Joint Center

At our Joint Center, professional medical staff with rich clinical experience, offer optimum personalized treatments for a variety of joint diseases of the knees, shoulders, hip-joints, etc. In particular, we actively conduct organized diagnosis-surgery-rehabilitative treatment using our modern and Korean traditional medical cooperation system.

Diseases & Treatment

Degenerative knee arthritis / osteoarthritis of the knee-joint / meniscus injuries / cruciate ligament injuries / frozen shoulders, calcific tendinitis / arthritis of the shoulder / rotator cuff disease, shoulder dislocations / hallux valgus/ treatment of a variety of dislocations / Stem Cell Treatment Center / non-surgical treatment / Korean traditional medical treatment

Degenerative arthritis of the knee

Definition

It is a degenerative disease where the joint cartilage gradually deforms and abrades and is often found in middle-aged or elderly patients.

Symptoms

• 01 The knee swells and aches.
• 02 It is difficult to bend the knee.
• 03 The pain worsens when walking or running, and it aches when sleeping.

Treatments

Conservative therapy

01 Medication: analgesic, non-steroidal anti-inflammatory drug (NSAID) 02 Physical therapy & rehabilitative exercises: These reduce pain and enhance joint function through increasing muscular strength and flexibility. 03 Assistive products: patellar supporter, shock absorbent shoes, crutches, canes, etc.

Surgical treatment

Surgical treatment is necessary if the conservative treatment is not effective. 01 Knee (knee-joint) arthroplasty This surgery for arthritis patients abrades the femur and tibia, replacing the surface of the joint with metal prosthetic structure and inserting artificial cartilage to enable early movement. Joint exercises to eliminate the pain caused by degenerative arthritis are also used. Diseases where we might need to consider surgery – Degenerative arthritis, rheumatoid arthritis, post-traumatic arthritis 02 Computer navigation assisted arthroplasty - This new surgical system applied a satellite GPS function. Just as a car’s system leads the driver to the destination, so this computer navigation system enables more precise surgery by locating the artificial joint. - Furthermore the computer can pre-estimate the location of the joint, the error range, the balance between muscle and ligament, the exercise range of the artificial joint, etc. to enable more precise and successful arthroplasty. Advantages of Navigation Assisted Surgery The surgery is accurate due the computer’s assistance. It can extend the lifespan of the prosthetic joint by enabling surgery to occur close to the normal knee-joint angle. Unlike conventional surgery, navigation-assisted surgery does not insert surgical instruments into the medullary cavity and can reduce the side effects of embolism. It allows the prosthetic joint to be inserted at the exact location required. It reduces the hospitalization and recovery periods. It uses a smaller excision area in comparison to the conventional method. This surgery conserves the normal joint structure and leaves the patient with post surgery joint-movement that is close to normal. This surgery causes less bleeding.

Hip-joint osteoarthritis

Definition

The hip-joint has a relatively low rate of degenerative arthritis in comparison to knees or vertebrae however, developmental dysplasia of the hip, osteonecrosis of the femoral head and degenerative arthritis of the hip-joints due to traumatic deformities, etc. are relatively common.

Symptoms

• 01 Patients can feel discomfort and stiffness in the groin, hips, femoral, etc. areas.
• 02 Patients cannot fold their legs to sit on the floor and limp when walking.

Treatments

Conservative treatment	01 Avoidance of excessive use of the hip-joints and adequate rest. 02 Gentle and regular physical therapy programs (swimming, water aerobics, cycling, etc.) 03 Pain relief with anti-inflammatory analgesics 04 In case of obese patients; weight loss and assistive products such canes, etc.
Surgical Treatment	01 Hip(hip-joint) arthroplasty This surgery removes the damaged femoral head or cervical areas and inserts prosthetic joints to enable early ambulation and normal joint exercise. Diseases where hip arthroplasty may be considered Rheumatoid arthritis, osteonecrosis of the femoral head, femoral degenerative arthritis, geriatric femoral neck or tibia fractures

Meniscus injury

Definition

Meniscus ruptures are the most common knee injuries and are caused by twisting the knee while it is slightly bent. This frequently occurs to athletes who undergo a lot of physical contact however such fractures are also common due to degenerative changes.

Symptoms

• 01 Pain and edema
• 02 The knee cannot be straightened or bent; locking phenomenon
• 03 Helplessness due to loss of energy in the legs while waking.

Treatments

Conservative treatment

If the rupture is small, located on the outside, does not exhibit continuous symptoms and there is not any instability of the knee, we practice non-surgical conservative treatments through rest and medication to ease the pain, etc.

Surgical treatment

01 Arthroscope Excise a small hole, less than 1cm diameter, in the effected joint area, insert a 2~5mm diameter arthroscope and surgical equipment, check the surgery area using the arthroscope and incise or suture the ruptured meniscus. 02 Rehabilitative therapy For 7~14 days after the surgery, the patient will use assistive devices like crutches, etc. to protect the knee and then will receive gradual rehabilitative therapy. In the initial stage, we will offer a rehabilitative therapy program to recover the knee’s exercise range. We will observe the progress and afterwards gradually use strengthening exercises. Regular strengthening exercises for the surrounding knee muscles after arthroscopic surgery is crucial.

Cruciate ligament injury / Anterior cruciate ligament injury

Definition

Sprains and ruptures of the anterior cruciate ligament are some of the most common knee injuries and are usually caused by damage during sports. It can happen to soccer players undergoing a lot of collisions, to basketball players because of landings after jumping, to skiers who make abrupt turns, stops and twists, etc.

Symptoms

• 01 Pain and edema
• 02 Instability of the knee while exercising and reduced exercise range
• 03 Difficulty in walking

Treatment

Conservative treatment

If the patient is elderly with a low activity rate, or if there is a partial rupture of less than 50%, or if there is no instability in the knee, then conservative treatments such as using an orthosis, or strengthening of the muscles through rehabilitative exercises, etc. will be pursued.

Surgical Treatment

01 Ligament reconstruction In cases of total rupture of the anterior cruciate ligament, general suture is not available and reconstructive surgery is required. The Autograft or the allograft method is used and it usually takes a few months for the surgical site to settle. 02 Arthroscope Excise a small hole, less than 1cm in diameter, in the effected joint area, insert a 2~5mm diameter arthroscope and surgical equipment. This method minimizes wounding and has the advantages of less post-surgery pain, a shorter hospitalization period and a more rapid recovery.

Arthritis of the shoulder

Definition

In comparison to arthritis of the knee or hip-joint, arthritis of the shoulder is uncommon however, once it has developed, patients will have serious discomfort in their daily lives due to pain and limitations of mobility. For patients over 50 degenerative shoulder arthritis is the main type of arthritis in the shoulder, while for younger generations it is caused by secondary factors such as post-traumatic complications, rheumatism, rotator cuff tearing, necrosis, etc.

Symptoms

• 01 Pain which becomes worse during activities
• 02 Limitations to shoulder-joint exercising
• 03 Frictions that produces clicking when moving the shoulder joint.

Treatment

Conservative treatment

In the earlier stages, arthritis in the shoulder-joint is treated through medication to control the pain with exercise therapy such as stretching and strengthening exercises.

Surgical treatment

01 Arthroscope In the earlier stages, where there is light ligament damage and fewer limitations on exercise, arthritis of the shoulder can be treated through arthrocentesis and debridement using an arthroscope. 02 Shoulder arthroplasty Shoulder arthroplasty can be considered when there is severe damage or deformity to the shoulder joint rendering partial treatment impossible. This surgery removes the severely injured joint that cannot function and inserts a specially engineered prosthetic joint. To assist the recovery of a normal joint exercise range and normal functions, active physical therapy must be followed. Diseases where shoulder arthroplasty may be considered A severe and complicated fracture of the humerus/ rheumatoid arthritis / total rupture of rotator cuff / rotator cuff arthropathy / avascular necrosis

Rotator cuff tear arthropathy

Definition

Once the rotator cuff tendon is ruptured, it will not heal naturally and if the rupture is neglected for a long time, the tendon becomes gradually drawn inside the joint and eventually it cannot be connected even with surgery. This causes the humerus to rise upwards and continue to collide with nearby tissues and bones, leading to degenerative changes.

Treatment

Reverse Total Shoulder Arthroplasty	If the patient is over 65 and cannot raise their arm, we practice reverse total shoulder arthroplasty.

Hallux valgus

Definition

As many people have become increasingly interested in fashion and prefer narrow-footed shoes, foot deformities have become more common especially among young women, and the number feeling pain in their big toes has increased due an increase in the wearing of high heels.

Symptoms

• 01 The big toe bends severely towards the second toe.
• 02 Pain and inflammation occur while standing or walking for a long time, due to friction with shoes.
• 03 Reduced function of the big toe (stability of inner side, power to kick to move forward while walking, etc.)
• 04 If the symptoms are severe, the big toe overlaps the second toe or dislocates, making it difficult to walk.

Treatment

Conservative treatment

It is important to wear comfortable shoes that do not irritate the protruding parts of the feet and avoid stilettos, which worsen the deformity of the feet.

Surgical treatment

There are various hallux valgus surgeries and the doctors will decide the appropriate methods based on the engagement state of the joint surfaces, the degree of deformation, the surgeon’s preference, etc. Generally, ‘distal chevron osteotomy’ is used for light hallux valgus but ‘proximal phalanx osteomy’ may be used simultaneously. Arthroplasty is rarely used due to issues of infection, implant infection, cost, etc.

Extracorporeal Shock Wave Therapy

Extracorporeal Shock Wave Therapy is a treatment method that uses shock waves, which have rapidly rising energy in very short periods of time, these are applied outside the painful area helping the reformation of veins and activating the surrounding bones to reduce pain and enhance functions.

Diseases that can be treated with Extracorporeal Shock Wave therapy

• Intractable diseases – frozen shoulders, golfer’s elbow, tennis elbow
• Intractable diseases – myofascial pain, calcific tendinitis, partial rupture of the rotator cuff, neck & shoulder pain, supraspinatus-biceps tendinitis
• Intractable diseases - bursitis, iliotibial band syndrome, knee osteoarthritis
• Intractable diseases – plantar fasciitis, pain on the sole of the foot
• Intractable disease – Achilles tendinitis
• Intractable diseases – All types of chronic musculoskeletal diseases

Injection Therapy

Ligament injection for strengthening

This injection therapy treats the fundamental cause of pain and resolves chronic pain by strengthening and renewing the weakened ligaments rather than working to temporally relieve pain.

Subjects for this therapy	Ligament pain (facet joint treatment) spondylolisthesis & stenosis discs spondylolysis scoliosis etc.

MBB (Medial Branch Block treatment)

This treatment is performed on the nerve responsible for the facet joints. It is an effective treatment that softens the vertebral facet joints, smoothing waist movement, easing pain and enhancing the ability to exercise.

Subjects that can be treated	Degenerative geriatric spinal disease spondylolisthesis & stenosis disc patients etc.

Exercise & Manual Therapy

This treatment is performed on the nerve responsible for the facet joints. It is an effective treatment that softens the vertebral facet joints, smoothing waist movement, easing pain and enhancing the ability to exercise.

Subjects that can be treated	Degenerative geriatric spinal disease spondylolisthesis & stenosis disc patients etc.

Korean Traditional Medical Treatment

Korean traditional medical treatment for joints

Arthritis of the shoulder, frozen shoulders, shoulder pain, degenerative knee arthritis, pyogenic arthritis, limb paralysis, rheumatoid arthritis, beriberi disease, gout, hand or foot numbness.

Korean traditional medical treatment is practiced to strengthen the weakened body parts and to restore immunity and the body’s self-sustaining ability.

Based on the results of radiological surveys using the latest imaging techniques; X-ray, MRI, CT, and bone density, etc., the Korean traditional medicine specialist selects the appropriate treatment for each patient and treats the disease with acupuncture and Korean traditional herbal medicine.

Korean traditional herbal medicine at Nasaret International Hospital uses top grade, pure, natural medicinal herbs, accurately dispensed by Korean traditional medicine pharmacists and prepared under a hygienic system. Our pills are also carefully dispensed for our patients and so are highly efficacious.

Stem Cell Treatment for Knee-joints

A knee joint regeneration therapy that treats arthritis of the knees while keeping the natural knee joint; Stem Cell Therapy!

Allogenic Umbilical Cord Blood derived, knee-joint regeneration, Stem Cell treatment is a new concept in treatment that separates mesenchymal stem cells from the allogenic Umbilical Cord Blood (human umbilical cord), cultures it and mixes it with polymer to induce cartilage regeneration in one surgery and so treat cartilage diseases such as degenerative osteoarthritis or osteoarthritis caused by repetitive trauma.

Based on clinical experience of surgery to the leg, Nasaret International Hospital maximizes the effectiveness of treatments for degenerative arthritis by simultaneously using stem cell therapy.

Advantages of Stem Cell Treatment

• 01 Can treat degenerative osteoarthritis or osteoarthritis caused by repetitive trauma in one surgical procedure.
• 02 Can offer certain therapeutic effects through selecting the optimum cell from the stem cells separated from the umbilical cord blood.
• 03 As the cell is separated from the allogenic umbilical cord blood and cultured, there is no change in effectiveness due to the patients’ age, disease or nutrition condition.
• 04 Can be collected and applied immediately when needed without requiring a culturing period.

Our "Stem Cell Center" keep doing research and giving treatments for patients suffering from intractable diseases to provide hope and happiness beyond specialized treatment.