Operation Walk In Egypt
Protocol of cooperation between Misr El kheir Foundation and Chairman of El Mohsen Medical charity, Professor Mahmoud Hafez, regarding the treatment of patients with severe knee osteoarthritis (OA) by conducting Total knee replacement (TKR) operations using custom made templates technology
This protocol also includes a medical training program, the transfer of computer assisted arthroplasty surgery and the establishment of a database for scientific research in custom made templates technology for TKR.
Introduction:
Delay in treatment leads to a non stop deterioration
Patients often delayed in Egypt and the Arab world from seeking treatment and they have a phobia of operations which leads to further deterioration such as the following:
· Patients visit the clinic very late in anadvanced stage of knees OA
· Then severe deformation occurs in the knee (bowing of legs)
· Inability to extend knee joint
· Bone erosion develop in the medial and posterior aspect of the knee joint
· Knee joint becomes lax and unstable
· Leg length discrepancy due to knee deformity
· bony osteophytes and severe stiffness develop
· excessive increase in weight
· Increase the incidence of other diseases (cardiac, chest, DM & liver diseases)
The magnitude of knee complications and its implications on the health or social or economic status in Egypt and Arabian nation:
The majority of Egyptians suffer from endemic bone diseases. The most common causes of most of these diseases are bad habits and daily malpractices which abuse the joints which may lead to chronic injuries and disabilities that require high skillful surgery. One of the most common diseases is knee osteoarthritis(OA).
Incidence of knee OA had increased with people over the age of 65 reached 60% in the Arabian region, while this ratio is less than 20% in the U.S. and Europe
A study in KSA had showed that OA presents in 13% of adults aged above16 years old and the incidence of these doubled in the age of 46-55 and reached30.8% and 60.6% in the 60-75 years old.
Predisposing factors of knee OA:
• Prolonged kneeling position
• Recurrent trauma
• Delayed and ignored injured knee
• Congenital knee diseases and deformities
Economic and social implications:
• Psychological disorders and depression
• Waste of manyhours of work (disabilities resulted from OA and make their relatives busy asthey caring them)
• Direct costs represented in therapy, painkillers,surgical interventions and change processes detailed
This shows how important the problem and itwas necessary to provide an integrated project includes radical solutions toeliminate this problem.
1 - Objectives of the project
Establishment of a specialized centerof excellence for knee joint replacement to be the first of its kind in Egyptand the Arab world in doing operations knee arthroplasty using custom madetemplates while providing quality service to patients with low-cost and withless complications and good results of the operation
This service further assists in helping toreduce unemployment since patients who perform this operation would be able to enjoylife and become independent from others.
Medical Education and Training Program (EnglishProgramis attached)
The preparation of a medical training program for arthroplastyandcomputer assisted surgeries is designed to establish a distinguishableMedical Training to graduate a highly specialized arthroplasty surgeons
Invite arthroplasty consultants to acquirenew skills in technology
Training of nurses and scrub nursesand internal department staff at the hospital to acquire expertise in the fieldof knee OA and Joint replacement operations and the accompanying technology
An integrated training program for doctorsand summarized as follows:
• Full year of surgical training for joint replacementinmany hospitals with a program having a comprehensive approach to teaching thosesurgeries
• Training methods include lectures, videos, trainingsurgeons on models, workshops, live surgeries.
• Acquire a professional arthoplasty diploma and computer assisted surgery which is recognized locally and regionally.
• To graduate a highly qualified arthroplasty surgeons committed to medical ethics
• Allow a chance to the arthoplasty surgeon to use the technology of computer assisted surgery
Scientific Research Program
This program allows the opportunity for doctors to work with high quality research suitable for international Publishing that encourages innovation and development of new arthroplasty techniques.
v Rationale and Facilities of the project:
1. Patent by Dr. Mahmoud Hafez. The idea has been universally applied with a rate of 10,000 cases each month in Europe and North America .
2. Experience in scientific research, publication and funding.
3. Previous experience in the medical training through the Professional Diploma in orthopedics, which began 3 years ago. As well as participation of the Egyptian fellowship program to train orthopedic surgeons affiliated to the Ministry of Health
4. The urgent need for the project because the Ministry of Health funding for arthoplasty operations in Egypt has decreased. Although the high rate of knee OA and the demand for arthroplasty operations in Egypt is more than England, only (1/20) TKA operations take place in Egypt compared to England due to economic reasons and fear of failure and complications of the operation
v Stages of the implementation of the project
ü 1st stage:
Implementation of the project on a number of 50 cases of knee replacement within 6 months and the beginning of 01.09.2012 in October 6 University Hospital
Medical implementation of the training program for surgeons to create a database of patients with periodic follow-up of the patient with the work of Statistics and the deployment of the international research journals. This falls under the heading of scientific research
ü 2nd stage:
Implementation of the project on another 50 knee replacement cases in the following 6 months to be total 100 cases per year. This is what has been agreed upon along with the development of custom made templates invention, registering a new invention, and encouraging innovations in joint replacement operations which falls under the heading of scientific research