An Amazing Advance in Spinal Fusion Baltimore MD

It has long been possible for orthopedic surgeons and neurosurgeons to stabilize unstable spines using a spinal fusion Baltimore MD surgical procedure. This has been a possibility for patients for the greater part of the last century.  There are a number of reasons for an individual's spine to possibly become unstable, including injury, a genetic disorder like Scoliosis, or simply as a result of the effects of age-related conditions like osteoporosis.  The spinal fusion operation is performed by connecting two or more of the vertebrae, which are the small, bony structures that are stacked on top of one another, into a single piece of bone.

Spinal Fusion Surgery and Bone Grafts

One of the most important things to know about this spinal operation is that bone grafting material is needed to make the individual vertebrae fuse as necessary.  This where it is possible to be amazed by very recent scientific breakthroughs.

In the past, the medical team performing a spinal fusion surgery Baltimore had to somehow procure bone grafting material to place in the spine and subsequently facilitate the fusing of the identified bone structures.  The oldest method of procuring grafting material was to utilize some from the body of the surgical patient.  It is called an autograft.  The donor material was usually taken from the femur, which is the long bone that supports the upper leg, or thigh.  The autograft process was effective, but painful for the patient.  Many patients complained that the surgical site from which the graft was obtained was even more painful and took longer to heal than the actual spine surgery site.

Medical advances eventually made it possible to utilize donor material from a cadaver.  This spared the patient a second surgical site, and was successful in many cases.  This procedure, called an allograft, did have some drawbacks.  Sometimes, the donor bone material was not compatible with the patient and it did not function to fuse the vertebrae.

Scientists have now learned to use a minuscule amount of a patient's own bone material to grow more bone grafting tissue in a laboratory environment.  This method is currently in use to help people who have suffered devastating bone breaks in accidents.  It shows promise for spine surgeries and many other medical applications.

The History of the Total Hip Replacement Baltimore MD

Orthopedic surgeries are considered to be among the safest and most successful medical interventions available today.  The total hip replacement Baltimore MD is no exception and is, in fact, one of the first of these kinds of surgeries to be developed.  The very first hip replacement was attempted in Germany in 1891.  Tuberculosis was a common ailment at the time.  There was no cure for it.  It caused a lot of varied secondary problems in patients who suffered from it.  A medical professor endeavored to use ivory as a replacement for the femoral head (the ball part of the ball-and-socket hip joint) in patients whose natural bone material had been destroyed by Tuberculosis.  This surgery was given the technical name "total hip arthroplasty" (THA).

Total Hip Replacement Surgery Baltimore in the 1920's

Following the presentation of this experimental total hip replacement surgery Baltimore at an early international medical conference, doctors and scientists continued to experiment with different materials for making better and better replacements for parts of the hip joint.  In 1925, an American surgeon invented a new "socket" that could be fit into the pelvis to provide a smooth surface that facilitated movement if that part of the joint had been impacted by disease.  It was called a "mold arthroplasty" and was made from glass.  The glass socket replacements were found not to be durable enough for long-term use.  Experimentation then moved on to stainless steel as a replacement material.  It is still used today.

The first metal-on-metal artificial hip joint that was able to serve as a replacement for both the femoral head and the pelvic socket parts of the hip joint was used in England in 1953.  This was a huge advance in this kind of surgery for a few reasons.  One of these replacement hip joints functioned for a remarkable 28 years.  Total hip replacements done in the 1950's did frequently require revision surgeries because the materials were not yet available to build artificial joints that would stand up to many decades of wear.  In the 1970's, advances in materials sciences allowed researchers to create joints that function more realistically and wear much longer without a revision surgery.

The Future of Total Hip Replacement Baltimore MD

There are currently many orthopedic surgeries available that have the ability to literally replace a damaged or worn-out body part with a synthetic equivalent.   The total hip replacement Baltimore MD was the pioneer of all of these surgeries.  Since it was first described by a German professor of medicine at an international conference in the early 1890's, it has paved the way for knee replacements, shoulder replacements, and even replacements for structures as small and delicate as individual finger joints.  This does not mean that the total hip replacement procedure Baltimore is perfect, though, or that those doctors and scientists who work in that field have stopped trying to make it better.

To Cement or Not Cement in Total Hip Replacement Baltimore

One of the questions that doctors and medical researchers are currently working on is whether or not to cement in the part of the replacement hip joint that stands in for the femoral head.  This ball apparatus has a tapered end that fits down inside of the femur to keep it secure.  Cementing this part in place was first described over a hundred years ago at the medical conference already mentioned.  Cementing techniques were improved in the 1950's when a creative orthopedic surgeon borrowed some cementing compound from the practice of dentistry.  Still, it remains a problem that cementing sometimes fails.

In recent times, cementless prosthetics have been developed.  They are covered in a special substance, hydroxyapatite, that allows bone material to grow into it and subsequently affixes the prosthetic quite securely.  This technique also allows for a greater conservation of biological bone material which can be particularly important in the case of younger patients who are likely to need at least one revision in the course of their lives.

To cement or not to cement remains somewhat of an open question in the field of orthopedics.  Short-term studies have suggested that cemented prosthetics have better results than those using hydroxyapatite.  There is a poverty of long-term studies on outcomes for these two different surgical techniques.  The cementless  variety of prosthetic continues to be a popular choice for younger, more active patients.

Risks of Spinal Fusion Baltimore MD

Many hundreds of thousands of people have spinal fusion Baltimore MD every year in the United States.  The vast majority receive at least some benefit from the procedure and go on to have good recoveries and an elevated quality of life as a result of their decision to have a surgical intervention.  It is, however, important to keep in mind that spinal fusion surgery Baltimore does carry some risks.  The risk of actual death is relatively small--approximately one quarter of one percent of patients die during the procedure or during the immediate post-operative stay.   Still, there are other risks to consider.

Spinal Fusion Risks During and After Surgery

• Every surgical procedure carries a few risks that can be reduced by a contentious staff, but not completely eliminated.  During the surgical procedure, any patient can have a bad reaction to general anesthetic, even one who has successfully tolerated it in the past.  Excessive blood loss is always a possibility, as is the body's immediate or eventual rejection of any medical hardware that is used.  If an allograft is used (donor bone material from the patient's thigh), there are risks of a bone infection in that surgical site.  Nerve damage is always a consideration when operating on any part of the central nervous system.

• There are a few factors that make certain patients more likely to have complications with this kind of surgery within the first few days of recovery.  Those who are older, obese and/or smokers are the group with the highest rate of post-surgical complications, as are those who have had a previous spinal surgery.  Some of the complications often seen in individuals with these pre-surgical risk factors include neurologic deficit, malnutrition, urinary retention, pulmonary embolism and deep vein thrombosis.

• Some of the risks of spinal fusion continue to be present for quite a long time after the patient is discharged from the hospital.  The most significant of these risks is a clinical failure of the surgery, meaning that the sections of the spine intended to be fused simply do not grow together as expected.  There is some good news about this outcome.  Even patients with an incomplete fusion frequently report diminished pain and improved functioning.

Patient Guide to Total Knee Replacement Baltimore MD

Having any kind of surgery can be overwhelming.  Making a choice to have a surgery that is usually elective, like a total knee replacement Baltimore MD, is often fraught with uncertainty and many questions.  The fact that a knee joint and other complete body parts can now be replaced by medical science is amazing.  It can also be frightening for the patient who is contemplating that option.  Asking questions and gathering information is one way to make the decision process more manageable.

What to Ask Before Total Knee Replacement Surgery

Since making this kind of decision can be emotionally overwhelming, having a list of questions written down to ask the treatment team about total knee replacement surgery Baltimore is a good idea.  Here are a few ideas and examples:

• How can I expect my quality of life to be improved by the surgery?  As mentioned already, knee replacements are often elective surgeries that are chosen in order to help people be more active, or return to a better quality of life that they had before illness or injury caused their knee joints to stop working well.  Understanding the expected benefits of the surgery is essential to decision making.
• Do I have other options besides a total knee replacement surgery?  Today, there are some minimally invasive procedures that can repair certain parts of the knee joint without replacing the whole thing.  A less radical procedure may offer lesser benefits, yet enough improvement to achieve the treatment goals desired by the patient.
• What kind of joint replacement would be best?  What is the cost?  There are a number of different standardized joint replacements available today.  These come in different sizes to fit different patients.  The technology also exists to make a customized knee replacement joint that will fit each patient exactly.  For those who are concerned about cost, it is necessary to know the prices of all available options, and how much of each one might be covered by insurance.
• What will the recovery from surgery involve?  While recovery from knee replacement surgery is somewhat difficult for all patients, it does vary according to how healthy the individual is before surgery, and their commitment to putting time and effort into post-surgical therapies.

Who gets Total Hip Replacement Baltimore MD?

The total hip replacement Baltimore MD is a safe and effective way for those whose natural joints are not functioning well to recover a better quality of life.  Ongoing pain and stiffness from a hip impacted by a disease like osteoarthritis can limit an individual's ability to do most activities, even resulting in them being confined to a wheelchair or bed at some point.  It is really hard to imagine how badly bone diseases can hurt until it has been experienced or closely observed.

Who are Hip Replacement Surgery Patients?

While the older individual who has suffered for a long time with osteoarthritis may be the "typical" patient for a total hip replacement surgery Baltimore MD, there are many types of individuals who receive this procedure today.

• Some people suffer incredible hip pain as a result of rheumatoid arthritis, which is a systemic disease rather than a more natural process of aging (like osteoarthritis).  Rheumatoid arthritis attacks the synovial tissue of the joint, causing it to swell and occlude joint function.  Replacing a specific joint will solve the problem in that part of the body.  It will not cure the disease of rheumatoid arthritis.  Other joints in the body may continue to be painful.  Systemic issues like fever and fatigue will persist also.
• Avascular necrosis is a cause of hip joint issues that results from bone tissue in that area not receiving an adequate blood supply.  It can be the result of a disease or an injury.  When the bone tissue does not get enough blood, it dies and ceases to function as intended.
• Tumors can form anywhere in the body at any time.  The hip joint is no exception.  Even benign tumors can lead to bone malformation that will impact the function of the hip joint.  Malignant tumors need to be removed as soon as possible for obvious reasons.  An artificial hip joint can preserve function when tumors form on bone tissue in that area.
• Younger and younger people are becoming candidates for hip replacement surgery.  It was once thought that only older, less active, individuals would do well with artificial hip joints.  Improvements in materials technologies have now made the replacement joints suitable for pretty much anyone.

History of the Modern Total Knee Replacement Baltimore MD

Prior to the 1970's, people who were unfortunate enough to have very advanced arthritis in their knees had no really good treatment options.  The same was true for folks who experienced accidental injuries that rendered their knee joints inoperable.  Dr. John Insall was a pioneer of orthopedics who wanted to help patients in these situations.  He was the head of a specialized knee clinic and worked with some other doctors and a biochemical engineer to develop the total knee replacement Baltimore MD, also called the total condylar knee at that time.  Dr. Insall's work started in 1969, just as advances in technology and materials development were becoming sufficient to support the invention of a completely artificial knee joint that functioned similarly enough to a natural structure to make it a viable replacement.

Total Knee Replacement and Longitudinal Research

The total knee replacement surgery Baltimore became advanced enough to be commonly available to the average patient in about 1974.  Advances in materials sciences and engineering since that time have allowed the development of knee replacement implants that much more closely mimic the function and form of the biological knee joint.  Longitudinal research on patient outcomes has allowed doctors to understand more and more about the surgical process of replacing the knee joint as well.  Thanks to the Mary and Fred Trump Institute for Implant Analysis, more than 30,000 patients have been enrolled to track the performance of various stages of implant design over time.

Due to careful longitudinal research, a lot of advances have been made in the ability of the medical field to replace the biological knee joint in the last forty years or so.  Currently, there are more specific points of focus on research in this area.  One of them is experimentation with different kinds of materials that will more successfully and realistically mimic the soft tissues of the knee like the cartilage and tendons.  There is also a focus on what can be done for patients who are pre-surgery to improve their eventual outcomes.  Scientists also consider rehabilitation in different settings to determine which ones are the most effective and efficient.