“Oh my aching (circle one or more) back, knee, hip, neck, wrist, ankle, shoulder…” If you find yourself uttering that sentiment several times a day, you’re not alone. One in every seven of us has an orthopaedic impairment, and four out of every five experience significant back pain at some time. Orthopaedic complaints are the most common reason why patients make appointments to see their doctors. In the US alone, more than 6 million orthopaedic surgeries was performed in 2016, with bad knees topping the list. Millions more do not seek treatment, electing instead to live in chronic pain, most often for financial reasons.
In recent years, orthopaedic specialists have increased their ability to provide care and restorative treatment, especially in the arena of joint replacements. Since the first knee replacement was performed in 1968, the demand for artificial joints to replace natural ones lost to age and osteoarthritis has grown dramatically.
Part of the reason is an aging population, but don’t be misled. Senior citizens aren’t the only patients seeking orthopaedic treatments and surgeries. More than 20 percent of patients are affected by arthritis, and two-thirds of them are under the age of 65. Among the young and old alike, the rise in sports medicine has paralleled the popularity of athletics and rigorous exercise, with surgeries and physical therapies at the epicenter of treatment.
Why It Works for Medical Travel
Orthopaedic patients travel for the same reasons other medical travelers do: they want quality treatment at an affordable price. They find both at some of the top orthopaedic hospitals and specialty centers abroad, where prices can run as much as 80 percent lower than at home. Like other medical travelers, orthopaedic patients may find that their surgery is labeled “elective,” in which case a health insurance policy may not pay even part of the cost. Patients in countries served by national health plans may find the waiting list uncomfortably long for the most sought-after procedures, such as knee and hip replacements.
Another factor that weighs heavily in the decision making of many orthopaedic patients is the availability of the newest and most technologically advanced treatment methods. Every year sees innovation and improvements on minimally invasive procedures, including arthroscopy, arthroplasty and stem cell therapies. Some countries, like the US, require long spans of time and lengthy periods of clinical trials before new techniques are approved for general use.
The upside of that approach is safety. Patients in “cautious countries” aren’t likely to be harmed by experimental techniques that fail. The down side is that doctors in those countries may find themselves lagging behind in their mastery of a new technique when approval is eventually granted. Doctors overseas may have developed greater expertise because they have been using a technology longer.
Orthopaedics patients are spoiled for choice when seeking treatment overseas. Dozens of fine JCI-accredited hospitals and sports medicine clinics offer outstanding orthopaedics services and surgeries at the hands of experienced surgeons.
All orthopaedic surgeries carry a risk of complications. While rare, patients should not ignore this when deciding about surgery. Some risks are specific to a particular procedure. A repaired or rebuilt ligament may stretch or tear. A fracture may not heal properly. An operation done to slow the progression of age-related arthritis may accelerate it. A procedure performed to reduce pain may increase it.
Happily, orthopaedic surgeons can, on average, boast high success rates for their patients. After knee arthroscopy, for example, more than 80 percent of patients return to walking, yard work, and other light activity within one week. Success rates for knee replacements run around 90 percent, but 10 percent of knee-replacement patients may encounter difficulties. Stiffness, pain, or swelling may occur. The prosthesis may become infected, in which case antibiotic treatment or “revision surgery” may be necessary. Other risks include:
- failure of the surgery (the most common postoperative problem)
- infection (some sources say the risk is 1-2 percent)
- stiffness or loss of motion of the joint or nearby joints
- blood clots
- injury to nerves or blood vessels
For the medical traveler, these risks can be diminished in three ways:
- Don’t return home too soon
- Make sure you have a good understanding of your physical rehabilitation program before returning home
- Ensure that your hometown specialists (including your physical therapist) are ready and willing to supervise your rehabilitation in the weeks and months following your return
Before you plan an orthopaedic treatment at home or abroad, discuss your alternatives fully with a specialist. A major surgery to correct a minor annoyance may not be a wise choice. Make sure, also, you understand what you can reasonably expect as an outcome of a successful surgery.
Be realistic. If you’re 70, you not going to return to the athletic prowess you enjoyed when you were 20. But, assuming a knee replacement looks right for you, you may look forward to walking, bicycling, golfing, and swimming—although skiing, basketball, and racquetball might be more of a reach.
Orthopaedic specialists emphasize the need for formal physical therapy and informal self-motivational therapy after nearly every orthopaedic procedure. The longer a joint stays immobile (after healing), the less likely becomes its return to normal movement and functioning.
Orthopaedic patients must be strong and resilient in both body and mind. For example, while getting a repaired rotator cuff moving again is going to hurt, performing the daily exercises recommended by the orthopaedic surgeon and the physical therapist is a must. Doctors tell us that their patients who work with consistency and persistence—working their way through moderate pain—fare best in the end.
Note: Lifestyle choices play a huge role in joint pain. Obese patients, or patients that smoke or consume large amounts of alcohol, put themselves at far greater risk for wear and tear on the joints (particularly knees and hips), as well as damage resulting from injury. People with a BMI (Body Mass Index) of 30 or more are nearly nine times as likely to undergo an orthopaedic knee replacement surgery!
Patients, fit or otherwise, should also look into physical therapy as an alternative to surgery. In a medical world rife with over-treatment and misdiagnosis, non-surgical interventions might be a more prudent course. If in doubt, get a second opinion.