The rheumatology ward of the internal medicine clinic at the Tampere University Hospital was established in Pikonlinna in 1977. In those days minor arthritis surgery was carried out by orthopedic surgeons from the Tampere Central University Hospital (orthopedics is the branch of medicine and surgery concerned with diseases of the musculoskeletal system. Orthopedics involves surgical procedures of joints, bones, muscles, ligaments and cartilage) in the surgical ward of the central hospital, whereas the patients requiring more demanding arthritis surgery were referred to the Rheumatism Foundation Hospital in Heinola.
The Pikonlinna hospital introduced arthritis surgery services in 1978. Dr. Hannu Pätiälä was working as a physician specializing in orthopedics in the Tampere Central University Hospital. He had also worked in the Rheumatism Foundation Hospital in Heinola as an assistant physician in surgery and as a senior physician in charge of a ward in 1971 -1975 and he had acquired advanced skills in arthritis surgery. The introduction of arthritis surgery in Pikonlinna was entrusted to him. Pätiälä performed surgery 1 – 2 days a week. There were no resources to hire an anesthesiologist from the Tampere Central University Hospital in Pikonlinna, which is the reason why operations could only be carried out in local or block anesthesia. Now only the patients whose condition required major arthritis surgery requiring anesthesia were sent to the Rheumatism Foundation Hospital in Heinola.
Dr. Pentti Rokkanen, who was a professor in surgery at the University of Tampere, transferred to the professorship of the I surgical clinic at the University of Helsinki in 1981, bringing with him dr. Hannu Pätiälä, who had been in charge of arthritis surgery. Before this transfer dr. Pätiälä had taught the basics of arthritis surgery to Heikki Aho and Markku Härkönen, who were specialists in orthopedics in the Tampere Central University Hospital and also worked as assistant teachers at the university from time to time. They occasionally trained in the Rheumatism Hospital in Heinola. After Aho assumed a post in orthopedics in the Hatanpää Hospital in 1985, doctor Turkka Tunturi also pursued arthritis surgery for short periods in 1985.
After the mid-1980s the responsibility for the patient queue in arthritis surgery (ca. 230 patients) was shifted to ward 23A, and simultaneously the post-operative care of patients who needed ward monitoring was also transferred there. At that time an anesthesiologist also came aboard, which extended the range of surgical procedures that could be offered. In addition to dr. Markku Härkönen, orthopedic surgeon dr. Pekka Halonen also performed surgical procedures. When needed, they also carried out consultations in ward 23A, which provided arthritis surgery, orthopedic surgery, and outpatient surgery.
Hip and knee prosthesis operations were started in Pikonlinna around that time. As far as highly advanced joint diseases are concerned, there emerges a need, either after or instead of joint saving procedures, for an operation in which destroyed parts of joints are replaced with artificial ones e.g. of metal. Joint replacements enhance a person’s quality of life by removing pain and improving one’s physical functions. Joint prosthesis surgery can help both degenerative and inflammatory arthritis patients. In 1987 orthopedist dr. Juha Nevalainen organized the surgical activities into two categories – minor orthopedics and ambulatory surgery including procedures from other fields of surgery (ambulatory surgery refers to procedures that do not require post-operative care in a hospital.)
After dr. Markku Härkönen transferred to the private sector, specialist in orthopedics and traumatolgoy (traumatology refers to surgical treatment of injuries and acute medical conditions, often in the emergency room) dr. Lehto became the assistant chief in charge of arthritis surgery and orthopedics in Pikonlinna in 1992. He expanded the department’s repertoire of medical procedures with the introduction of shoulder and elbow joint replacement surgery. The lease with the Rheumatism Foundation Hospital in Heinola was terminated around the same time, but co-operation in the scientific field of arthritis surgery was initiated.
The renovation of Pikonlinna’s operating room and recovery room was implemented in 1993 and both the departments of rheumatology and arthritis-orthopedics obtained the posts of senior ward physician at that time. The surgical post was given to arthtisri-orthopedist Mauri Lehtimäki from the Rheumatism Foundation Hospital, a recognized expert in foot surgery. At this point all surgery for arthritis in the hospital district was concentrated in Pikonlinna, but services were also provided to some special responsibility areas to a small extent.