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In this disease, pain in the knee joint is usually caused by cartilage degeneration, while bone hyperplasia rarely causes pain unless the hyperplasia causes impact during joint movement.
Certain advertisements on TV often use bone hyperplasia as a threat, and there are a myriad of drugs for treating bone hyperplasia.
Because no matter who the elderly are, as long as they take X-rays, bone hyperplasia will be found in the lumbar spine and knee joints, making all elderly people the target of intimidation.
Nowadays, when the elderly see a doctor, they all know: Doctor, I have bone hyperplasia, which causes low back pain and knee joint pain. Please prescribe me some medicine to treat bone hyperplasia.
The obsession with bone hyperplasia is entirely due to the propaganda and brainwashing by doctors in the media.
In fact, most bone hyperplasia does not require treatment at all. It is a manifestation of degeneration. For example, most knee joint pain is not caused by bone hyperplasia, but by cartilage degeneration.
If bone hyperplasia really causes compression of the lumbar nerves or impact of the knee joint, it will not be solved by a few pills, and surgical intervention will be required.
The “doctors” who make medical advertisements on TV definitely put doctors all over the world to shame for their contributions to medicine.
If you pay a little attention, you will find that many medical problems in the world have been overcome by them, but they hide it from the people and disdain worldly things such as the Nobel Prize. If they care about this, I am afraid that all the Nobel Prizes in medicine in the world will be lost.
fell into the hands of this group.
Of course, although they are not interested in the Nobel Prize, they are also interested in something, which is the money in the pockets of their middle-aged and elderly friends.
"The patient is allergic to titanium, chromium, cobalt, nickel, molybdenum and other metals. I'm afraid artificial joint replacement cannot be done. Please help me see if there is any good method." Director Chang was quite embarrassed.
The artificial knee joints currently on the market must contain these metal components. Even if the artificial joint is customized, it cannot escape these metal components. However, there is an option. All-ceramic knee prostheses are also available, but the technology is immature and has few applications.
.
In fact, there are procedures for how to treat this disease. Director Chang asked Yang Ping for consultation, which fulfilled the wishes of the family and did not think there was any new method.
"Both ankle joints also hurt?" Yang Ping noticed the record in the medical record.
Then I retrieved X-rays of both ankle joints, which also showed signs of osteoarthritis, but the symptoms were not very serious.
"The original plan was to replace the ankle joint?" Yang Ping asked.
Director Chang nodded: "The original plan was to adopt conservative treatment for the ankle joint."
Ankle artificial joint replacement is currently immature. Mature artificial joint replacements are hip and knee joint replacements. Therefore, the postoperative effects of ankle joint replacement, especially the long-term effects, are poor.
"Let's go see the patient?"
Let's all go to the ward to see the patients.
The patient is a seventy-four-year-old male with a kind face, lean body, dark skin, and muscles, giving him a healthy feeling.
There were several family members nearby, all children. When they saw the doctor coming, they all greeted him politely.
The patient's vision and hearing were very good, but he spoke Chongqing dialect and could not understand Mandarin. Yang Ping had to use the help of his children to complete the medical history inquiry.
The old man was in good health and had no chronic diseases such as high blood pressure. He only had joint pain, pain in both knees and ankle joints, but the pain in the knee joint was more obvious, and the symptoms in the ankle joint were much milder than those in the knee joint.
He has a history of carrying heavy objects for decades. He is a "bangbang" in Chongqing. He is strong and has good stamina. He can carry more things than others and walk faster. He can carry all three children on a pole.
Send to college.
After these children graduated one after another, some became civil servants in Shanghai, some worked as teachers in G City, and some worked in the large Internet company Tencent, all of which were pretty good.
These children are very sensible and filial to the elderly. They take turns taking the elderly to live in big cities, and travel with their father every year so that he can enjoy his old age in peace.
However, the old man suffered from osteoarthritis in these four large joints and has been unable to walk for a year. When he could walk before, he had to endure the pain.
Several children discussed and asked around, and heard that joint replacement treatment was possible. It happened that my daughter lived near Sanbo Hospital, so they sent the old man to the hospital for treatment.
After asking about the medical history, Yang Ping checked both knee joints. There was obvious friction sound when moving, and there was obvious tenderness at the medial condyle, indicating that the pain mainly came from the cartilage defect of the medial condyle. At this severe stage, there is no other effective method except artificial joint replacement.
method.
Then check the muscle and nerve function. There is muscle atrophy, but it can be recovered through exercise. This is not a big problem. There is no problem with the skin. Apart from the loss of muscle strength caused by atrophy of each muscle, there are no neurological problems.
The auxiliary examination showed that there was an intervertebral disc herniation in the lumbar spine, but there were currently no obvious neurological symptoms in the lower limbs.
This shows that the effect of artificial knee replacement for this patient will be very good.
"How is it? Professor Yang?" the patient's daughter asked.
The patient has two sons and a daughter. The daughter graduated from graduate school and was admitted to the high school attached to G City Normal University as a teacher, and the son-in-law is also a teacher in the same unit.
The doctor in charge of the bed had communicated with the family beforehand and asked Professor Yang from the Department of General Surgery to come over and take a look.
Yang Ping did not make a clear statement for the time being: "Because the elderly are allergic to many metals, we have to consider the treatment plan."
"Yes, many hospitals recommend conservative treatment for this reason, but I have tried all methods of conservative treatment, but it has no effect. There is nothing we can do. We bought more than 10,000 yuan for the capsule on the TV, but it has no use."
The patient's daughter is a teacher, she is relatively talkative, and her Mandarin is very standard.
Yang Ping frowned. In this case, conservative treatment has no effect because the medial condylar cartilage has been severely worn, the medial joint space is severely narrowed, and the alignment of the lower limbs has also changed.
The old man watched the conversation between the doctor and his daughter and just smiled.
"How did you find out that the old man was allergic to metal?" Yang Ping asked.
The patient's daughter said: "I fell once and suffered a comminuted fracture of the distal end of the right radius. The doctor said that the joint surface collapsed and required surgery. Later, a steel plate was installed. However, the area around the surgical incision was red and swollen after the operation. It never healed and leaked fluid. At that time,
Thinking that there was an infection, the doctor took some liquid and cultured bacteria. After culturing for several times, the bacteria were gone. Then they took X-rays and found that the bone around the screws was resorbed, but they couldn't find the cause. Later, they said that they were considering metal allergies and needed to take out the steel plate. After taking it out,
The doctor said that the nail holes and the soft tissue around the steel plate are all black, and I still have photos."
The patient's daughter flips through photos on her phone.
Yang Ping looked at the photos, and combined with his previous medical history, it was indeed consistent with metal allergies, but he didn't expect to be allergic to so many metals, including titanium.
However, some problems in clinical practice are all kinds of strange. For things like allergies, allergens are even more strange.
For example, there is a woman who is allergic to her boyfriend's sperm. There is nothing she can do about it. It is very difficult to become a couple. In mild cases, she will develop urticaria afterwards. In severe cases, having sex once may cause laryngeal edema, causing difficulty in breathing, which is life-threatening.
There are also allergies to electromagnetic radiation, such as allergies to WIFI.
Some people are allergic to coins, some are allergic to banknotes, etc. Dermatologists who specialize in allergies know this very well.
"We will discuss it before replying to you," Yang Ping replied to the patient's daughter.
