One of the most important joints in our body is that of the hip in which the femoral bone articulates with the pelvis. Its smooth operation is a prerequisite for upright posture, walking, running and jumping. Over the years, degenerative lesions accumulate in the area that lead to the gradual destruction of cartilage that invests the surfaces of the articulated bone. This condition is called osteoarthritis and suffers millions of people.
Hip osteoarthritis
Hip osteoarthritis is a common condition, usually occurs after 60 years and causes a significant degree of disability and a decline in patients’ quality of life. The main symptoms are pain during the movement of the joint which at an advanced stage can also occur in calm, stiffness and shortage of the leg which in turn can affect the functionality of the spine (eg back pain/sciatica) and knee. Patients have a characteristic difficulty in simple daily movements, such as wearing their socks or nailing their nails.
A similar image can be caused by other hip diseases, such as post -traumatic arthritis and aseptic necrosis of the femoral head. These conditions may also occur in younger patients, after injury to the area (eg hip fracture, pelvis fracture) or in the context of another pathology (eg blood coagulation disorders, neoplasm medication, cortisone use). Finally, a large proportion of the population is born with anatomical peculiarities in the hip joint (dysplasia, congenital dislocation) that can cause early hip arthritis.
Method ASI (previously supine intermuscular)
Treatment in the early stages is conservative with medication, physiotherapy and restriction of activity. Radical treatment is total arthroplasty. The most sophisticated technique for surgery is the ASI (Anterior Supine Intermuscular) method applied to the large joints of the Athens Medical Center by Dr. John Tsaroucha.
The advantages of ASI method are many and come from its minimally traumatic philosophy as it is performed with Little incision (5 – 6 cm) on the anterior surface of the hip without intersecting muscles and tendons of the area. In this way Minimized blood loss and need for transfusion, hospitalization is shortened and permitted to quick mobilization and restoration of the patient. Minimum injury to the area and rapid rehabilitation after surgery contributes to avoid complications which are relatively common with other older techniques, such as thrombosis, high bleeding and respiratory problems. The ASI method is ideal for overweightsince there is no significant amount of subcutaneous fat on the anterior surface of the hip, and is also used with great success in the revision of total hip arthroplasty. Review interventions are one of the difficult and technical demanding interventions in cases where the old intention should be replaced (due to relaxation, inflammation, fracture, etc.). Asi’s minimally invasive philosophy reduces the complications that accompany these particular surgery.
One of the most annoying complications of total hip arthroplasty is the uneven that can be created after the intention is implanted. There may be significant inequality that causes significant problems for patients.
The Athens Medical Center Clinic has been given for many years Solution to the problem of inequality by using intraoperative control Clinically and radiologically, so that even a slight inequality is corrected in the surgical room. The latest innovation of the clinic concerns the refinement of the intraoperative protocol to avoid inequality by using a computer software that allows accurate measurement of the two -edge length difference after digital radiography during surgery. The use of the new protocol has led to even better results in terms of Avoiding the uneven and to the further Reduce the duration of the surgeryas shown in the study of the clinic recently published in the European Journal of Orthopaedic Surgery and Traumatology entitled “A New Method for Intraoperative Assessment of Leg Length, Sizing and Placement of the Components in Total Hip Replacement”.
The large joint clinic of the Athens Medical Center with Director Dr. John Tsarouha is considered by the pioneers in hip surgery by the ASI method. Her last distinction is her choice as the Unique Reference Center in Greece and one of the Little in Europe for education In ASI technique. The choice of our clinic to perform this role was the result of a thorough evaluation by representatives of Zimmer Biomet in how the technique was applied by our surgical team and the adequacy of our Hospital infrastructure in relation to the large number of successful interventions (over 3,000 cases).
As early as February 2019, our Clinic and Hospital have hosted more than 50 Orthopedics from Greece and Abroad. All participants successfully completed the program and were completely satisfied with the level of knowledge they acquired.
Written by Dr. John TsarouchasOrthopedist, manager Orthopedic clinic Large joints, Athens Medical Center
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