Interview with Dr. Sarem on hip and knee endoprostheses

Dr. Cyrus Sarem is the medical head of the Berlin Joint Care Center and specialist consultant in orthopedics, surgery and trauma surgery. Conducting more than a hundred operations annually, he is an eminent implantologist in hip and knee endoprosthetics and trains other physicians in the field. Dr. Sarem has implanted a total of 700 hip and knee prostheses. The Joint Care Center is an extension of the CHIMANOS Orthopedic Center and whose specialization is endoprosthetics: when joints can no longer be conserved with the aid of conservative treatments.

Dr. Sarem, people who seek you out are generally those who have exhausted all avenues of joint conservation. What’s the message you’re getting out?

Dr. Sarem: If we determine a joint to be irreversibly deteriorated or that a joint con- sequent to an injury fails to recover pain-free, we will recommend a joint replacement. Hip and knee endoprostheses have proved to be very good long-term remedies. For this reason, I advise my patients these days not to wait until they can’t sleep because of constant pain or until the joint becomes ever more immobile.

You specialize in knee and hip endo- prostheses. In the field of hip replacement, you are one of the most experienced surgeons in the McMinn method of hip resurfacing.

Dr. Sarem: I recommend hip resurfacing to my patients whenever possible. The great advantage of this technique is that only the worn-out parts of the joint are removed, while the femoral head and neck are conserved. In this way, the biomechanics of the joint are maintained and the body’s anatomy remains largely unaltered. For patients whose ail- ments are unsuitable for this technique, there are other modern implants which offer many advantages over hip resurfacing. What this means to the patient is a significant improve- ment in the quality of life.

Today such a surgical procedure no longer means the end of an active lifestyle for patients with hip ailments – regardless of age.

More and more minimally invasive tech- niques for knee endoprostheses are being deployed in operation rooms. What does it involve?

Dr. Sarem: A knee prosthesis replaces the worn-out parts of the knee with an artificial surface. It is composed of at least two parts: the femoral component and the shin component. In order to prevent the two joint surfaces from rubbing into each other and to enable metal parts to be embedded into the joint, an artificial anti-friction surface is inserted between the two components. To me, the most important point with regard to all the procedures is that at the end of the day the new joint is positioned exactly the way I had planned it. Using tiny precision instruments also allows me to perform the operation with minimal impact to the surrounding soft tissues.

You are a specialist in minimally invasive operation techniques. What advantage does this hold for the patient?

Dr. Sarem: This method allows us to operate with minimal impact to the surrounding tissues of the knees and hips. I perform the operation using tiny instruments introduced through a small incision in the skin. What it means for our patients is this: the smaller the cut, the less the pain, the quicker the healing and the shorter the hospital stay. But most of all, there is less muscle damage and greater mobility and faster rehabilitation of the body’s capabilities.

How safe is this surgical technique?

Dr. Sarem: Due to the small entry point in minimally invasive operations, the surgeon’s scope of vision is limited. For optimal safety in complicated procedures, I use state-of-the-art computer-aided orientation devices known as navigation systems. They help us to determine the positioning of the joint replacement on a precise 3-D image of the joint on the computer monitor before we make the actual changes to the bone. The operation time is slightly longer, but for the patient it means a greater level of safety.
The procedure itself takes place at the Havelklinik, a hospital which has the best facility for endoprosthetic procedures. There I know my patients will also get the very best post-op care.

Where does follow-up treatment take place?

Dr. Sarem: The patient’s post-op treatment and rehabilitation is taken care of by the expert staff at Chimanos. In our team we have Dr. Hartmann who is a specialist in conservative and rehabilitative medicine. The patient is given optimal care through the dovetailing of expert staff who attends to the individual patients several times a day. Our patients benefit from the close cooperation between the practice’s selected specialist consultants.