July 2017

Replacement Parts: Miracles of modern science keep bodies in motion

Author: Linda S. Hopkins

If you were born in 1900, most likely you would have been dead before your joints gave way. The average lifespan at that time was 50 years. Fast forward and see what today’s 50-year-olds are up to. Most are nowhere near their expiration date, but many are facing pain and limitations due to worn out joints.

Total joint replacements were introduced in the United States in the 1970s. Although shoulders, elbows and ankles are now being successfully replaced, hips and knees get the prize for most frequently performed joint replacements. According to a CBS News report, 7 million people in the United States are living with a total hip or knee replacement; more than 600,000 knees and 400,000 hips are replaced each year, and those numbers are expected to grow as the population ages.

Joint pain and disability occur when cartilage is damaged. Athletes, overweight people and people whose muscles are weakened by aging are at highest risk of grinding down their joints. When patients present with joint pain, depending on the underlying cause, doctors tend to start with conservative measures such as exercise, walking aids, physical therapy, vitamin supplements, anti-inflammatory medicines or steroid injections. If symptoms do not improve, replacement may be the best solution.

Replacement surgery entails removing the damaged joint and replacing it with a prosthetic made of plastic, metal or ceramic parts. The surgery is usually performed by an orthopedic surgeon. To determine if you are a candidate, your doctor will consider your activity level, general health and your age. Unfortunately, joint replacement materials can wear out, requiring revision surgery down the road if you outlive your new joint.
Meanwhile, researchers are looking at new materials and other ways to improve replacement surgery. And at the same time, scientists are exploring preventive treatments for osteoarthritis (OA), the leading cause of joint deterioration. Studies are underway to develop a non-surgical treatment to halt the pain and debilitation before replacement becomes necessary.

Total joint replacement is major surgery, and recovery is hard work. But if you can handle some post-operative pain and if you are faithful with rehab, you will likely get a positive outcome, meaning less pain, more mobility and greater freedom to participate in activities you enjoy.

Organs and tissues
Joint replacement has become so commonplace that we hardly blink an eye when a loved one, friend or neighbor gets a new knee or hip (although it’s nice to deliver a casserole, walk the dog, and offer rides until they get back in the swing of things). But what happens when major organs fail or new tissues are needed?

According to Mayo Clinic, over 120,000 people in the U.S. are waiting for an organ transplant. Organs that can be transplanted include the liver, kidney, pancreas, heart, lung, intestine, face and hand. Tissues that can be transplanted include corneas, middle ears, skin, heart valves, bones, veins, cartilage, tendons, and ligaments, which can be stored in tissue banks and used to restore sight, cover burns, repair hearts, replace veins, and mend damaged connective tissue and cartilage.

But there are many challenges in the world of organ replacement. For one, demand far outweighs supply. Artificial organs (man-made) do exist, but the challenge is how to make them last. For now, the goal is to buy time until a real organ is available.

The shortage of human donor organs has led scientists to experiment with laboratory grown parts. With just a few cells, doctors can engineer everything from skin to bladders. Scientists would also like to conduct further studies with embryonic stem cells, however, research has been limited due to ethical debate.

What about breasts?
Perhaps one of the most intriguing of all body part replacements is the reconstruction and/or augmentation of breasts. After a surgery that alters or removes a breast, some women opt to remain flat, but many prefer to restore their shape in a way that looks and feels as natural as possible.

The most permanent solution is to undergo breast reconstruction. There are two types of operations that can be done: breast implants (using silicone or saline inserts) or tissue flap procedures (using your own body tissues). Sometimes a combination of the two procedures is most effective.

In addition to restoring shape, nipple and areola reconstruction can make the reconstructed breast look more natural. Patients should have a thorough discussion with a board-certified plastic surgeon regarding the available options and the most medically sound reconstruction method based on many factors that can influence this important decision.

For women who choose to forego reconstruction or find it necessary to wait, mastectomy breast forms and prostheses can be the ticket to balance out the figure and restore confidence. Lightweight polyfill or foam is ideal during recovery and can be worn inside a bra. Silicone prosthesis are made of materials that mimic the feel of natural breasts and can be attached with adhesive or magnets.

Of course, for women who are still blessed to have their natural breasts, many options are available for enhancing a small chest, lifting saggy breasts or simply improving overall shape.

Despite many hurdles, doctors can now replace nearly every part of the human body, and the future is bright with possibility for new and improved methods and devices. Once a figment of the imagination, replacement parts are no longer science fiction, but real options for improving quality of life and extending our stay here on earth.

Organ Donation: Sign Up, Save a Life
Perhaps you have considered becoming an organ donor but are not sure why or how.

Why: For many transplant recipients, organ donation is a second chance at life. For others, an organ transplant means no longer depending on costly treatments to survive and can allow the recipient to return to a normal lifestyle. A cornea or tissue transplant means the ability to see again or the recovery of mobility and freedom from pain.

On the donor side, grieving families of organ donors can take comfort in the fact that their loss may help save or improve the lives of others. Each year, thousands of people die while waiting for a transplant because no suitable donor can be found. By signing up as a donor, you can save up to eight lives through organ donation, and save or improve the lives of up to 50 recipients through tissue and eye donation.

How: Registering to be a donor and telling your family about your decision is the best way to ensure your wishes are honored. You can also designate donation in an advanced directive or in a health care power of attorney.

There are two ways to register as an organ donor. You can register online at organdonor.gov or in person at your local department of motor vehicles.

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