Prof. Dr. Plamen Kinov: A football player was the first to undergo partial arthroplasty

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Prof. Dr. Plamen Kinov: A football player was the first to undergo partial arthroplasty
Prof. Dr. Plamen Kinov: A football player was the first to undergo partial arthroplasty

More and more people suffer from joint pain, morning stiffness and reduced mobility. Sedentary lifestyle, lack of sufficient physical activity, excess weight, everyday stress, mature and advanced age, as well as insufficient supply of the articular cartilage with valuable building elements - collagen and hyaluronic acid - contribute to the deepening of these problems

“Reducing weight even by just a few kilograms reduces complaints of joint problems. In a study, it was even found that reducing body weight by 5-6 kg leads to a 50% reduction in the risk of developing wear and tear on the knee," explains Prof. Dr. Plamen Kinov, head of the Orthopedics and Traumatology Clinic at the hospital "Tsarica Joanna - ISUL" and national consultant in orthopedics and traumatology.

Prof. Kinov, what is partial arthroplasty?

- Partial arthroplasty successfully treats patients with arthrosis of the knee joint detected at an early stage. The new modern method is extremely successful and for the last 3 years it has been applied to more than 40 people, and the results are excellent. The very next day after the operation, the patient can move, and a month later he is fully recovered.

For the first time in Bulgaria, a partial knee joint replacement was performed. The operation was performed on a former soccer player who had long since retired from professional sports, but serious injuries over the years had affected his knees. Learning about the new method, the athlete decided to undergo the intervention, since the technique is minimally invasive, i.e. a minimal incision is made and the implant is placed. This allows the patient to recover as quickly as possible and within two weeks to return to his normal rhythm of life.

The method was first introduced in 2003 in the USA. Worldwide, it is most often performed on patients of active age. We started applying it to ex-athletes so they could live normally. This method preserves the biomechanics of the joint, and after recovery, patients are pain-free, able to move normally, play sports, and carry out other activities of daily life.

With the new partial prosthetic method, recovery takes about two weeks, while with a knee prosthesis, this period is about a month. Therefore, our ambitions are to continue to apply it in our work in the future, as well as to train our colleagues in its use.

How is partial arthroplasty done?

- Through a small incision 8-10 cm in size, the joint is penetrated, the damaged cartilage and remnants of the meniscus are removed, after which the damaged and missing parts are replaced with a small prosthesis. In this way, the progression of the disease is stopped, the function of the knee is preserved, and the movements are normal.

Recovery is extremely fast, as the very next day after the intervention the patient can walk and has a normal volume of movement. Postoperative pain is easily controlled with medication and gradually disappears within one to two weeks, and the patient recovers his functions completely within a month after the operation.

This method is not suitable for treating patients with inflammatory diseases, such as rheumatoid arthritis, gout or psoriasis, in which the inflammatory process covers the entire joint

Can we and how to deal with morning stiffness in the joints?

- Joint stiffness is a common complaint. If the stiffness is in the morning or after a long rest and disappears after a short movement within 15 to 30 minutes, it is most likely a matter of joint wear, the so-called osteoarthritis. Stiffness that lasts for an hour or more may be due to rheumatoid arthritis or another inflammatory disease affecting the musculoskeletal system. Other less common causes can be systemic diseases of a different nature, intestinal problems, side effects of drug treatment, intoxication or some diseases of the nervous system.

Predisposing factors are improper diet and overweight, working in a harmful environment - chemicals, dust, moisture or cold, long forced postures at work, reading, lying down also worsen complaints.

Various harmful factors worsen the functioning of the joints by two main mechanisms - impaired lubrication of the articular cartilage and a decrease in the elasticity of the surrounding articular structures - joint capsule, ligaments. In a state of rest, the production of joint fluid decreases, and it is of fundamental importance for the smooth gliding of the joint ends. Without its help, the cartilage cannot function normally and move and slide with minimal resistance.

Is this condition treatable?

- The variety of possible causes requires prompt identification of the causes of stiffness and their proper treatment. When complaints of joint stiffness appear

consultation with a specialist is mandatory

Treatment of joint stiffness involves a balanced lifestyle with adequate nutrition and rest. The diet should contain more fruits and vegetables. Drink plenty of fluids. A balanced diet, food rich in vitamins and trace elements, prevents cramps and cramps and reduces muscle tone at rest. Sleep in a calm and comfortable environment, without cold or drafts, ensuring a minimum of eight hours of sleep.

How can we help ourselves?

- In cases of wear and tear of the joints as a result of arthrosis, an effective measure against stiffness is the intake of warm liquids. Dehydrating the body and warming it increases the production of joint fluid. This is the reason why spa treatments and saunas have a beneficial effect on the joints. Common anti-inflammatories, including aspirin, also help ease the motions. In addition to pain relief, they have a soothing and anti-inflammatory effect, which reduces the local pain inherent in stiffness. In this way, trouble-free movements are restored very quickly after taking them. In cases with stiffness as a result of another disease, treatment of the underlying disease takes an important place.

Stress is another harmful factor

for the joints. Reduced muscle tension leads to relaxation and relaxation of the joints at rest. Periodic stretching and shaking of the limbs leads to a reduction in accumulated tension.

Regular sports and gymnastics activities reduce stiffness. We recommend training at least three times a week. These should include a good warm-up and stretching exercises.

What disease is gonarthrosis?

- Gonarthrosis is the most common degenerative disease of the musculoskeletal system, which affects about 20% of people over the age of 50. One of the first symptoms of the disease is pain, which is felt more strongly on the inside on the knee or behind the cap. It also occurs when going down stairs or standing up from a sitting position. In the initial stages, the pain appears with more intense load on the knee and subsides at rest, and in more advanced stages it is almost constant.

The main risk factor for gonarthrosis is a family history in which there is reduced durability of the cartilage, poor bone formation or improper loading of a certain part of the knee. Injuries can also contribute to overloading the damaged part of the joint.

What kind of treatment can help with this disease?

- Traditional treatment, including rest and the methods of folk medicine, as well as physiotherapy, sanatorium treatment and medication, are effective at the beginning of gonarthrosis. Their application helps to reduce pain and swelling and restore function in a shorter time. In the case of advanced wear and tear of the knee, the impaired function remains and painkillers only blur the picture - complaints decrease, but the problem is not eliminated. Although more slowly, wear and tear on the joint progresses. It is in these patients that the application of the so-called unicondylar, or partial endoprosthetics.

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