Four times to Vietnam for joint replacement in one year

“This is the first time we have received 4 joint replacement cases in one year,” said MSc.BSc.CKI Le Dinh Khoa, Head of Joint Reconstruction Department, Tam Anh General Hospital, Ho Chi Minh City.

Previously, Ms. San Samphors was treated with medication at a hospital in Cambodia and Thailand but did not recover, but recently the pain has gotten worse. X-ray results at Tam Anh General Hospital in Ho Chi Minh City showed that the cartilage on both sides of the patient’s knee joint was completely worn away and dissolved. The hip joints of both legs were severely degenerated, the femoral head deviated from its normal position and entered the abdominal cavity. Doctor Khoa believes that this is a very serious case, surgery is the only method to free the patient from pain and restore mobility.

Doctors consulted and made a plan for Ms. San Samphors to replace four artificial joints in one year, including the right knee, left knee, left hip and right hip.

In the first joint replacement case, the doctor applied a non-muscle cutting, minimally invasive surgical technique, helping to preserve the soft tissue system around the knee joint. The patient has the damaged part removed, an artificial knee joint replaced in accordance with the size based on the natural anatomical structure of the joint, then pain is reduced using a multimodal method, combining many drugs and anesthesia techniques to inhibit pain transmission and reduce side effects. After surgery, patients have less pain, recover quickly and can walk on the first day. Two months later, Ms. Samphors had her left knee replaced with the same technique and procedure as her right knee replacement.

The doctor replaced her left hip 6 months later, giving her enough time to recover and be ready for the next major surgery. According to Dr. Khoa, the biggest challenge at this time is that the patient has had long-term degenerative inflammation, causing the femoral head to move inwards a lot, losing the acetabular bone base. If you do not accurately calculate the amount of bone to be compensated and the direction to place the artificial joint, after surgery, the new joint is at risk of falling straight into the abdominal cavity, reducing joint life and dislocating the hip.

The team assigned the patient a 3D CT scan and used MediCAD 3D software to plan the surgery, optimize the joint location and the amount of bone needed to compensate for the bottom of the acetabulum. The surgery is performed using the ABMS technique without muscle cutting, helping the patient avoid the risk of dislocation and nerve damage, and avoid post-operative paralysis. The artificial hip joint is placed in the correct planned position, the joint is solid and the range of motion is restored to almost the same as before surgery, the length of both legs is equal, the patient can perform difficult movements after hip replacement such as squatting, crossing legs… Three months later, Ms. Samphors once again came to Vietnam to replace the right hip joint with the same technique.

Doctor Khoa said that rheumatoid arthritis is a chronic autoimmune arthritis disease that cannot be completely cured. If not well controlled, the patient is at risk of disability and damage to many other organs such as the eyes, heart, lungs, skin, blood vessels… After surgery, Ms. Samphors continued to take medication, practice physical therapy and periodically monitor to prevent the disease from progressing and maintain the flexibility of the joints.

Doctors recommend that for autoimmune bone and joint diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus erythematosus… patients should be closely monitored from the beginning to control the disease well, avoiding the development of complications that destroy joint cartilage. In case surgery is indicated, the patient should go to the hospital as soon as possible for treatment.