Dr. JAVAD PARVIZI

Please use WhatsApp or Telegram line +90 (537) 699 81 11 or +1 215 356 8201

You can also contact International Joint Center Coordianator Dr. Aida Miadfar at aida.miadfar@acibadem.com

The International Joint Center (IJC) is located at Acıbadem Maslak Hospital in Istanbul, one of the leading medical facilities in Türkiye.

• Hip preservation

• Hip and knee arthritis requiring joint replacement

• Failed hip or knee replacements requiring revision surgery

• Patients with periprosthetic joint infection (PJI)

• Patients with complex deformities of lower extremities

Yes. Dr. Parvizi mentors fellows through internationally recognized programs, offering both surgical and research training opportunities.

There are many reason why a replaced joint can hurt. One of the most important causes of pain related to periprosthetic joint infection (PJI). This condition occurs when bacteria or fungi enter the area around the artificial joint and result in formation of biofilm on the implant, leading to pain, swelling, and difficulty with moving the joint.

Treatment Options for PJI

Treatment depends on how severe the infection is and when it occurs after surgery.

1️ DAIR Procedure (Debridement, Antibiotics, and Implant Retention)

• If infection is caught early after replacement, w emay be able to retain the implant and perform cleaning and wash out, otherwise known as DAIR (debridement, antibiotics and implant retention).

• During DAIR the surgeon cleans the infected area, replacesmoving parts of the joint, followed by antibiotic treatment

• The result of DAIR is very much dependant on how good the surgeon can clean the joint. We utilize a multistep approach and use numerous antiseptic solutions during DAIR. .

2 One-Stage Revision Surgery

• In some cases, when the implant is not grown into bone yet (and hence is easy to remove) or in chronic infection cases, we remove the entire prosthesis and perform extensive wash out

• During the same surgery, and when we are convinced that the infection has been cleared, we insert new implants

• Not many centers are able to do one-stage revision surgery. I have been doing this procedure for many years and this is my preferred method of treating many infections. Obviosuly this option is so much better fort he patient.

3 Two-Stage Revision Surgery (For Severe Infections)

• We sometimes need to do two operations to clear the infection, During the first surgery the infected implantsa are completely removed, and a temporary spacer with antibiotics is placed.

• During the second surgery, some weeks later, and after completion of course of antibiotics, a new joint implant is inserted.

You may be a candidate if you have:

✔Severe knee pain that affects walking, climbing stairs, or daily tasks. ✔Osteoarthritis or Rheumatoid Arthritis causing joint damage.

✔Deformity – such as a bowed or knocked-knee appearance.

🔹There are many different ways to do knee replacement. We prefer to use small incision and minimal soft-tissue dissection. The surgery is performed by making a small incision over the knee

🔹 The surgeon removes damaged cartilage and bone from the knee joint. Leaving the healthy bone intact

🔹 A metal and plastic implant (prosthesis) is placed to mimic a natural knee joint.

🔹 The artificial joint allows for smooth movement and eliminates pain.

The surgery takes about 1 hour. Patients walk on the same day as the surgery. Patients typically stay in the hospital for a day or two to recieve physical therapy.

• Walking with support starts within 24 hours after surgery.

• Physical therapy is crucial for regaining strength and movement and is started on the same day as surgery

• Most patients return to normal activities within 6–12 weeks.

Recovery time varies depending on the patient’s overall health, the procedure performed, and the complexity of the case. Most patients are able to walk the day after surgery and should be fully recovered by 6-12 weeks.

Patients with severe hip arthritis, hip fractures, or other cause of joint damage who experience persistent pain, stiffness, or reduced mobility may be candidates for hip replacement. Most patients are treated by non-surgical means for a while. Surgery is offered when all other options have failed.

Hip replacement (arthroplasty) is a surgical procedure where the damaged parts of the hip joint are replaced with artificial implants to relieve pain and improve mobility. There are many ways to do hip replacement. We perfer to use the anterior approach to the hip that spares cutting any muscles, requires a very small incision, and allows for faster recovery.

Recoverd depends on how the hip replacement was done. When done through direct anterrio approach, the patients walk a few hours after surgery (using cane or a walker), leave the hospital soon after anda re allowed to do most activities within days. Patients can sleep on their side, drive, walk up stairs, and resume sports very quickly. Using direct anterior approach and sparing the muscles reduces the risk of dislocation after replacement to almost zero and hence patients do not need to make any adjustments to sleeping, toilet, chairs and so on.

Patients can typically return to walking, swimming, cycling, and golfing. We also do not stop patients from engagein high impact sports like running, skiing, weight lifiting and so on.

Hip preservation refers to a group of treatments and surgeries designed to keep your natural hip joint without replacing it with implants. This allows for normal functioning of the joint for as long as possible. Instead of replacing the hip with an artificial implant, the goal is to correct problems early, relieve pain, and delay or avoid hip replacement surgery.

Patients with hip pain caused by structural issues such as femoroacetabular impingement (FAI), hip dysplasia, or early cartilage/labral damage may be candidates for joint preservation procedure. These are often younger and active patients without much damage to joint cartilage.

• Hip arthroscopy – a minimally invasive surgery to repair labral tears, remove impingement, or smooth cartilage.

• Periacetabular osteotomy (PAO) – re-aligns the hip socket in patients with dysplasia.

• Femoral osteotomy – reshapes the thigh bone to improve hip function.

• Cartilage or labral repair – restores damaged tissue.

Typically, younger and active patients with hip pain but without advanced arthritis are good candidates. If the joint still has healthy cartilage, hip preservation procedures can be very effective.

This depends on how much arthritis is present. If your hip joint is already badly worn, replacement may be the best option. If you have pain but the joint is still healthy, hip preservation can provide pain relief and extend the life of your natural hip.

Recovery is a process, and it varies depending on the type of surgery. For arthroscopy, many patients walk with crutches for a short period and then progress to physical therapy. For osteotomies, recovery takes longer, but the results can be life-changing when the hip is properly realigned.

PJI is an infection that occurs in an artificial (prosthetic) joint. It can happen shortly after surgery or years later.

Symptoms include persistent joint pain, swelling, warmth, redness, fever, and sometimes drainage from the surgical site.

Treatment may involve antibiotics, surgical cleaning (debridement), implant removal and replacement, or staged revision surgery depending on severity.

Yes. Preventive strategies include strict infection-control measures during surgery, patient optimization (e.g., diabetes control, smoking cessation), and prophylactic antibiotics.

Dr. Parvizi has led global efforts to improve infection prevention, including chairing the International Consensus Meeting (ICM) on Musculoskeletal Infection, which established worldwide, evidence-based guidelines. He has served as a member of nuemours guidlines committees for infection prevention including the Guidelines produced by the Center for DIsease control (CDC).

With appropriate treatment, most patients recover. However, outcomes depend on patient health, timing of intervention, and type of organism causing infection. We have a very high success rate (over 90%) in treating patients with PJI. We also utilize one stage exchange (one operation as opposed to two operations) to treat PJI.

Yes, many patients return to active lives after treatment, but recovery may take longer than primary hip replacement surgery.