Joints replacement. Arthroplasty

Elbow arthroplasty (elbow joint replacement) is a more recent and much less common operation.

However, Israel is considered to be a country where accumulated years of experience in elbow replacement. This allows our surgeons to perform it at a high level. This operation may be performed only by a highly specialized physician who regularly operates the elbow using advanced replacement technology.
Operation to replace the elbow joint is performed in cases where other measures medical and surgical do not bring satisfactory results.

You can also send us MRI, CT-images or X-ray of elbow. We will contact you as soon as possible.

Basic pathology of the elbow joint which can lead to elbow arthroplasty are as follows:
 Arthritis
 Rheumatoid Arthritis
 Complicated elbow fracture, including that in old age
 Severe damage or break the soft tissues of the elbow
 Malignancies in joint or around the elbow
 Negative results of previous surgery on the elbow

Standard preoperative test includes: and X-ray of elbow, blood test, ECG and chest X-ray (in patients older than 40 years). For hemophiliacs measures to improve the rate VIII  is important.

The surgery usually takes one to two hours and is performed under general anesthesia. In some cases also used regional anesthesia.
The incision is carried out, as a rule, on the rear side for opening the elbow. Surgeon removes the lower end of the humerus and the upper end of the ulna together with the damaged tissue. Then, in the central part of the humerus and the ulna installed kernels and cemented prosthesis. Two bases are connected with hinge mechanism. The wound is closed and hand is superimposed on the tire for fixing and stabilizing the prosthesis. Sometimes surgeons use a plaster bandage which is typically removed from 48 to 72 hours.

As with any surgery there is a possibility in complications: bleeding, infection, thromboembolism (rare in surgery of the upper extremity).

Postoperative management 

The patient will stay in hospital for about three or four days. A splint may be used after surgery to help stabilise the elbow.

Physiotherapy begins with light exercise. Patients who have a splint typically start therapy a few weeks later than those who do not. During the first 6 weeks after surgery the patient will need assistance in daily activities (driving , shopping, taking a bath, cooking and housework).

In some patients elbow function recovery begins with 12 weeks after surgery although complete recovery may take up to one year.
After the restoration of function patient should not lift more than 2.5 kg of the operated hand, even if it is fully recovered.

Choice of prosthesis
Elbow prosthesis personally determined by a surgeon based on the pictures and the anatomical structure of joint.

The most commonly used prostheses unrelated Kudo and Souter-Strathclyde, and related prostheses Coonrad-Morrey, Gschwend and Discovery. Practice shows that the linked hinge implants better reduced arc motion, which promotes faster recovery and a lower level of radiological loosening.

Being a complicated operation, hip replacement is one of the routine procedures in Israel and performed, on average, 2-3 times a day by an experienced orthopedic surgeon. The success rate hip arthroplasty in Israel 99%.

Hip is one of the largest joints in the body. It is built of a ball-shaped head, which is adjusted into a concave niche in the pelvis. Around the joint there is a capsule, ligaments and muscles that help the activity of the joint and support its stability. The femoral head and the acetabulum are coated with a cartilage, allowing for smooth, painless movement.

Articular cartilage plays an important role as a shock absorber and reduces friction during movement. When you walk, jump or run, the forces of soil damage are absorbed by the cartilage. When there is destruction of the cartilage, friction is created between the bones, leading to the erosion of the joint and severe pain, which restrict movement.

Some orthopedic conditions that Israeli doctors have successfully treated with arthroplasty and other methods

• Coxarthrosis – wear or damage to the articular cartilage.
• Osteoarthritis due to peculiarities of the joint anatomical structure.
• Aseptic necrosis of the femoral head –  death of the femoral head tissue.
• Femur fracture.
• Post-traumatic hip arthrosis.
• Progressive rheumatoid arthritis.

What are the osteoarthritis symptoms and its causes?

Trauma, arthritis, and osteoarthritis, which is the most common. Osteoarthritis, is the main cause of dysfunction in older age. Nearly 80% of the population will suffer from a certain erosion of the articular cartilage above age 65 and about 15% will suffer from pain and functional limitation.

The main symptoms are pain, discomfort and stiffness in the hip that restrict movement and significantly reduce quality of life. Typically, the disease develops gradually, reminding itself from time to time during long walks, habitual motion, tilt, squat, that yesterday seemingly given with greater ease. And here comes a time when a person can no longer cope with the pain overtaking him not only under load but during sleep in a relaxed position.

The cause of osteoarthritis is not known, and the treatments currently known primarily treat symptoms – pain and movement limitation. Modern medicine has not yet been able to develop effective methods for regenerating cartilage.

As a rule, in all these cases our doctors recommend as much as possible not to interfere with the body and not to damage the integrity of the natural tissues. But when pain and stiffness reach such a limit that the person is no longer able to deal with them there is a need for a hip replacement.

The necessity to select a proven orthopedic doctor

Big role in the success of the operation plays a choice of a surgeon. Such a physician must have an appropriate qualifications and extensive practical experience of operations in prosthetics.

Hip arthroplasty surgery preparation and purpose

Upon review of X-ray and MRI images of the hip as well as physical examination, the physician makes a conclusion regarding the treatment, makes a determination regarding the operation and identifies the type of prosthesis taking into account the peculiarities of hip anatomical structure.

Hip replacement is performed after all non-surgical treatments have been exhausted, including anti-inflammatory and anti-inflammatory drugs, physiotherapy, and so on.

The purpose of the hip replacement surgery is to reduce the pain the patient suffers from, improve the range of movements in hip and thus significantly improve the quality of his life.

How is doing the operation?

Pre-surgery day

Pre surgery process helps patients and their families prepare for optimal surgery, dispel fears and answer all questions that arise. First of all initial meeting at the private appointment with a physician, where the doctor and the patient discuss the different treatment options and decide on the most appropriate treatment.

Surgeon explains the pre-surgical process, surgery and rehabilitation. Patients are invited to ask the questions about the whole process.

Before the operation patient will be invited to a “day of admission” at the pre-operative clinic of Assuta Hospital. On this day, the patient will be examined by the department’s physician and anesthesiologist, make blood test, ECG, Chest X-ray.

Day of surgery

On this day, the patient is hospitalized in Assuta hospital, examined by physician and the nursing staff, ensuring that there is no change in the his medical condition.

In the operating room the patient will be accepted by surgical team, anesthesiologist and the nurse.

Duration of hip replacement surgery – 1.5 – 2 hours.
At the end of the operation, a surgeon will leave the surgical team and inform the family of the operation and condition of the patient. The patient moves to the awakening unit, where he will be under close observation for about two hours. After his condition stabilizes, the patient will be placed to intensive care unit and one day later to the regular (or private) room at the orthopedics department.

The rehabilitation of our patients

Every day during the hospitalization, the patient will meet with a senior physician who will explain the patient rehabilitation process, what is expected of him, and in which he will answer the patient’s questions.

The day after surgery patient begins rehabilitation process, which includes removal of drains and urinary catheter (if inserted).
Patient will meet physiotherapy team that will treat him during hospitalization. Patient will get out of bed, start walking with a walker, and will receive explanations about what is permitted and what is forbidden after the operation.

On the first day, pain, range of movements and walking are expected to be limited.
It is important that the pace of recovery depends very much on the patient’s personal motivation and cooperation with the physiotherapy team.

On the second day after operation patient will continue to receive painkillers according to the usual treatment protocol.

The physiotherapy team will continue with the treatment, with an emphasis on walking patterns, increasing walking ranges, and providing functional independence for the patient.

Home release

After about 5 days of hospitalization patient can be discharged. If necessary, the patient is rehabilitated at home or in hospitalization.

In preparation for discharge, the patient will receive guidance from the nursing staff and physiotherapists.

Total time spent in Israel for total hip replacement – about 1 month.

Pain relief and significant increase in quality of life from first days

More than 90% of people undergoing hip replacement have reported dramatic pain relief, improved mobility and mobility, and a significant increase in quality of life within 6 weeks of surgery.

The rehabilitation period for each patient is different, but, as a rule, when properly performed operation after 3-4 months patient is completely accustomed to the prosthesis and no longer feels a foreign item in the body.

The success of the operation depends on a number of factors: level of patient’s activity prior to surgery, the range of movement of the hip joint prior to the operation, the success of the surgical procedure itself, but mainly the degree of patient cooperation and compliance with the medical guidelines of the rehabilitative staff.
After a complete recovery from surgery, the patient will be recommended to perform moderate activities such as walking, swimming and cycling in order to strengthen the muscles in the area and support the joint.

It should be noted, that the surgery will not allow the patient to perform intensive physical activity such as jogging or physical or aggressive sports that require contact or jumping.

It should be noted, that naturally, an artificial joint is eroded over time, even by moderate daily activity, and accelerated erosion under intense activity. Approximately 97% of the transplanted joints hold at least 15 years.

In case when joint function restoration is impossible by any surgical methods physician may recommend total knee replacement.

It may be done in such cases as:

 Osteoarthritis of the knee ( gonarthrosis ) – wear or damage to the articular cartilage
 Osteoarthritis due to peculiarities of the anatomical structure of the joint
 Posttraumatic arthrosis of knee
 Progressive rheumatoid arthritis

The main symptoms are pain, discomfort and stiffness in the knee that restrict movement and significantly reduce quality of life. Typically, the disease develops gradually, reminding itself from time to time during long walks or descending the stairs, habitual motion, tilt, squat, that yesterday seemingly given with greater ease. And here comes a time when a person can no longer cope with the pain overtaking him not only under load but during sleep in a relaxed position.

As a rule, in all these cases our doctors recommend as much as possible not to interfere with the body and not to violate the integrity of the natural tissues. But when pain and stiffness reach such a limit that the person is no longer able to deal with them there is a need for a knee replacement.

Being a complicated operation, in Israel knee replacement is one of the routine procedures and performed, on average, 2-3 times a day by an experienced orthopedic surgeon. The success rate knee arthroplasty in Israel 99%. But a big role in the success of the operation plays a choice of doctor. Such a physician must have the appropriate qualifications and extensive practical experience of operations in prosthetics.

One of the leading Israeli experts in knee treatment is Dr. Gideon Burstein -a specialist in knee and hip joints treatment, Senior doctor of Orthopedics Department, Sheba Medical Center, Tel Hashomer

Upon review of X-ray and MRI images of the knee as well as physical examination, the physician makes a conclusion regarding the treatment, makes a determination regarding the operation and identifies the type of prosthesis taking into account the peculiarities of knee anatomical structure.

As a rule, operation is assigned a day or two after consultation.

Before the surgery preoperative assessment is necessary which includes: blood test, ECG, Chest X-ray, consultation by anesthesiologist.

Duration of surgery knee replacement – 1.5 – 2 hours.

Recovery period 
After surgery the patient is in a hospital setting for 7 days. During this period surgeon visits him every day, monitors the overall health as well as initial rehabilitation.
In the first days after surgery for arthroplasty is very important to walk with each passing day more and more, but not by giving more stress on the joints.
After hospitalization rehabilitation period is about 3 weeks. There are rehabilitation centers in Israel equipped with everything necessary for recovery operations, including 24 hours medical supervision, three meals a day and all amenities. Here patient is taken care by specially trained nurses, which promotes rapid restoration of joint function and return a person to normal life. We will help you organize your stay in one of the best rehabilitation centers before your arrival in Israel.

Total time spent in Israel for total knee replacement – about 1 month.

From the first day of your stay in Israel we are close helping in oral and written translation, medical consultation, arranging accommodation in a hotel or apartment, transportation as well as your leisure time. We maintain constant communication with you and after you leave for city of living, and answer all your questions.

Of course, the rehabilitation period for each patient is different, but, as a rule, when properly performed operation after 3-4 months patient is completely accustomed to the prosthesis and no longer feels a foreign item in the body.