Friday, March 19, 2010

Day 2: Friday March 19th

Today was our first full day in the OR and the team is starting to hit its stride. Between the time the first case started at 8am and the time the last case ended at 8pm, there were 16 joint replacements performed in 12 patients.

Meanwhile, on the floor, the patients who underwent procedures on Thursday began the process of postop rehab. With the assistance of our enthusiastic physical therapists, many patients were able to get out of bed and walk with their new joints less than 24 hours from their procedure!

It recently occurred to this blogger that while some of you reading these entries may be experts in orthopaedics, some of you may not be! To give you a sense of what's involved, here's a brief explanation:

At the many joints of the human body, including the hip and knee, bones are covered by cartilage -- a smooth substance which allows bones to slide past each other without causing pain. When this cartilage wears down, movement of the joint causes bone to scrape against bone, a process that is generically termed "arthritis." Take a look, for example, at one of our patients' x-rays below:

The patient's right hip (which is on the left side of the above image) is relatively normal -- there's a well-appearing ball and socket which are separated by a nice space on the x-ray (the cartilage layer). In contrast, the patient's left hip (on the right side of the image) has advanced arthritis with obvious abnormalities in the ball and socket, as well as the cartilage that normally coats the two bones. This condition can be quite painful, and often leads to difficulty with walking, climbing stairs and other activities.

In cases of advanced arthritis, joint replacement can be an excellent way to decrease pain and, in turn, improve function. In the hip, this involves replacing the ball (which is attached to the femur, or thigh bone) as well as the socket (which is attached to the pelvis). Here's an x-ray of the same patient depicted above, this one taken shortly after undergoing total hip replacement earlier today:

Total joint replacement of the hip and knee are common procedures in the United States and other wealthy nations, but remain relatively inaccessible for most individuals living in the developing world. As a result, individuals with advanced arthritis continue to suffer with pain, limited mobility and, in certain cases, loss of livelihood.

Thanks to the generous support of Operation Walk donors, scores of disadvantaged patients who would otherwise not have been able to afford joint replacement have been given the opportunity to eliminate pain, and walk again. This is the goal that drives our mission, and we remain deeply grateful to those who enable us to do this work.

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