October 12 is World Arthritis Day
Arthritis is the world's number one disabling disease
Severe people cause joint disability and affect the quality of life of patients
But when suffering from knee arthritis for many years
Is there any better solution besides joint replacement?
Maybe this story of the patient from the joint center of our hospital can help you
Let's take a look at
"Thanks to the joint center of the Third Hospital, my legs no longer hurt, and they have become straight!" Aunt Li (pseudonym), a patient from Macau, said excitedly.
It is reported that Aunt Li had been tortured by knee pain for more than 10 years before visiting the joint center of our hospital. She was told that artificial knee replacement was needed to completely solve the problem. Although Aunt Li is healthy, her quality of life has decreased significantly due to knee pain, and she is worried about various complications after joint replacement surgery, so she has not had any surgery until now. Until she heard that there was a precedent for minimally invasive knee protection surgery for knee osteoarthritis in the Joint Center of Guangtai Hospital 3, she thought that there might be an opportunity to solve the problem without joint replacement surgery. After someone introduced her, she finally walked into the clinic of Li Peng, the attending physician of the knee protection team of our hospital.
In the clinic, Li Peng conducted a detailed examination of Aunt Li's physical condition. Aunt Li's left knee joint was severely deformed. The image showed that Aunt Li's knee osteoarthritis was very serious. Although the lateral ventricular and patellofemoral joints were intact, the medial ventricular degeneration was obvious, with an angle of varus of 28°. In simple terms, Aunt Li's left leg turned into a trolley leg.
▲Patient appearance
▲The entire length of lower limbs, severe varus deformity on the left
Then, Chen Leilei and Yu Cuntai, deputy chief physicians of the knee protection team of the joint center, conducted a comprehensive assessment of Aunt Li's condition, and unanimously believed that Aunt Li's left lower limb deformity mainly comes from outside the joint, not caused by wear and degeneration in the joint. Aunt Li not only has femoral deformities, but also has tibial deformities.
Experts point out that when there are deformities in both the femur and tibia, if such deformities are corrected only by single tibial lateral osteotomy or femoral lateral osteotomy, the correction may be insufficient, and the residual valgus deformities may also lead to non-physiological tilt of the joint line after surgery, resulting in increased shear force on the cartilage on the joint surface. Long-term shear stress will cause the cartilage to exceed its load limit, causing damage to the cartilage surface and speeding up the occurrence and progress of osteoarthritis. In addition, tilting the joint line may also cause sagging of ligaments around the knee joint, which can easily cause instability when loading weights.
Therefore, based on the patient's specific condition, the knee protection team has formulated a personalized and precise knee protection treatment plan for the patients: the left knee joint is subjected to distal femoral osteotomy (DFO) and proximal tibial high osteotomy (HTO) at the same time to correct the severe valgus deformity of the left knee and better restore the joint force line and the normal anatomical angle of the knee joint to achieve the purpose of knee protection.
Knee Center Knee Protection Team Chen Leilei, Yu Cuntai and Li Peng accurately calculate the correction angle based on the patient's imaging examination results before the operation, so as to formulate the optimal osteotomy plan and accurately and efficiently complete the distal femur osteotomy of the left knee joint and the high osteotomy of the proximal tibia. After the operation, based on the patient's physical constitution and traditional Chinese medicine syndrome differentiation, a personalized rehabilitation plan was formulated for oral, external use combined with traditional Chinese medicine techniques and functional exercise.
"Many doctors asked me to undergo knee replacement surgery, but I was afraid and unacceptable. Unexpectedly, the minimally invasive knee protection technology carried out by the Joint Center of the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine not only solved knee pain, but also retained my own joints. After the operation, there was also a complete traditional Chinese medicine rehabilitation treatment. I felt that I was recovering very quickly, so I praised the knee protection team of the Third Hospital of ." After the operation, Aunt Li raised her thumbs to the knee protection team of the Joint Center of our hospital.
▲Aunt Li’s knee joint appearance after the operation, and the left lower limb has become straightened.
▲The full length of the left lower limb X-ray force recovery
Knee protection experts come to popularize
Knee protection treatment development trend
Knee arthritis is a common chronic osteoarthropathy, which seriously affects the limb function and quality of life of middle-aged and elderly people. When knee osteoarthritis develops to the late stage, the joint cartilage is worn out in full layer, and the joint space is severely narrowed, knee arthroplasty is considered.
In the middle and early stages of arthritis, when the patient is relatively young (60 years old), peri-knee osteotomy can be used to achieve effective treatment and greatly reduce the chance of total knee replacement in the future. According to current literature statistics, the satisfaction rate in the first 10 years after high tibial osteotomy is the same as total knee replacement. In the second 10 years, the proportion of knee replacement required due to progression of the disease is about 15%, which means that within 20 years after the operation, 85% of patients no longer need artificial joint replacement. At present, knee arthroplasty is an effective means to treat severe osteoarthritis, but it often also contains corresponding complications, such as prosthetic infection, periprosthetic fractures, wear and looseness of the prosthesis, resulting in difficulty in later revision, affecting the prognosis, and at the same time, medical expenses have also increased accordingly. A deep understanding of these issues has promoted the development of the concept of knee protection, and a step-by-step treatment plan for knee joint treatment with knee protection and knee replacement. High tibial osteotomy (HTO), distal femoral osteotomy (DFO), and unicondylar replacement are important methods of knee joint protection.
Compared with total knee arthroplasty, peri-knee osteotomy around the knee joint has the following 6 advantages:
1. The original knee joint is completely preserved, the operation is completely outside the knee frame, the cartilage and ligaments of the joint are completely preserved, and the original motion mode of the joint is also preserved;
2. It can correct the abnormality of the lower limb force line to the maximum extent and correct the "rock leg" or "O" leg;
3. It can restore the patient's desire and demand for motor function;
4. HTO has not removed any external bone mass of the knee joint, retaining the original lower limbs to the greatest extent;
5. The postoperative functional exercise is less painful and the recovery cycle is short;
6. The surgical incision, bleeding volume and trauma are significantly smaller than that of total knee arthroplasty.
Joint Center Knee Protection Team Advantages
Guangzhou University of Traditional Chinese Medicine Third Affiliated Hospital (Guangdong Institute of Traditional Chinese Medicine Orthopedics) is one of the earliest hospitals in Guangzhou to carry out knee protection treatment. With the development of imaging and digital orthopedics in our hospital, the joint center can perform osteotomy planning and simulated osteotomy orthopedics before surgery, which can solve some problems in orthopedic surgery.
With the development of our hospital's digital orthopedic studio, the articular center will carry out a lot of work in precise preoperative planning and personalized surgery of orthopedics, especially in knee protection osteotomy. By designing the osteotomy parts and correction angles before the surgery, personalized osteotomy templates will be formulated to make knee protection surgery more accurate and minimally invasive.
Department introduction
Department 1 of orthopedics (Arthrocenter Articulation Department)
Guangzhou University of Traditional Chinese Medicine Third Affiliated Hospital is an important part of the national key discipline "Traditional Medicine Orthopedic Science". It is a key specialty of the National Administration of Traditional Chinese Medicine and Guangdong Provincial Traditional Chinese Medicine. It is a clinical department based on the Hip Research Center of Guangzhou University of Traditional Chinese Medicine and the Guangdong Academy of Traditional Chinese Medicine. It includes two majors: articulation and sports medicine. It is one of the departments with the largest number of joint surgeries and the richest treatment methods in China.
Diagnosis and treatment scope
Adult and children osteonecrosis, osteoarthrosis, degenerative osteoarthritis, rheumatoid arthritis and ankylosing spondylitis involve limb joints, bone and joint infection, bone and soft tissue tumors , middle-aged and young people femoral neck fracture , major joints of the limbs (shoulder, elbow, wrist, hip, knee, ankle), cartilage, ligament, meniscus , glenoid labrum, rotator cuff and other sports injuries.
Featured medical advantages
○ Hip disease mainly consists of femoral head necrosis hip joint disease protection and diagnosis and treatment .The joint center has more than 30 years of clinical experience and has formed a comprehensive prevention and treatment system of systematic, innovative prevention, early and accurate diagnosis, comprehensive conservative treatment based on traditional Chinese medicine, and hip-protective surgery that retains its own hip joints, significantly improving clinical efficacy. It has always been a leading position in the field of hip-protective research and enjoys a high reputation at home and abroad, allowing young patients to avoid or greatly delay the use of artificial joint replacement surgery.
○ Knee osteoarthritis ladder treatment . In response to different parts and degrees of damage to knee osteoarthritis, the joint center step-by-step method adopts simple drug treatment mainly in traditional Chinese medicine, comprehensive conservative treatment, minimally invasive arthroscopic surgery, osteotomy surgery that changes the joint gravity line (parts), partial joint replacement surgery to total knee surface replacement surgery, providing more comprehensive and accurate treatment methods for knee osteoarthritis and improving clinical efficacy.
○ is one of the earliest units in China to carry out artificial joint replacement surgery . In recent years, the number of joint replacement surgeries performed by the joint center has ranked among the top in the province. In recent years, the department has also actively promoted and applied the concept of rapid rehabilitation surgery, strengthened the construction of painless wards, and combined traditional Chinese and Western medicine with the "holistic concept" of traditional Chinese and Western medicine to enable patients to synchronize and recover quickly after surgery, while reducing the incidence of complications such as infection and deep venous thrombosis.
○ Arthroscopic minimally invasive surgery . The joint center has carried out minimally invasive arthroscopic surgery for more than ten years and is widely used in the treatment of sports injuries and diseases in the shoulder joint, hip joint , knee joint and ankle joint , and the average annual number of surgery is increasing year by year. The joint center has widely carried out high-difficulty surgery such as multiple ligament injuries in the knee joint under arthroscopic knee joint, tissue flap transplantation and repair of huge rotator cuff injury in the shoulder joint, habitual dislocation of the shoulder joint Latjet surgery, hip labrum repair and osteophyte removal. Arthroscopic minimally invasive surgery greatly reduces surgical trauma, makes the local more beautiful, speeds up the postoperative rehabilitation process, and makes the efficacy more satisfactory.
Expert introduction
Chen Leilei
Deputy Director of Traditional Chinese Medicine, Ph.D., Deputy Director of Articulation Department of the Joint Center, Ph.D., Doctoral Supervisor, winner of Guangdong Natural Science Outstanding Youth Fund, "Guangdong Special Branch Program" top young science and technology talent, Guangdong Province Outstanding Young Medical Talent, and National Natural Science Foundation Review Expert.
is good at
Master 0 Professor He Wei from the famous femoral head necrosis expert in my country. He is good at treating hip protection for femoral head necrosis, pediatric femoral head necrosis, hip dysplasia, congenital hip dislocation and other hip lesions; knee protection for knee arthritis, intra- and extra-articular deformities; rheumatoid arthritis, ankylosing spondylitis, pigmentation, villi nodular synovitis, hemophilic arthritis and other arthritis diseases; first complex artificial hip and knee replacement, minimally invasive unicondylar arthritis, and artificial joint renovation, etc.
Discovery information
General Hospital: On Friday morning, femoral head necrosis specialist
Orthopedics Branch: Thursday and Sunday morning,
Yu Cuntai
Deputy Chief Physician and Doctor of Medicine
2
Starting from February 2022, he is a special expert in the Joint Center of the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (Guangdong Institute of Traditional Chinese Medicine Orthopedics).
focuses on hip and knee surgery clinical work and artificial total hip and total knee replacement surgery for 25 years, focusing on the comprehensive treatment of knee degenerative, rheumatoid, post-traumatic, and post-infectious diseases, including non-surgical treatment and surgical treatment for 27 years.
Discovery information
General Hospital: Sunday morning
Li Peng
Attendant physician
Tested at
Tested at
Hourism diagnosis and treatment of various hip and knee joint diseases, especially the first artificial hip and knee arthroplasty, Knee arthroplasty stepped treatment, knee protection treatment (unicondylar, HTO and conservative treatment), rapid functional rehabilitation after artificial joint replacement, standardized diagnosis and treatment of postoperative pain and postoperative infection, postoperative revision of hip and knee arthroplasty, etc.
Discussion information
Osteopathy Branch: Sunday all day, Monday afternoon
General Hospital: Thursday morning 201
Contributed by: Li Peng | Initial review: Chen Leilei
Type editing (intern): Wang Yunyan
Text editor: Ye Meiqi |Proofreading editor: Li Longhao
Audit: Wang Jian |Audit release: Fan Linyan
Text editor: Ye Meiqi |Proofreading editor: Li Longhao
Audit: Wang Jian |Audit and release: Fan Linyan
Text editor: Ye Meiqi |Proofreading editor: Li Longhao
Audit and release: Wang Jian |Audit and release: Fan Linyan
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