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Patients with debilitating conditions such as sickle cell anaemia, whose bones and joints have been damaged as a result of their illnesses, may now be able to move around again in more comfort thanks to pioneering treatment.
The first customised hip replacement surgeries have been carried out successfully in the region for the first time at the German Orthopaedic Hospital in Manama.
Two patients have been fitted with bespoke implants after medical examinations showed that a normal procedure was not an option.
Dr Stefan Dragulescu, one of the facility’s leading hip and knee orthopaedic consultants, performed the delicate operations and said: “Every hip is different. For example, if you are two metres tall, you have longer bones and the anatomy of the joint is different. If you are a sickle cell patient, the circulation of the blood in the bone is poor so it’s severely damaged.
“Sickle cell disease is rampant in the Middle East, being a hereditary condition, so the need for more specialist procedures is necessary.
“The customised hip replacement I’ve just performed was on a 26-year-old patient, the youngest person I’ve ever done a replacement for. Usually patients are around 60-70 years old, but if you have a destroyed joint then you can’t wait and have to act quickly.”
Sickle cell disease is a potentially-fatal genetic condition. Patients have red blood cells that are hard, sticky and C-shaped – like the farm tool, a ‘sickle’.
The misshapen sickle cells clog smaller blood vessels, result in excruciating pain and put patients at an increased risk for infection, acute chest syndrome and stroke.
There are about 18,000 sickle cell patients and around 65,000 sickle cell carriers in Bahrain.
Dr Dragulescu was born in Romania and studied in Bucharest, before moving to Germany in 1990 to continue his studies. There, he became a German citizen and for 16 years was the head of the orthopaedics department in a private practice in Soest.
It was during this stint, in 2011, that he started a relationship with Symbios, one of the very few companies worldwide which produces customised titanium implants. In Western Europe, approximately five per cent of people need a custom replacement, but the number in the Middle East is higher due to hereditary illnesses and the poorer quality of general health and awareness.
When Dr Dragulescu took up his position in Bahrain in October 2017, he brought not only his expertise, but his partnership with Symbios to the kingdom.
“I came to Bahrain because I wanted a change and more importantly, I also saw an opportunity to introduce this new technology to Bahrain and perhaps leave a lasting legacy in the field of orthopaedics, where in the near future the standards of surgery will be more in line with Europe.
“We’re the first hospital in the Middle East to offer this service, and I’m incredibly proud to be a part of that.”
The hospital now offers both customised hip and knee replacements, with the decision to proceed based on a lengthy consultation process.
In a regular procedure, a doctor will take X-rays from either side of the patient to get a view of the hip and go from there. If it appears that a standard implant will work, then the doctor will proceed as normal. However, if there are issues with the bone or joint structure, and a customised replacement is needed, then Dr Dragulescu will perform a full 3D scan of the front and side of the hip. Not only that, but he will go inside the bone to make a volume reconstruction and get the precise measurements.
Then, a special software is used to plan the operation on a computer, which is then sent to the Symbios headquarters in Switzerland. Once verified, Symbios will produce both the hip and the rasp (the instrument to implant the hip) and send it within four-to-six weeks.
The actual surgery itself is the exact same process, though with the implant there is a certainty that it will match and infuse with the bone structure.
The first successful procedure was carried out on a woman with sickle-cell last November although it will be an option for all people who require replacement surgery rather than the one-size-fits-all alternative. Prices are determined on a case-by-case basis.
German Orthopaedic Hospital, under the care of chief operating officer Stefan James MacMillan Skrzywanek, offers a variety of orthopaedic and rehabilitation services, including sports medicine, pre and post operation care and pain therapy. To find out more, call 17239988 or email info@germanortho.com
