LATEST NEWS 02/10/2016
Your vertebrae are the column of bones that form your spine. The vertebrae are curved and are linked together with smaller facet joints and separated by spongy discs. The laminae (the official term for the curved joints) form the spinal canal – like a tunnel protecting the spinal cord, which runs from your brain down the canal. The spinal cord’s nerves and blood vessels lead into the canal via the vertebrae. The nerves communicate messages from your brain enabling muscle movement. They also transfer messages from your skin alerting you to both touch and pain.
There is a natural tendency for a narrowing of the spinal canal as we age. This is to do with wear on the facet joints, a thickening around ligaments that are in close proximity and also discs bulging. Arthritis and other bone problems in the spine can also cause the spinal canal to narrow. Some people have a narrow spinal canal from birth. This narrowing, whatever its cause, means that space for both the nerves and blood vessels is compromised. This results in poorly working nerves, especially if you have been exercising or standing for long periods of time. Some symptoms include a tingling sensation or pain in the leg, which can prevent normal walking.
Relief can often be found by bending forward or sitting down.
Surgery can offer relief from pain and the ability to walk further. Surgery will also ensure the symptoms do not worsen.
Had a sterilisation previously? Changed your mind?
Sterilisation is a surgical procedure performed to permanently prevent pregnancy. It involves applying clips to the fallopian tubes. For many reasons, 5-10% of women want the sterilisation reversed. They may have a new partner or want additional children due to unforeseen circumstances.The reversal operation regoins together each of the fallopian tubes, give them the chance to get pregnant again in a nature way.
In addition to the renewed desire to mother a baby, many women consider tubal ligation reversal to overcome the undesirable effects of Post Tubal Ligation Syndrome. The symptoms may include menstrual irregularities, loss of libido, vaginal dryness and early onset of menopausal symptoms (hot flushes, mood swings, irritability, palpitation, and anxiety).
However not all women with tubal ligation, can consider a reversal. Reversal depends upon certain factors like age, the procedure used for the tubal ligation, the exact position of the ligation, and fallopian tube length available after the procedure. Women who have been sterilised using clips are likely to have the best chance of success. Women who have had a sterilisation operation where the tubes have been removed cannot have a reversal. The medical team would require examining other health considerations before suggesting the viability of a tubal ligation reversal.
The procedure usually takes about 1-2 hours under general anaesthetic and involves precise surgery. The fallopian tubes have very small internal openings and are best seen using magnification. This enables the surgeon to join the tubes together accurately using delicate stitches to give the best possible results. The surgery can be done as a conventional abdominal surgery (bikini line incision approx 10-12 cm lenght accross the lower abdomen) or nowday it can be done also as a keyhole surgery.
Clinical evidence suggests that the success rate for tubal ligation reversal is about 20% to 80%. The most important consideration is the age of the women, with women below forty years of age showing pregnancy success rate of as high as 80%. You need to know that All women requesting a reversal of sterlilisation are treated with a totally non-judgemental attitude. No one can predict what is to happen in their lives and this service is offered to help individuals become fertile again.
Budapest Medical Services provide both conventional and key-hole procedures for tubal ligation reversal surgery. If you want to have done your surgery in Budapest you need to plan 12-14 days stay for conventional surgery and 8-10 days for a keyhole surgery.
Up until the last ten years, the only treatment option available for venous insufficiency was a major surgery called vein stripping, which was an invasive procedure with a long recovery that tended to fail after a few years. Over the past decade, a revolutionary new treatment has been developed by interventional radiologists, doctors who are experts in imaging and specialize in minimally invasive treatments.
This new treatment, called endovenous laser ablation (EVLT), is a minimally invasive procedure used to close down, or ablate, the incompetent superficial vein which is the underlying source of your symptoms and varicosities. This is accomplished through thermal ablation – or heat sealing – the vein shut using a very hot laser fiber tip which has passed into the vein through IV access lower in the leg. In order to allow the laser tip to heat up enough to seal the vein without causing damage to surrounding tissue, we will also be injecting a small amount of lidocaine all along the course of the vein to be treated. Ultrasound imaging is used before (to locate the target section of the vein), during (to monitor the therapy), and after (to ensure the treatment has been completed and other important deep veins have not been damaged). The procedure is commonly done in the office outpatient setting with minimal anesthesia and is generally very safe. The EVLT generally takes less than 30 minutes.
In conjunction with EVLT, a minimally invasive surgical technique called ambulatory microphlebectomy is commonly used to complete treatment of varicose veins. After EVLT treats the source problem, the varicose veins which are bulging and dilated are then removed using a tiny nick. The blade used for this procedure is the same scalpel used for eye surgeries, and therefore is relatively painless after lidocaine administration and generally leaves no scars. The abnormal vein is then removed through this tiny incision or incisions using special tools. The procedure is done under local anesthesia and typically takes only a few minutes. Recovery is rapid, and most patients do not need to interrupt most regular activity after the procedure.
Being satisfied with the reflection you see in the mirror day by day is important. It affects your confidence and self-esteem, and being in a conflict with yourself over your appearance can influence your relationship with the outer surroundings.
Plastic surgery provides the possibility to change in order to attain and keep the desired natural harmony of mind and body. Current plastic surgery methods and devices not only ensure an excellent outcome, but are also really safe to use thanks to the latest technology and professional skill. The surgeries we perform are adjusted to meet individual needs and expectations: our specialist always gives a personalized opinion beforehand at a preliminary examination and consultation.
Plastic surgeries usually require a one-night hospital stay for monitoring, but certain interventions can be performed as ambulatory treatment.
Budapest Medical Services organizes and provides a wide range of plastic surgeries. Moreover our experienced specialists can combine different types of surgeries: if the patient wishes to undergo more changes, they can perform all necessary operations on a single occasion while you are anesthetized.
LATEST NEWS 27/10/2014
Comprehensive up-to-date information on our: treatments, services, rehabilitations, clinics, consultants, the EU Directive on cross-border healthcare and more…
Whatever your age, you can be affected by problems with your hips. Whether old or young, it is a serious problem and the condition that most people suffer from is called osteoarthritis. This happens when the cartilage in the hip joint is damaged and the bones are left exposed and rub against one another causing severe pain. Hip problems can also be the result of falls, injuries sustained whilst doing sport or congenital diseases.
If you are affected by problems with your hips, it is more than likely that you will experience difficulty moving around and performing simple tasks. Walking, standing and bending not only become uncomfortable, they also become painful.
To match the range of issues that affect hips, there is also a range of treatments available. Whether you are suffering from arthritis, cartilage damage, joint inflammation or bone trauma, we can offer a full range of specialist treatments and support.
Our team of orthopaedic specialists and hip surgeons are recognised as experts in their line of work. They are always on hand to offer you reassurance and support right through from diagnosis, to treatment and follow-up care.
If your arthritis is in advanced stages you may need a full hip replacement. This means that a surgeon removes the neck of the femur and replaces it with a metal stent and artificial ball, using a metal cup to line the acetabular. The implants used are made from metal, plastic and ceramic depending on the part.
For arthritis that is less advanced, another procedure known as resurfacing surgery may be possible. This means that the whole hip joint does not have to be replaced, instead just the head of the femur and the lining of the acetabular are resurfaced.
Our team works closely with musculoskeletal physiotherapists helping you return to your former fitness levels as soon as possible.
Budapest Medical Services organizes and provides treatment for a whole range of hip problems and injuries. If you cannot find what you are looking for in the list above, then please do not hesitate contact us. We look forward to hearing from you.
A cholecystectomy is a surgical procedure in which the gall bladder, a small organ located under the liver, is removed. This procedure is performed in cases when patients experience chronic gallstones which cannot be resolved, or severe gallbladder inflammation which does also an indicator for gallbladder removal. This procedure is classically performed by a general surgeon.
The vast majority of cholecystectomies are performed laparoscopically, with the use of cameras and surgical tools inserted through very small incisions in the skin. In some cases, it may be necessary to perform open surgery, which involves the creation of a large incision which allows the surgeon to see the site directly. Surgeons try to use laparoscopic options whenever possible, as the healing time is greatly reduced with this type of surgery. However, patients should be aware that even when a laparoscopic cholecystectomy is scheduled, it is sometimes necessary to switch to an open surgery.
This abdominal surgery is performed under general anesthesia. Prior to the procedure, the patient will be asked for blood samples so that the doctor can confirm that the patient is in good physical condition, and the patient will also usually meet with the anesthesiologist to discuss pain management and what to expect. After the surgery is finished, the patient is moved to recovery and monitored until he or she is fully conscious. The gallbladder may be sent to pathology for further study.
Patients who receive a laparoscopic cholecystectomy usually can return to work and regular duties within a week, while healing times after open surgery can take four to six weeks.
About Knee Replacement…
Knee replacement surgery (arthroplasty) involves replacing a damaged, worn or diseased knee with an artificial joint.
It’s a routine operation for knee pain most commonly caused by arthritis.
More than 70,000 knee replacements are carried out in England and Wales each year, and the number is rising. Most people who have a total knee replacement are over 65 years old.
For most people, a replacement knee will last for at least 15 to 20 years, especially if the new knee is cared for properly and not put under too much strain.
Types of surgery
There are two main types of surgery, depending on the condition of the knee:
- total knee replacement (TKR) – both sides of your knee joint are replaced
- partial (half) knee replacement (PKR) – only one side of your joint is replaced in a smaller operation with a shorter hospital stay and recovery period
Why is knee replacement surgery needed?
The most common reason for knee replacement surgery is osteoarthritis. Other conditions that cause knee damage include:
- rheumatoid arthritis
- knee injury
A knee replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, haven’t helped reduce pain or improve mobility.
You may be offered knee replacement surgery if:
- you have severe pain, swelling and stiffness in your knee joint and your mobility is reduced
- your knee pain is so severe that it interferes with your quality of life and sleep
- everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
- you cannot work or have a normal social life
Can I have knee replacement surgery?
Adults of any age can be considered for a knee replacement, although it’s typically recommended for older people as young, physically active people are more likely to wear the joint out.
The earlier you have a knee replacement, the greater the chance you will eventually need further surgery. However, there is some evidence that replacing the knee joint before it becomes very stiff leads to a better outcome.
Most total knee replacements are carried out on people between the ages of 60 and 80. You will need to be well enough to cope with both a major operation and the rehabilitation afterwards.
Questions and Answers about Hip Replacement
This publication contains general information about hip replacement. It describes what a hip replacement is, who should have it, and alternatives to surgery. If surgery is required, it explains what the surgery involves, recovery, and rehabilitation. If you have further questions, you may wish to discuss them with your health care provider.
What Is a Hip Replacement?
Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the hip joint are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain. According to the Centers for Disease Control and Prevention (CDC), 332,000 total hip replacements are performed in the United States each year.
Who Should Have Hip Replacement Surgery?
People with hip joint damage that causes pain and interferes with daily activities despite treatment may be candidates for hip replacement surgery. Osteoarthritis is the most common cause of this type of damage. However, other conditions, such as rheumatoid arthritis (a chronic inflammatory disease that causes joint pain, stiffness, and swelling), osteonecrosis (or avascular necrosis, which is the death of bone caused by insufficient blood supply), injury, fracture, and bone tumors also may lead to breakdown of the hip joint and the need for hip replacement surgery.
In the past, doctors reserved hip replacement surgery primarily for people over 60 years of age. The thinking was that older people typically are less active and put less stress on the artificial hip than do younger people. In more recent years, however, doctors have found that hip replacement surgery can be very successful in younger people as well. New technology has improved the artificial parts, allowing them to withstand more stress and strain and last longer.
Today, a person’s overall health and activity level are more important than age in predicting a hip replacement’s success. Hip replacement may be problematic for people with some health problems, regardless of their age. For example, people who have chronic disorders such as Parkinson’s disease, or conditions that result in severe muscle weakness, are more likely than people without chronic diseases to damage or dislocate an artificial hip. People who are at high risk for infections or in poor health are less likely to recover successfully. Therefore they may not be good candidates for this surgery. Recent studies also suggest that people who elect to have surgery before advanced joint deterioration occurs tend to recover more easily and have better outcomes.
Why Do People Have Hip Replacement Surgery?
For the majority of people who have hip replacement surgery, the procedure results in:
-a decrease in pain
-improvements in activities of daily living
-improved quality of life.
What Are Alternatives to Hip Replacement?
Before considering a total hip replacement, the doctor may try other methods of treatment, such as exercise, walking aids, and medication.
1. An exercise program can strengthen the muscles around the hip joint. Walking aids such as canes and walkers may alleviate some of the stress from painful, damaged hips and help you to avoid or delay surgery.
2. All medicines can have side effects. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.
For hip pain without inflammation, doctors usually recommend the analgesic medication acetminophen.
For hip pain with inflammation, treatment usually consists of nonsteroidal anti-inflammatory drugs, or NSAIDs. Some common NSAIDs are aspirin and ibuprofen.2 When neither NSAIDs nor analgesics are sufficient to relieve pain, doctors sometimes recommend combining the two. Again, this should be done only under a doctor’s supervision.
3. Warning: NSAIDs can cause stomach irritation or, less often, they can affect kidney function. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a patient is being treated with NSAIDs because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. Also, NSAIDs sometimes are associated with serious gastrointestinal problems, including ulcers, bleeding, and perforation of the stomach or intestine. People age 65 and older, as well as those with any history of ulcers or gastrointestinal bleeding, should use NSAIDs with caution.
In some cases, a stronger analgesic medication such as tramadol or a product containing both acetaminophen and a narcotic analgesic such as codeine may be necessary to control pain.
Topical analgesic products may provide additional relief. Some people find that the nutritional supplement combination of glucosamine and chondroitin helps ease pain. People taking nutritional supplements, herbs, and other complementary and alternative medicines should inform their doctors to avoid harmful drug interactions.
In a small number of cases, doctors may prescribe corticosteroid medications, such as prednisone or cortisone, if NSAIDs do not relieve pain. Corticosteroids reduce joint inflammation and are frequently used to treat rheumatic diseases such as rheumatoid arthritis. Because of the serious side effects associated with corticosteroids, a doctor must prescribe and monitor treatment.
Sometimes, corticosteroids are injected into the hip joint.
If exercise and medication do not relieve pain and improve joint function, the doctor may suggest a less complex corrective surgery before proceeding to hip replacement. One common alternative to hip replacement is an osteotomy. This procedure involves cutting and realigning bone, to shift the weight from a damaged and painful bone surface to a healthier one. Recovery from an osteotomy takes several months. Afterward, the function of the hip joint may continue to worsen and additional treatment may be needed. The length of time before another surgery is needed varies greatly and depends on the condition of the joint before the procedure.
What Does Hip Replacement Surgery Involve?
The hip joint is located where the upper end of the femur, or thigh bone, meets the pelvis, or hip bone. A ball at the end of the femur, called the femoral head, fits in a socket (the acetabulum) in the pelvis to allow a wide range of motion.
During a traditional hip replacement, which lasts from 1 to 2 hours, the surgeon makes a 6- to 8-inch incision over the side of the hip through the muscles and removes the diseased bone tissue and cartilage from the hip joint, while leaving the healthy parts of the joint intact. Then the surgeon replaces the head of the femur and acetabulum with new, artificial parts. The new hip is made of materials that allow a natural gliding motion of the joint.
In recent years, some surgeons have begun performing what is called a minimally invasive, or mini-incision, hip replacement, which requires smaller incisions and a shorter recovery time than traditional hip replacement. Candidates for this type of surgery are usually age 50 or younger, of normal weight based on body mass index and healthier than candidates for traditional surgery. Joint resurfacing is also being used.
Regardless of whether you have traditional or minimally invasive surgery, the parts used to replace the joint are the same and come in two general varieties: cemented and uncemented.
Cemented parts are fastened to existing, healthy bone with a special glue or cement. Hip replacement using these parts is referred to as a “cemented” procedure. Uncemented parts rely on a process called biologic fixation, which holds them in place. This means that the parts are made with a porous surface that allows your own bone to grow into the pores and hold the new parts in place. Sometimes a doctor will use a cemented femur part and uncemented acetabular part. This combination is referred to as a hybrid replacement.
Is a Cemented or Uncemented Prosthesis Better?
The answer to this question is different for different people. Because each person’s condition is unique, the doctor and you must weigh the advantages and disadvantages.
Cemented replacements are more frequently used for older, less active people and people with weak bones, such as those who have osteoporosis, while uncemented replacements are more frequently used for younger, more active people.
Studies show that cemented and uncemented prostheses have comparable rates of success. Studies also indicate that if you need an additional hip replacement, or revision, the rates of success for cemented and uncemented prostheses are comparable. However, more long-term data are available in the United States for hip replacements with cemented prostheses, because doctors have been using them here since the late 1960s, whereas uncemented prostheses were not introduced until the late 1970s.
The primary disadvantage of an uncemented prosthesis is the extended recovery period. Because it takes a long time for the natural bone to grow and attach to the prosthesis, a person with uncemented replacements must limit activities for up to 3 months to protect the hip joint. Also, it is more common for someone with an uncemented prosthesis to experience thigh pain in the months following the surgery, while the bone is growing into the prosthesis.
What Can Be Expected Immediately After Surgery?
You will be allowed only limited movement immediately after hip replacement surgery. When you are in bed, pillows or a special device are usually used to brace the hip in the correct position. You may receive fluids through an intravenous tube to replace fluids lost during surgery. There also may be a tube located near the incision to drain fluid, and a type of tube called a catheter may be used to drain urine until you are able to use the bathroom. The doctor will prescribe medicine for pain or discomfort.
On the day after surgery or sometimes on the day of surgery, therapists will teach you exercises to improve recovery. A respiratory therapist may ask you to breathe deeply, cough, or blow into a simple device that measures lung capacity. These exercises reduce the collection of fluid in the lungs after surgery.
As early as 1 to 2 days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with assistance.
While you are still in the hospital, a physical therapist may teach you exercises such as contracting and relaxing certain muscles, which can strengthen the hip. Because the new, artificial hip has a more limited range of movement than a natural, healthy hip, the physical therapist also will teach you the proper techniques for simple activities of daily living, such as bending and sitting, to prevent injury to your new hip.
How Long Are Recovery and Rehabilitation?
Usually, people do not spend more than 3 to 5 days in the hospital after hip replacement surgery. Full recovery from the surgery takes about 3 to 6 months, depending on the type of surgery, your overall health, and the success of your rehabilitation.
It is important to get instructions from your doctor before leaving the hospital and to follow them carefully once you get home. Doing so will you give you the greatest chance of a successful surgery.
What Are Possible Complications of Hip Replacement Surgery?
New technology and advances in surgical techniques have greatly reduced the risks involved with hip replacements.
The most common problem that may arise soon after hip replacement surgery is hip dislocation. Because the artificial ball and socket are smaller than the normal ones, the most dangerous position usually is pulling the knees up to the chest. Ball can become dislodged from the socket if the hip is placed in certain positions. The
The most common later complication of hip replacement surgery is an inflammatory reaction to tiny particles that gradually wear off of the artificial joint surfaces and are absorbed by the surrounding tissues. The inflammation may trigger the action of special cells that eat away some of the bone, causing the implant to loosen. To treat this complication, the doctor may use anti-inflammatory medications or recommend revision surgery (replacement of an artificial joint). Medical scientists are experimenting with new materials that last longer and cause less inflammation. Less common complications of hip replacement surgery include infection, blood clots, and heterotopic bone formation (bone growth beyond the normal edges of bone).
To minimize the risk of complications, it’s important to know how to prevent problems and to recognize signs of potential problems early and contact your doctor. For example, tenderness; redness and swelling of your calf; or swelling of your thigh, ankle, or foot could be warning signs of a possible blood clot. Warning signs of infection include fever, chills, tenderness and swelling, or drainage from the wound. You should call your doctor if you experience any of these symptoms.
When Is Revision Surgery Necessary?
Hip replacement is one of the most successful orthopaedic surgeries performed. However, because more people are having hip replacements at a younger age, and wearing away of the joint surface becomes a problem after 15 to 20 years, replacement of an artificial joint, which is also known as revision surgery, is becoming more common. It is more difficult than first-time hip replacement surgery, and the outcome is generally not as good, so it is important to explore all available options before having additional surgery.
Doctors consider revision surgery for two reasons: if medication and lifestyle changes do not relieve pain and disability, or if x rays of the hip show damage to the bone around the artificial hip that must be corrected before it is too late for a successful revision. This surgery is usually considered only when bone loss, wearing of the joint surfaces, or joint loosening shows up on an x ray. Other possible reasons for revision surgery include fracture, dislocation of the artificial parts, and infection.
What Types of Exercise Are Most Suitable for Someone With a Total Hip Replacement?
Proper exercise can reduce stiffness and increase flexibility and muscle strength. People who have an artificial hip should talk to their doctor or physical therapist about developing an appropriate exercise program. Most of these programs begin with safe range-of-motion activities and muscle-strengthening exercises. The doctor or therapist will decide when you can move on to more demanding activities. Many doctors recommend avoiding high-impact activities, such as basketball, jogging, and tennis. These activities can damage the new hip or cause loosening of its parts. Some recommended exercises are walking, stationary bicycling, swimming, and cross-country skiing. These exercises can increase muscle strength and cardiovascular fitness without injuring the new hip.
What Research Is Being Conducted on Hip Replacement?
To increase the chance of surgical success and decrease the risk of complications and prosthesis failure, researchers are working to develop new surgical techniques, more stress-resistant materials, and improved prosthesis designs. They are also looking for ways to reduce the body’s inflammatory response to the artificial joint components.
Researchers are also studying gender and ethnic discrepancies in those who have the procedure, and characteristics that make some people more likely to have successful surgery.
Studies are exploring the use of various agents to minimize bone loss around the implant. Strategies to prevent blood clots and implant-related infection are also being investigated.
Other areas of research address issues of recovery and rehabilitation, such as appropriate postsurgical analgesia for older people, and home-health and outpatient programs.