The prosthetic type of orthopedic surgery is able to effectively cure degenerative disease of the joints, essentially osteoarthritis, as well as minor fractures, arthritis, and tumors. Thanks to the evolution of the techniques and materials, the implantation of prosthesis allows one to obtain a lasting result and it is able to take away the pain and to restore mobility and functionality, normal articulation and, in an efficient and young person, it provides the possibility to practice some sports activities.
The Humanitas Department of Hip and Prosthetic Surgery, headed by Dr. Guido Grappiolo, performs over 2,500 operations and sees 9,000 patients annually.
The team uses different types of implants: uncemented, that is constituted by a stem of titanium alloy, which is applied in direct contact with the bone, and cemented implants, or covered by a layer of acrylic cement that prevents direct contact of the stem with the bone and finally the prosthesis surface. The types are equally valid, reliable and durable. The choice of the prosthesis is made by the surgeon who interprets in the most correct manner the parameters from which the indications for the use of one type of prosthesis rather than the other emerge (sex, age, index of osteoporosis, index morpho-cortical, need performance etc.).
Knee prostheses are implanted with minimally invasive techniques therefore a small prosthesis of a single condyle may be used. Total knee replacements are also performed and they can be with or without cement. In certain cases there is an indication suggesting the use of navigation through complex computerized tools.
At Humanitas a surgical indication of osteoarthritis (a form of arthritis of the hip) is generally carried out after performing a conservative therapy of pharmacological and physical treatment, to restore or maintain the functionality of the joint. Prior to the surgery the patient is also subject to all the necessary examinations and a blood test for a possible auto transfusion during surgery.
The preparation in the Day Hospital minimizes the need for hospitalization. The intervention of implantation of the prosthesis can be executed with traditional access route or minimally invasive technique and with an incision of a few centimeters. The intervention may be more or less conservative, depending on the type of prosthesis used: the classical one fully replaces the head and neck of the femur; on the other hand, the surface intervention, usually used for younger patients, is used for the femoral head and the acetabulum.
After surgery, the average stay at the hospital is 4 days. The patient is then sent to the department where they receive a rehabilitative treatment that can continue at home.