Surgery in summer
* this article was originally published at www.koreatimes.co.kr
By Song Sang-ho
During the rainy season, which this year begins earlier than usual, those with arthritis suffer from particularly painful knees. When it rains, the atmospheric pressure decreases and humidity increases by around 30 to 80 percent. Because the knee joint is sensitive to temperature and humidity, it expands, which causes pain.
Around this time of the year, many patients ask me “Is it okay to get knee replacement surgery in summer?” Because of the knee joint’s sensitivity, they think the surgical site won’t heal well and will get infected. In truth, however, there is no correlation between the surgery and the season.
Nowadays, a good surgical prognosis can be expected regardless of the timing of the surgery thanks to advances in surgery and surgical systems. According to research by Johns Hopkins University in the United States, the rate of infection after surgery is highest in the winter (January) and lowest in the summer (July and August).
One of the most important advances in surgery is the mini-incision. For patients in late-stage degenerative arthritis, which is especially painful during the rainy season, the mini-incision enables fast recovery and reduces the risk of infection and complications. In this procedure, the incision is reduced from the usual 20 centimeters to between eight to 10 centimeters. The smaller incision size minimizes potential damage to the muscle and tendon around the joint and risk of bacterial infection.
Patients can walk four hours after the surgery; they can freely go to toilet or sit on a wheelchair or a chair. This reduces the risk of complications. In the past, patients who have undergone hip joint replacement surgery have limited mobility for more than six weeks in order to prevent dislocation. However, this lack of mobility increases the risk of infection such as bedsores.
The mini-incision for hip joint surgery to preserve the external rotator involves a high level of difficulty because the smaller incision minimizes visibility. Therefore, patients should check a specialist’s experience and proficiency fully rather than worry about seasonal factors when planning to have knee surgery. In addition, they should check the hospital’s environment, such as whether it has a sterile operating room, which minimizes the risk of infection by filtering out the dirt or germs in the air through an air purification system.
Finally, patients should also check information about antibiotic use evaluation. The Health Insurance Review and Assessment Service provides such information on its website. Antibiotic use evaluation is conducted among patients to prevent surgical site infection and monitor potential abuse of antibiotics, which increases bacteria’s resistance to antibiotics.
Patients shouldn’t put off knee surgery because of incorrect information or lack of understanding. A painful joint isn’t healthy and affects one’s daily life. Some patients who have put off surgery become depressed because they are limited in what they can do. Patients should remember that when it comes to knee surgery, the season doesn’t matter and that improving one’s health is not something they should wait for.
Sang Ho Song, MD, PhD
The writer is the president of the Wellton Bone and Joint Hospital
Wellton Hospital is an orthopedic Specialty Hospital in Seoul, Korea.
Wellton Hospital is well-known for its clinical excellency in hip replacement and knee replacement surgery. Dr. Sang Ho Song is an orthopedic surgeon / consultant who has developed Minimally Invasive Total Hip Arthroplsaty with muscle & tendon sparing technique.
His study on over 1,000 cases of Hip replacement surgery is planned to be published at the Journal of Arthroplasty this fall, 2014.
