Arthritis is a condition that affects millions of people worldwide. When conservative treatment is not effective, advanced arthroscopy, new Minimally Invasive Surgery (M.I.S.) techniques for arthroplasty, robot-assisted arthroplasty using the MAKO robotic system or navigators (navigator) or digital systems, and fast-track rehabilitation protocols are the modern “tools” for effectively managing it.
What is Arthritis?
Arthritis (osteoarthritis, rheumatoid arthritis, post-traumatic arthritis) is an inflammatory condition characterized by the destruction of the structural elements of the joints (knee, hip, shoulder, etc.). The main symptoms are pain, swelling, and stiffness, which can cause significant difficulties in daily life and even disability in severe cases.
Arthritis Treatment
Conservative
Early-stage osteoarthritis, mild or moderate, is initially treated conservatively with medication, physiotherapy, and intra-articular injections of hyaluronic acid (with or without chondroitin) or corticosteroids. Additionally, biological treatments using the patient’s own cells, such as P.R.P. (platelet-rich plasma) or stem cells, as well as chondrocyte cultures, can be applied in combination.
Arthroscopy
In cases of early arthritis when conservative treatment does not relieve the patient, an orthopedic surgeon can use arthroscopy to repair minor joint damage by performing partial meniscectomy, osteophyte removal, partial synovectomy, chondroplasty, or removal of loose bodies.
Arthroscopy is a modern, minimally invasive method that allows viewing inside the joint through small incisions (about 3-5 millimeters) without damaging it, diagnosing and treating problems without requiring long hospital stays. For even better results, biological therapies with stem cells and P.R.P. can be combined.
If all the above treatments fail, arthroplasty is indicated.
Minimally Invasive Arthroplasty (M.I.S.)
Arthroplasty is a surgical procedure replacing the damaged joint surfaces with a special prosthesis. It restores joint function and relieves pain, allowing the patient to return to normal daily activities and improve quality of life.
The newest and most effective total arthroplasty method is Minimally Invasive Surgery (M.I.S.), which offers much better results than traditional methods in a significantly shorter time.
The incisions are much smaller compared to classical arthroplasty, which means less damage to the anatomical structures of the joint area and minimal blood loss. The patient experiences very little postoperative pain and returns to activities faster with immediate recovery of joint mobility starting from the day of surgery.
The prosthetic joint replacement parts are made from special titanium and steel alloys, as well as polyethylene plastic, materials that are very durable and fully biocompatible. The components of this artificial joint mimic the natural joint.
The patient can get up a few hours after surgery, once anesthesia wears off, and return home after 1 day for shoulder arthroplasty or 1-2 days for hip or knee arthroplasty, depending on clinical status and health history.
Advantages of M.I.S. Arthroplasty
- Less soft tissue damage
- Avoidance of muscle injury
- Smaller incisions and fewer postoperative scars
- Reduced hospital stay
- Less blood loss and reduced need for transfusions
- Immediate mobilization after surgery
- Minimal postoperative pain
- Faster recovery and quicker return to daily activities
M.I.S. Arthroplasty Techniques
Various minimally invasive techniques combined with fast-track rehabilitation protocols offer better and faster results compared to traditional methods.
For hip arthroplasty, common minimally invasive approaches include classic, AMIS, ALMIS, mini posterior, and others, mainly differing in the surgical approach (anterior, anterolateral, or posterior).
For the knee, M.I.S. techniques can be used to perform either total arthroplasty, replacing the entire damaged joint surface with a prosthesis, or unicompartmental (partial) arthroplasty, replacing only the damaged part while preserving healthy cartilage surfaces.
Personalized total arthroplasty is also possible, designed according to the unique anatomy of each patient (custom femoral and tibial guides).
For the shoulder, besides classic arthroplasty, the modern reverse total arthroplasty is applied, suitable for patients with severely damaged shoulders where arthritis is accompanied by irreparable rotator cuff tendon tears (rotator cuff arthropathy), as well as for certain fractures.
Robot-Assisted Arthroplasty with the MAKO System
With the MAKO robotic assistance system, partial or total knee arthroplasty and total hip arthroplasty can be performed with great precision (to the millimeter), resulting in outcomes that closely mimic the natural knee or hip.
The MAKO technology, using a robotic arm, helps the surgeon prepare tissues and position implants with exceptional accuracy.