Shahid Akhter, editor, ETHealthworld, spoke to Prof. C. Niek van Dijk, orthopaedic surgeon and former professor in orthopaedics, University of Amsterdam and presently working within the FIFA Medical Centre of Excellence, Madrid, Porto, Sapin,and Pisa, to know extra in regards to the developments in orthopaedic sports medicine.

Sports Medicines: Latest Advancements
While speaking in regards to the newest developments in orthopaedic sports activities medication, I feel the largest development is that now we have moved away from open surgical procedure and now we do far more minimal invasive surgical procedures, arthroscopy, tendoscopy, therapies for cartilage, therapy for instability, therapies for tendon accidents. Most issues within the hind foot and within the ankle and the tendons, achilles tendon these days are carried out, are handled arthroscopically. I feel it’s a main benefit as a result of the affected person has much less ache, has smaller scars, and the rehabilitation is far faster.

The second most important benefit within the latest years is the rehabilitation and the rehabilitation packages are actually extra fast, extra superior than up to now. The affected person can now return to his regular exercise, his each day exercise, his work, his sports activities, due to faster rehabilitation. Numerous therapies are extra purposeful. In the previous, we did immobilization with the plaster, with a solid, and these days we consider extra within the pure therapeutic of the physique by purposeful therapies. That is an development.

Another latest development is the therapy of ankle instability. We have far more data now within the anatomy subject. It appears unusual that we needed to require new perception in anatomy. But there have been loads of analysis finished within the latest years on the anatomy of the ankle. And we now can far more exactly restore the instability, the ligaments with minimal invasive strategies, which have proved to be higher than the open restore. Also, due to the purposeful rehabilitation. Another benefit, after all, is within the subject of therapy of cartilage issues. There is loads of new methods to deal with cartilage issues within the ankle.

Osteochondral Lesion Surgery
When we speak in regards to the cartilage drawback, Osteochondral Lesion, some 25 years in the past, and even longer, we handled with simply eradicating the cartilage, the broken cartilage, eradicating the subchondral bone micro fracturing. And then the affected person will get new cartilage fibrocartilage, not the highline cartilage that was, allow us to say, 25 years in the past. Statman from us launched it. But principally it comes again to perhaps 1959, Bridie, who already did this therapy. And then over the past 25 years, there was loads of analysis and the analysis was directed extra in the direction of the biology, in the direction of making new cartilage.

When you have a look at the proof, principally that has not been proven to have higher outcomes than this Micro fracturing. What I’m speaking about is the smaller defects. For the bigger defects, we at all times had an issue within the therapy. And these days now we have this metallic implant, this customized metallic implant, which I feel is a serious benefit since you restore principally the subchondral bone. And the ache doesn’t come from the cartilage as a result of the cartilage has no nerve endings, the ache comes from the bone. We have been forgetting to deal with the bone over the past 25 years, and now we’re coming again to treating the bone. And this customized resurfacing is a superb methodology to revive the bone. And on this case, not solely the bone, but additionally the contour of the cartilage as properly.

Ankle Prosthesis
What I used to be speaking about is that this customized implant for Osteochondral defects, it’s native defects. But when you could have an arthritic joint, you can not deal with it with a localized implant. You need to deal with it both with a prosthesis or with an arthrodesis. Arthrodesis means fixing the bone. Patients are at all times afraid for an arthrodesis as a result of they consider that they are going to be incapacitated as a result of there isn’t a joint anymore. Patients at all times prefer to have a prosthesis. But on this subject, now we have been made small advances, however not as a lot as with a hip prosthesis or a knee prosthesis.
The ankle prosthesis is the affected person with an anchor prosthesis, I at all times say, just isn’t a cheerful affected person within the sense that the affected person expects to have a standard vary of movement to haven’t any ache. And in the event that they nonetheless have somewhat ache and the movement just isn’t 100%, they’re dissatisfied. And a affected person with an arthrodesis expects that he’ll nonetheless have ache and that he can’t stroll and he can be a cheerful affected person as a result of he has no ache. And there’s nonetheless loads of movement not within the ankle joint, however within the different joint. In common, an arthrodesis affected person is a cheerful affected person and a prosthesis affected person, ankle prosthesis affected person is an sad affected person. In this subject, loads of analysis must be finished to make these sufferers with ankle prosthesis joyful.