According to The Lancet Rheumatology, the number of people with joint disease has reached 595 million by 2020. Every year, hundreds of thousands of people visit their doctors with complaints of pain and clicking during movement. These health problems significantly reduce their quality of life and opportunities. Joint diseases are a widespread issue, that arises due to various causes and affect patients of a wide age group. According to statistics, 43% of the world’s population encounters diseases of the musculoskeletal system during their lifetimes. In this article, we will discuss the prevention and treatment of joint diseases.
Joint diseases and injuries
Joint diseases can develop in two main ways: gradual degeneration of cartilage and bone tissues, as well as acute or chronic inflammatory processes in the joints.
- Degenerative joint diseases are typically diagnosed in elderly individuals and are associated with the “wear and tear” of tissues. Exceptions are patients with excessive body weight, as well as athletes.
- Inflammatory processes can occur at almost any age. The cause may be previously received injuries, the consequences of infectious diseases, hypothermia, hormonal imbalance, etc.
Almost all joints of the human body are subject to problems. The large ones are most often affected: hip, knee, elbow, shoulder, elbow, shoulder, and ankle.
Of these, the first three lead in the number of diagnosed diseases. Smaller joints (interphalangeal joints of the hand and metatarsal joints of the foot, temporomandibular joint) are affected to a lesser extent.
Read: What changes occur in the joint?
“The early stages of osteoarthritis are usually asymptomatic, and patients who present to their GP with joint pain typically have advanced disease when the cartilage has already been lost.” – Dr Deborah Mason, principal investigator and programme leader for preclinical research at Arthritis Research UK’s Centre for Biomechanics and Bioengineering in Cardiff.
Regardless of the cause of joint damage, pathological processes in the initial stages are manifested by a weakening of the ligamentous apparatus. In addition, the composition and amount of intra-articular fluid changes. Further, in the absence of timely treatment for chronic inflammation or under the influence of other factors, the articular surfaces are gradually erased. The shape of the joint can be deformed, and the articular gap decreases.
At this stage, patients complain of limited mobility, pronounced pain, cracking during movement, and stiffness. Sooner or later, bony structures become involved in the process, which leads to unbearable pain syndrome and complete restriction of mobility.
In the first stages of the disease, conservative approaches to treatment are possible. Specialists prescribe anti-inflammatory, analgesic and trophic drugs, chondroprotectors (medicines that accelerate the regeneration of cartilage tissues), physiotherapy and physical therapy.
Conservative therapy aims to stop the active inflammatory process and slow down the progression of the disease. Treatment can bring tangible or partial relief.
It is difficult enough to completely stop the pathological process, especially when it comes to autoimmune processes.
In some cases, such innovative techniques as PRP therapy (platelet-rich plasma injected into the knee) and stem cell therapy are effective.
“It has recently been discovered that osteoarthritis is accompanied by the same inflammatory signals as other forms of arthritis, such as rheumatoid arthritis. Rheumatoid arthritis is now effectively treated in many patients with new drugs that inhibit inflammatory signalling and prevent joint destruction. Trials are underway to determine whether such drugs can effectively control inflammation and joint destruction in osteoarthritis.” – Dr Deborah Mason from Cardiff University.
According to Dr Mason, drug treatment is almost always completely ineffective in the late stages of the disease (grade 3-4 osteoarthritis). In such cases, irreversible tissue changes are already so pronounced that surgery remains the only possible treatment. Surgery is indicated for patients with the last stages of arthritis and arthrosis, certain types of fractures (e.g. fracture or dislocation of the femoral neck), and cancer.
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Joint replacement surgery
Orthopaedic traumatologists perform partial or total endoprosthetics (replacement of the affected joint with an artificial high-tech prosthesis). Today, these surgeries are no longer difficult and inaccessible.
Foreign specialists have accumulated extensive experience in performing surgeries of varying degrees of complexity, and surgical techniques have been modernised to minimise traumatisation of the patient’s tissues. More than 420,000 joint replacements are performed annually in such medical centres.
Total (total) endoprosthesis
A total endoprosthesis is a surgical intervention aimed at restoring the function of a damaged joint by replacing it with an artificial high-tech implant. The operation is performed under general anaesthesia. During the intervention, surgeons remove the damaged joint surfaces and replace them with prostheses. The type of prosthesis and the material of the articular surfaces is chosen by the doctor taking into account the anatomical features of the patient and the level of activity of the person.
The rehabilitation period begins as early as the 3rd day after surgery, which allows the patient to move around with minimal assistance (cane) after 14 days. This type of prosthetics is performed most often and is available for knee, hip, elbow, ankle, and shoulder joints.
Partial joint replacement
It is at earlier stages of the disease when parts of cartilaginous joint surfaces can be preserved. During the surgery, the orthopaedic doctor removes the destroyed tissue, replacing them with artificial implants.
Partial joint replacement is an easier surgery, although it is used less frequently. It is only used for knee joints.
After partial joint replacement, the patient does not need specialised rehabilitation. Indications for partial or full prosthetics should be determined exclusively by an orthopaedic traumatologist.
What examinations are necessary?
Usually, imaging diagnostics – digital X-rays or MRI – are performed to qualitatively monitor the function and condition of the joints. These examinations are sufficient to assess the condition of the tissues and prescribe treatment.
Where are joint prosthetics performed?
Almost every large multidisciplinary clinic abroad has a department of orthopaedics and traumatology where joint replacement surgery can be performed. In addition to large medical centres, there are also narrow-profile orthopaedic hospitals. They offer a full range of medical services to patients with diseases of the musculoskeletal system.
According to ratings and statistics, the best destinations for surgical interventions on joints, including prosthetics, are:
Turkey
Liv Clinic
Endoprosthetics is one of the key areas of Liv Hospital (Istanbul, Ankara). The surgeries here are personally performed by Professor Çağatay Öztürk, the best orthopaedic surgeon in the country with 27 years of experience. He is a member of national and international medical organisations. He performs surgeries of varying complexity to treat diseases of the musculoskeletal system. He has received several prizes and awards for his work, including the Professor Ridvan Ege Research and Publication Award.
Hisar Clinic
Joint replacements are also performed at Hisar Hospital. This institution is one of the oldest and largest medical centres in Turkey. It has a large endoprosthetics department. The surgeries are performed using original implants supplied by the world’s best manufacturers. A renowned Turkish orthopaedic surgeon Dr Gürsel Saka with more than 34 years of experience works here. He was a finalist in the Tubitak 9th Technology Awards for developing an intramedullary fixation nail suitable for the middle part of the forearm bones (radius and ulna). The doctor performs surgeries using modern minimally invasive techniques. He is a member of the Turkish Association of Orthopaedics and Traumatology (TAOT), Bone and Joint Surgery Association (BJSA) and other organisations.
Czech Republic
Motol University Hospital
The Motol University Hospital in Prague is the #1 choice of patients travelling to the Czech Republic for joint endoprosthetics. Knee and hip replacements are most often performed here. They are done by Professor Tomáš Trč, who has 40+ years of experience. He is a medical expert of the Ministry of Health of the Czech Republic in the field of orthopaedics and traumatology, and a member of the international orthopaedic community SICOT and other organisations. He performs surgeries for the treatment of joint diseases of various degrees of severity.
Spain
Quironsalud Barcelona Clinic
The clinics of the Quironsalud network are the leading institutions for the treatment of orthopaedic pathologies. They perform joint replacements using innovative minimally invasive technologies. Patients of these institutions have access to new-generation endoprostheses, which have maximum biocompatibility and a service life of more than 30 years. Ramon Cugat, the internationally renowned orthopaedist and traumatologist, founder of the Artroscopia G.C. Centre and head of the Orthopaedics Department, practices at the Quironsalud Barcelona Clinic. He is the personal surgeon of the Barcelona football team and was a member of the team of doctors at the 1992 Olympic Games. He is a member of 19 international scientific medical organisations. He uses the most modern treatment methods, including growth factors and stem cells.
Germany
Munich Orthopaedic Centre OST
The Munich Orthopaedic Centre OST is Germany’s leading clinic for the treatment of musculoskeletal disorders. Minimally invasive joint replacement techniques are available here, which allow the prosthesis to be fitted through small incisions. Dr Frank Meinhard Balensiefen is a world-renowned orthopaedic surgeon with an excellent reputation and a wealth of experience. He has performed over 5,000 joint replacements, 630 tumour removals and 2,000 hand and foot interventions. He is the attending doctor of the German national ice hockey team.
University Hospital Rechts der Isar
Endoprosthetics can also be performed at the Rechts der Isar, one of the largest hospitals in the European Union in Munich. Treatment is available on the basis of the Department of Orthopaedics and Traumatology. Prosthetics of any degree of complexity are performed here. The treatment of diseases of the musculoskeletal system is carried out by a team of experienced doctors under the direction of Professor Rüdiger von Eisenhart-Rothe. He is the head of the Centre for Orthopaedics and Sports Medicine. He is involved in osteoarthritis therapy, osteo-oncology and endoprosthetics. He conducts research in the field of regenerative therapies. The doctor is a member of 10 international medical organisations.
Poland
KCM Clinic
The KCM Clinic is a hospital that ranks among the best Polish medical centres in the field of orthopaedics and rheumatology. Prosthetics is performed by a renowned specialist, Professor of Orthopaedics Krzysztof Czerkasow. He is the head of the orthopaedic department of the KCM Clinic. He has over 40 years of experience and has performed over 5,000 joint replacements. He is a member of several national and international associations in the field of orthopaedics and traumatology.
South Korea
Orthopaedic centres and departments of the top clinics in Korea are equipped with the latest technology. They have everything necessary for successful joint replacement. The SoonChunHyang Hospital and the Anam University Clinic are particularly popular with foreign patients. These hospitals have experienced orthopaedic surgeons such as Shin Byungjun, Suh YouSung, Lee JaeChul and others. These doctors use the latest methods and technologies to treat diseases of the musculoskeletal system.
SoonChunHyang Hospital
Anam University Clinic
Israel
Sourasky Medical Centre (Ichilov)
For joint endoprosthetics, foreign patients choose large orthopaedic centres and departments of the leading clinics in the country. Among them are the Sourasky Medical Centre (Ichilov) in Tel Aviv and the Chaim Sheba Clinic in Tel Hashomer.
The Orthopaedics Department at Ichilov Hospital is headed by Dr Amal Huri, who has been practising in his field for over 30 years. In 2021 he was ranked by Forbes as the best orthopaedic surgeon in Israel, and in 2023 he was included in the Duns100 list of the best doctors in Israel.
Sheba Medical Center
One of the best endoprosthetic specialists at Sheba Clinic is Dr Guy Vogel. He is a senior surgeon in the Department of Orthopaedics. His areas of interest are sports injuries, degenerative diseases, arthroscopy and joint replacement. Dr Vogel is a member of several scientific organisations, including the Israeli Hip and Knee Society, Shoulder and Elbow Society, and Society for Knee Surgery and Arthroscopy.
Contact MediGlobus to choose the most suitable clinic for your case. We will make an appointment without waiting lists and help you organise your travel for treatment.
Summary
- Whatever the cause of the joint disease, at an early stage pathology typically manifests as weakening of the ligaments. In addition, the composition and amount of intra-articular fluid changes. Chronic inflammation and external factors lead to gradual erasure of the joint surfaces. As the shape of the joint deforms, the articular gap decreases.
- Orthopaedic traumatologists use partial or complete endoprosthetics (replacement of the affected joint with an artificial high-tech prosthesis). Today, these surgeries are no longer difficult and inaccessible. Foreign specialists have accumulated extensive experience in joint replacements of varying degrees of complexity, and surgical techniques have been modernised to minimise traumatisation of the patient’s tissues. Over 420,000 joint replacements are performed in foreign medical centres each year.
- Virtually every large multidisciplinary clinic abroad has an orthopaedics and traumatology department where joint replacements are available. In addition to large medical centres, there are narrow-profile orthopaedic hospitals. They offer a full range of medical services to patients with diseases of the musculoskeletal system.
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