Is It Possible to Delay Prosthesis Surgery with Joint-Preserving Surgeries?
Joint diseases, especially osteoarthritis and other degenerative joint disorders, are commonly seen in the elderly population. In these conditions, joint surfaces wear down, cartilage tissue is damaged, and movement becomes restricted. The resulting pain and loss of function significantly impact quality of life. Prosthesis surgery is a traditional treatment method that gains importance in advanced disease stages; however, it is a major surgical intervention and can impose lifelong limitations on patients. Therefore, postponing prosthesis surgery as much as possible or considering alternative treatment options is a critical subject in orthopedics.
Definition and Purpose of Joint-Preserving Surgery
Joint-preserving surgeries are surgical methods applied to preserve joint structures as much as possible, slow disease progression, reduce pain, and maintain function. These include techniques such as osteotomy, non-union surgeries, arthroscopic debridement, ligament reconstruction, and deformity correction. Compared to joint-replacing surgeries (prostheses), these less invasive procedures are preferred especially in early and moderate stages of osteoarthritis.
The Role of Joint-Preserving Surgeries in Delaying Prosthesis Surgery
With advances in surgical techniques, correcting mechanical deformities caused by osteoarthritis has become feasible. For instance, in the knee joint, osteotomy can correct varus (inward angulation) or valgus (outward angulation) deformities, improving load distribution and slowing cartilage wear. This results in pain reduction, increased mobility, and postponement of the timing for prosthesis surgery. Similarly, bone reconstruction procedures performed around the hip joint contribute to preserving joint surfaces.
Ilizarov Method and Limb Reconstruction
One of Prof. Dr. Halil İbrahim Balcı’s specialties, the Ilizarov method, is known as an effective technique especially in deformity surgery, bone lengthening, non-union treatment, and managing bone infections. This method is used not only to regulate mechanical alignment around joints but also to address limb length discrepancies and deformities. Correction of deformities with the Ilizarov method helps prevent progression of existing joint wear and accordingly delays the need for prosthesis surgery.
Importance of Non-Union and Deformity Surgery
Non-union situations, where bone healing does not occur, are challenging cases requiring careful surgical intervention. Surgical techniques used in non-union treatment improve joint stability and load transfer, helping protect joint health. Additionally, correcting deformities related to non-union restores normal joint function and thus allows patients to delay their need for prosthetic surgery.
Combatting Bone and Soft Tissue Infections
Controlling bone and soft tissue infections is a critical factor in planning joint-preserving surgery. Deformities and abnormal load transmission caused by infections lead to joint dysfunction and pain. Effective treatment of infections preserves the joint structure and function. Consequently, surgical outcomes improve and the need for prosthetic surgery can be reduced.
Joint-Preserving Approaches in Pediatric Orthopedics and Sports Surgery
In children during growth and development, joint-preserving surgeries are preferred to correct deformities and growth disturbances at an early stage. Early intervention prevents permanent damage and minimizes the future need for prosthesis. In sports surgery, joint-preserving methods aim to maintain joint function long-term, especially in young and active patients.
Limitations and Future Perspectives of Joint-Preserving Surgery
Although joint-preserving surgeries can delay prosthesis surgery, prosthetic surgery remains the gold standard for advanced osteoarthritis and severe joint damage. Surgical choice should consider patient age, whether thresholds for surgery are crossed, congenital or acquired deformities, degree of joint surface damage, and functional expectations. Currently, developments in biomaterials, cellular therapies, and 3D printer-supported reconstruction approaches show promise to enhance the effectiveness of joint-preserving surgeries in the future.
When performed under the right indications by experienced orthopedic specialists, joint-preserving surgeries reduce pain, improve function, and allow postponement of prosthesis surgery. The multidisciplinary efforts and reconstructive surgery expertise of Prof. Dr. Halil İbrahim Balcı aim to improve patients' quality of life in this field.