Replacing joint replacement surgeries with Ayurveda
Joint replacements don’t last forever
The more primary joint replacements surgeries there are, the more “do-over” joint replacement surgeries there will be. Repairs of previous joint replacement surgeries are called revision surgeries. The new projections suggest that the number of revision surgeries will double by 2015 for total knee replacements, and hip replacement revisions will double by 2026.
Patients need to be aware that while artificial joint replacements are successful, they don’t last forever, the studies say. There is roughly a 40% chance that an artificial joint will last 10 years, “so if you are 50 or 60 when you undergo your first surgery, you should expect to undergo a revision surgery.”
Complications of joint replacement surgeries
The common complications of joint replacement surgeries are
1. Blood clots in the veins of the legs are the most common complication of hip replacement surgery. As long as the clots remain in the legs, they are a relatively minor problem. Occasionally they dislodge and travel through the heart to the lungs (pulmonary embolism).
2. Surgeons have found that the risk of infection after joint replacement was much greater than with most other operations, unless special precautions are taken. The artificial joint can become infected many years after the operation. The bacteria travel through the blood stream from a source elsewhere in the body, such as from an infected wound, or a gall-bladder infection. Even regular dental work can release bacteria into the blood. Infections of the bladder, teeth, prostate, kidneys, etc. should be cleared up by appropriate treatment well before the day of surgery. Patients who have had joint replacements must take antibiotics by mouth before and after any dental work and must have all infections vigorously treated.
3. Loosening of the prosthesis from the bone is the most important long-term problem.
How long the bond will last depends on a number of factors.
a) How well the surgery is done. This is by far the most important factor.
b) The quality of your bones. The harder your bones are, the better the bond will be, and the longer the replacement will last.
c) How active you are. Excessive force on the implant can cause the bond to loosen.
d) Your weight. You should also keep your weight down because every pound you gain adds three pounds to the force on the hip.
e) Whether or not the implant is cemented. At present it is believed that uncemented implants will last longer than cemented ones.
f) The design of the implant. Small abrasion particles from the implant may play a role in implant loosening. Plastic surfaces shed more particles than metal or ceramic ones.
4. Wear of the Plastic Polyethylene Socket starts from the day of surgery. The plastic socket is the weakest link in the implant.
The rate of plastic wear against a metal ball is about 0.1 millimeters per year, but is more rapid in very active patients. “Cross-linked” polyethylene promises a wear rate about half that of regular poly. Plastic wear against a ceramic ball is much less in the lab, but this has not yet been shown to be true in the human body. Metal-on-metal bearings will never wear out. Nor will ceramic-on-ceramic implants, but there is a 1/20,000 risk of fracture of the ceramic ball.
5. Dislocation of the hip replacement occurs in a small percentage of patients regardless of how good your surgeon is (some surgeons report as high as 4%). With the Anterior Approach or the Gluteal Split techniques of hip replacement or the use of a large femoral head the risk of dislocation is greatly reduced, although it can still occur.
Dislocation means that the metal ball slips out of the plastic socket.
6. Extra bone formation (ectopic bone) around the artificial hip develops less than 1% of the time. It causes the hip to be stiffer than desired. This is more likely to occur in younger males with severe osteoarthritis.
7. Fracture of the femur can occur during hip replacement. This can be a small crack or a major fracture. It is more common during revision hip surgery, but can occur with first time hip replacement. Occasionally the femur may be accidentally perforated during first time or revision hip surgery.
8. Residual pain and stiffness can occur. In virtually all cases, hip replacement will make a significant improvement in your pain and mobility.
9. The length of the leg may be changed by the surgery. Getting leg lengths exactly right can be very difficult. Some leg length difference may be unavoidable. Sometimes the leg will be deliberately lengthened in order to stabilize the hip or to improve muscle function.
10. Injury to the arteries or nerves of the leg is an exceedingly rare but possible complication
11. Bleeding complications.
a. Sometimes bleeding can occur into the wound in the days after surgery as a result of the use of blood thinners. It may distend the hip and cause dislocation. If it is excessive, it may require re-opening the wound under anesthesia to let the blood out.
b. Occasionally, the blood thinners may cause bleeding into the urine (or elsewhere), but this is usually temporary, and not of serious consequence.
12. Allergy to the metal parts. About 15% of the population has skin sensitivity to some metals. All metal implants release some metal ions into the body
13. Complications from blood transfusions. The risk of getting AIDS from banked blood is believed to be about 1 in 2,000,000. The risk of Hepatitis B is estimated to be approximately 1 in 550 units, and Hepatitis C is 1 in 100. The risk of an allergic reaction (hives) is 1 in 500.
14. Fat Embolism. Fat from the bone marrow can get into the circulation and cause lung or neurological symptoms. This is a very rare complication. In very rare cases it can be fatal
15. Other minor complications can rarely occur, such as tape allergies, allergies to medications, skin rashes and so on.
What is the non-invasive solution?
Ayurvedic approach to joint disorders includes
1. Strengthening the metabolic pathways that prevent blockage of circulatory channels to joints, by impurities
2. Strengthening of digestion to create nutritional plasma that is pure and easy to assimilate
3. Improving the lubrication of joints
Ayurveda, the science of life offers two kinds of solutions to joint problems
a) Prevention: Ayurveda recommends Abhyanga – Daily application of medicated oil followed by warm water bath to protect the joints, inter articular ligaments and liquids, muscular and nervous functions etc. These practices have been clinically proven as effective in preventing all kinds of muscular and joint-related disorders and diseases
b) Management: The strength of Ayurveda in the area of spine and joint treatment is globally appreciated. Since it addresses the root cause of the issue, the results are fantastic. It is a well-planned health pack using all the possibilities of Ayurveda & Yoga to treat various spine and joint problems like spondlitis, slip disc, sciatica, osteo-arthritis, rheumatoid arthritis, scoliosis, spots injury, etc.
The therapies like Pathrapotala-swedam, Choorna swedana, Pizhichil, Kati Vasti, Greeva Vasti, Pichu and lepam included in the treatment depends on the condition, and are directed towards relieving the inflammatory changes, releasing the spasm in the affected area, strengthening the supportive tissues holding the spine/joints, and nourishing the joints by improving circulation.
Source: Dr K Gowthaman, Medical Director, rVita (rVita Ayurveda Centers)
Image: Flickr Creativecommons ElvertBarnes