non-wear part of the knee, excellent stability and mobility of the joint after surgery, lead to a faster recovery and offer excellent subsequent quality of life.

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It also minimizes postoperative pain, provides better stability, while patients who undergo it can climb stairs more easily than those who undergo total knee arthroplasty”, points out Mr. Vasilios Bernardakis, Orthopedic Surgeon, Director of the 3rd Orthopedic Clinic – Minimal Surgery Clinic of Invasiveness (MIS) at Metropolitan General.
Unicompartment arthroplasty can be done either robotically or with a custom-made technique, which means that preoperative planning is done with a CT scan and customized guides are made for precision osteotomies.

“Oxford Uni knee arthroplasty has evolved over the last 40 years and therefore there is an increased interest in it, especially after the introduction of surgical techniques that minimize surgical trauma. Today, it is considered one of the most appropriate interventions for the management of symptomatic osteoarthritis of the medial compartment. The method rivals the outcome of total knee replacements, with its excellent long-term clinical results supported by multicenter clinical studies,” explains the doctor.

It can easily be converted to a total arthroplasty while total knee arthroplasty revisions are a complex affair. Statistically, more than 95% of unicompartmental knee arthroplasties are functional even 10 years after the operation and more than 98% of patients are satisfied with the results it offers.

Reverse shoulder arthroplasty: It is a relatively new, internationally widespread method of total replacement of the shoulder joint, which differs from classic arthroplasty in terms of design, it has an “upside down” shape, which is why it is called reverse arthroplasty.

It is aimed at patients with accumulated shoulder problems, which have either not been treated at the right time or have been treated insufficiently. These are quite painful and stiff shoulders, symptoms which often worsen to an extreme degree, making everyday life difficult and significantly affecting the quality of life.

With this method, better and painless movement is achieved in cases in which no other classical surgical technique would work.
The application of the method is indicated in:
• Severe arthritis with failure or rupture of the shoulder tendons
• Compound fractures, which are not treated in any other way
• Replacement – revision shoulder arthroplasty after complications or failure
• Elderly patients with extensive patellar tendon tears with limited and painful shoulder movement.

“It is a method with several technical details, which when performed correctly on the right patient has impressive results. Hospitalization lasts one to two days, during which post-operative pain is controlled and an individualized physical therapy program is designed. For the first 2-3 weeks the patient rests his arm in a suspension envelope, which he removes for personal hygiene as well as physical therapy.

The envelope is then permanently removed and a more intensive physical therapy program is followed for approximately 6 weeks. Very soon after the surgery, the patient enjoys a painless and functional shoulder”, concludes Mr. Bernardakis.

The reverse arthroplasty method is carried out in collaboration with the specialized Orthopedic Surgeon – Shoulder Surgeon, Mr. Georgios Flevarakis, associate of the 3rd Orthopedic Clinic of Metropolitan General.

Written by:

Mr. Vasilios Bernardakis, Orthopedic Surgeon, Director of the 3rd Orthopedic Clinic – Minimally Invasive Surgery Clinic (MIS) at Metropolitan General

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