JOINT replacement is no longer surgery reserved for the elderly. Younger Fijians are increasingly requiring new hips and knees because of obesity, sports injuries, road accidents and previous joint damage.
Pacific Specialist Healthcare orthopaedic specialist and consultant Dr Vaigalo Eddie McCaig says these are among the main reasons for hip and knee replacement, but joint problems can affect people across all age groups.
“Osteoarthritis is when we lose the cartilage which protects the joint,” he said.
That protective cartilage allows the bones to move smoothly. Once it wears away, bone begins
to rub against bone causing pain, stiffness and reduces mobility.
McCaig said carrying excess weight over many years places additional stress on weight-bearing joints such as the hips and knees.
The problem is particularly relevant to Fiji and the wider Pacific, where changing lifestyles and increasing body weight are contributing to orthopaedic problems.
Age, however, is far from the only factor.
McCaig recently treated a woman in her early 50s who had suffered injuries in a 2018 car crash. She had previously undergone a partial hip replacement but is now experiencing problems and may require a total hip replacement.
In another case, McCaig said, a 28-year-old rugby player dislocate his hips and underwent surgery in New Zealand. The hip subsequently dislocated again and remained out of position for about a year, eventually resulting in severe arthritis.
“It’s not just the elderly person with osteoarthritis. It can affect anyone,” Dr McCaig said.
He stressed, however, that an X-ray alone should never determine whether a patient requires joint replacement.
“The indication for an operation is not based on X-rays It’s based on your quality of life,” he said.
“Surgery should always be the last option.”
PSH is looking at introducing joint replacement surgery at its hospitals in the future. This could give patients a local treatment and follow-up option instead of requiring them to travel overseas.
McCaig said the operation itself was only one part of successful treatment.
“It’s about the follow-up , its about preventing complications, you have to deal with that complication,” he said.
He also identified sports trauma, road crashes, infections, diabetes and HIV as major considerations in orthopaedic care.
For patients with diabetes or HIV, the risk of complications, including problems with wound healing, can increase significantly.
His message is simple: a damaged joint may appear on an X-ray, but it is the pain and loss of quality of life experienced by the patient that ultimately matter.
Source: PSH Media
