【The story of coordinator】Artificial joint replacement enables a female patient to run. The patient was impressed by the doctor who accurately pointed out her general medical condition at a glance.

Until the surgery in Japan

She wished to undergo surgery in Japan due to difficult case

A female patient living in Russia had pain in the area connecting her pelvis and leg (femur), which interfered with her daily life although she could walk, and was diagnosed with osteoarthritis. She traveled to Korea to undergo a thorough examination by an orthopedic surgeon, but contacted EAJ because she wanted to have the surgery in Japan “because Japanese medical institutions have the most modern facilities specialized for artificial joint surgeries and she thought Japanese doctor can perform difficult surgeries. A thorough examination in Korea indicated possible complications of osteonecrosis and acetabular (hip bone side of the joint) dysplasia in addition to osteoarthritis. The patient was an energetic businesswoman. Although she wanted to be active in her business, her medical condition prevented her from doing so, and she had a strong desire to be cured somehow.

Bone grafting found necessary before joint replacement

We immediately sent the medical information to a university hospital in Tokyo, where a famous doctor for artificial joints belongs, and the treating doctor told us, “There was severe destruction on the acetabular side, and a bone graft was necessary first in order to attach an artificial joint”. The doctor suggested the following treatment plan. “The necrotic portion of the femur is cut away and healthy bone, even within the necrotic portion, is used as a bone graft. The patient was hospitalized for 3 weeks until fusion of the grafted bone was achieved, as walking was not possible. After that, surgery to insert an artificial joint is performed on one leg first, and the patient is hospitalized for about one and a half months, including rehabilitation. As of 3.5 months later, when one leg is solid, the patient undergoes surgery, hospitalization, and rehabilitation on the other leg. If legs are strong enough, she is able to walk slowly with one leg and then the other leg.” The treating doctor told us that what was important for the surgery was “to understand the patient’s general condition, to know the details of hip function, muscle strength, and range of motion, and to predict the degree of functional recovery that could be expected through postoperative rehabilitation,” so she decided to visit Japan for a consultation before preparing surgeries.

She was surprised and impressed on the day of consultation

On the day of the examination, as soon as the doctor entered the examination room, he pointed out that the reason for the osteoarthritis was probably acetabular dysplasia due to juvenile rheumatoid arthritis (JRA), since the wrist was greatly deformed, and he also told her that the knee joint was also hanging more than normal because of the strain on the knee due to the hip joint.

The doctor suggested to place artificial joints to allow active movement after surgery on one leg, and also carefully explained the negative possibilities that artificial joints made in Japan may not fit the European skeletal structure. The patient repeatedly told the interpreter that she had been disappointed and sometimes cried because she was not satisfied with previous explanations from other doctors, but here she was impressed by the accurate advices and thoughtfulness.

Effects of bone graft and joint replacement surgery

Rehabilitation after bone grafting is progressing well, and finally the surgery date for artificial joint replacement in one leg is approaching. The patient became sometimes nervous before major surgeries, but when she talked with her doctor during the consultation, she felt at ease and was admitted to the hospital to prepare for the surgery.

Surgery was successfully completed. During rehabilitation, some muscle pain at the base of the leg occurred, but it turned out to be muscle soreness caused by muscles that had not been moving normally before, and the recovery went smoothly, so the patient was able to leave the hospital a little earlier than planned.

Then, due to the child’s illness and other factors, the second surgery was performed six months later. After leaving the hospital, she had follow-up visits about once a year. She informed me that the pain was completely gone and that she could walk normally.

After returning home country

Immediately after returning to her home country, the patient referred several people she knew who were also suffering from joint pain and other problems to EAJ. Three years after the surgery, when I visited the area where the patient lived on a business trip, I saw her again. She even showed me a light running gesture and seemed satisfied with her recovery, which was better than she had imagined. There was also the issue as to whether Japanese artificial joints would fit the body, which had been a concern, but the patient was rather petite, and as a result, the size of the joints turned out to be a perfect fit. Five years after the surgery, we asked her how she was doing. To our surprise, she told us that she had started to play sports little by little and was leading an active life.