Editorial Vere Álvarez N
Dr. Pablo De Linares, our trusted orthopedic surgeon, treats upper and lower limbs. Joints, meniscus injuries, osteoarthritis, and, this time, prosthetics. Sometimes a knee or hip can't take any more, and there's no other option but to have an artificial extension implant. This prosthesis implant surgery can change your quality of life.
On other occasions, you've mentioned that you always leave surgery as a last resort. In what cases do you think a prosthesis should be placed?
Indeed, hip and knee replacements are always best left as a last resort, given that they're a more aggressive procedure in which we replace the joint. As I tell my patients, this is like the hinges on a large door: if the hinge starts to fail, you have to fix it, tighten the screw, use a 3-in-1, clean it well... but if it fails beyond repair, there's no choice but to replace it before it breaks the entire door. That's what we aim for with prostheses: we change the hinge, which would be that large joint.
What knee and hip problems are serious enough to prevent you from enjoying a good quality of life?
Orthopedic surgeons consider that major knee and hip problems that lead to a prosthesis occur when your quality of life is significantly diminished. This would be when you can't live a normal life, although this varies for each person depending on their needs. Depending on these needs, it would be when it prevents you from performing everyday activities.
How can having a prosthesis change your life?
Prostheses change your life because where you couldn't do many normal daily activities, including leisure and entertainment in general, you can now do them. From putting on socks, which you can't do with hip osteoarthritis and need assistance, to not being able to take a step and having to use a wheelchair, or having constant, permanent pain that requires painkillers. The quality of your life changes completely.
There are different types of hip and knee prostheses, and their use depends on the specific problem. What types are most commonly used and why?
Generally, hip and knee replacements depend on the type of osteoarthritis and the pathology. Some are implanted, which have a kind of glue that adheres to the bone... others are not, and others require removing more bone to provide greater stability to the joint. It always depends on the type of pathology we are dealing with; all replacements are ultramodern, and the latest ones have been released with tremendous advances.
What is the process like in the operating room?
First, in the operating room, an incision is made in the knee or, if it's the hip, on the side. Then, the soft tissue is removed to reach the bone, which must be carved to remove the damaged area. Finally, the prosthesis is inserted into the bone, which is like a new hinge that gives you quality of life.
Intervention time, recovery times, and rehabilitation tips.
The surgery itself lasts about an hour or an hour and a half at most. If we consider the entire process, from the moment the patient arrives, enters the operating room, speaks with the anesthesiologist, prepares, performs the procedure, leaves the room, and returns, it takes a few hours, between four and six hours. Regarding recovery, the first day you lie in bed peacefully while they perform the tests, and on the second day you're sitting up and starting to walk, obviously with discomfort from the surgery, but the horrible pain caused by the osteoarthritis or other pathology is gone. Logically, from that second day on, you begin a recovery process that involves the patient only extending and flexing their knees and hips, and taking their first steps again. Essentially, it's about starting to walk, and what patients appreciate most is the wonder of walking again without pain, albeit with the logical discomfort of such a major surgery, but not the pain they had before.
Are these types of interventions risky?
These are major procedures that carry a certain risk. It's true that these risks are increasingly lower and more controlled, in the sense that a preoperative evaluation is performed by anesthesia, including blood tests, chest X-rays, and an electrocardiogram to ensure the patient will tolerate the procedure well and because the material is better. The incisions are also smaller and the technique used is more refined, but as with any surgery, a risk always exists.
A message for followers and those looking to resolve knee and hip problems…
My mission as a doctor is to help the patient and provide them with quality of life, to reduce their pain. As I tell my patients, we have to achieve this, as I jokingly say, through civil or military means, by good means through the measures we try to implement before physical therapy, rehabilitation, modern sports medicine treatment, injections, or by bad means, so to speak, which would be surgery. Obviously, the goal and the advantage of our profession in this case is that we manage to cure the patient, which is no small feat.
Every person suffers from a problem, and at Dr. Mosqueira Clinic we aim to provide the best solution. On our website, you can find all the information regarding the services and conditions treated, or you can request information by calling 951006638.
