Hip, knee and other joint replacement procedures are among the most common elective surgeries in the United States with more than 7 million Americans living with a prosthetic knee or hip.
Patients also are seeking joint replacement at an earlier age, according to the American Academy of Orthopaedic Surgeons. The trend likely is driven by a generation of adults who have been active and athletic through adulthood and expect their level of activity to remain high as they age.
Advancements in joint replacement technology and surgical techniques now make it possible to significantly reduce recovery times and improve joint replacement outcomes, according to orthopaedic surgeons Cory Calendine, M.D. and Brian Perkinson, M.D with Bone and Joint Institute of Tennessee.
“Our patients come to us with very high expectations and are less inclined to endure years of pain before seeking relief. They want to get back to work, grand kids, sports, whatever is important to them,” said Calendine. “Our goal is to give them the ability to live their life without restrictions, get more miles from a joint replacement and help it to last longer.”
Robotic technology at Williamson Medical Center is helping surgeons do just that. In joint replacement surgery, the arthritic portion of the joint is removed and covered with a combination of plastic and metal parts that form new surfaces of the knee or hip. During a robotic procedure, surgeons use computed tomography (CT) scans to map a virtual model of the patient’s knee. With that model as guide, the surgeon then uses the robotic arm to embed the components of the new knee with precision.
This robotic technology is a tool that allows the surgeon to perform a more accurate placement and achieve better balance of the orthopaedic device to more closely replicate the normal joint mechanics.
“We believe a more accurate alignment of components offers a better range of motion and better functional outcomes for our patients,” said Perkinson. “It stands to reason that improved alignment also will help a joint replacement to last longer.”
“One major reason for pain following joint replacement is instability - or “looseness” - in the replaced joint,” Calendine said, “But, the latest robotic technology being used at Williamson Medical Center and Bone and Joint Institute Surgery Center, can detect that at the time of the surgery and address that at the initial surgery.”
According to Perkinson, robotic technology is a real game- changer for partial knee replacements, which are a large part of his surgical practice. “Robotic technology allows us to do smaller procedures like partial knee replacements instead of total knee replacements with as good, if not better, outcomes,” he said. “Joint replacement is traditionally done using anatomical landmarks. Now we can more accurately balance the knee to the individual person.”
“Partial knee replacement is a great option for many patients because only a small portion of the knee is resurfaced and it maintains more of the normal knee function,” said Perkinson. “However, it requires very precise alignment and accuracy for it to function properly. As surgeons, we are highly skilled technicians and the robotic technology provides a second point of reference and precision.”
“The robotic technology is especially good in patients who have joint injuries, fractures or abnormal anatomy that makes using traditional anatomical landmarks more complex,” said Calendine, who trains and educates orthopaedic surgeons from across the world on these procedures.
While greater sophistication in orthopaedic implants and new, less invasive procedures are helping to meet patient expectations, recent advances in anesthesia and pain control are making recovery far less difficult. In fact, a growing number of joint replacement surgeries can now be performed as an outpatient procedure.
“Outpatient surgery is safer because it involves no general anesthesia and very little or no narcotic pain medication, resulting in fewer side effects and faster recovery,” said Calendine. “Advanced recovery techniques get patients moving within two- four hours after surgery and early ambulation lessens the risk of blood clots in the legs or lungs. It also enables us to eliminate the use of heavy blood thinner medications.”
“Shorter hospital stays or performing surgeries in an outpatient setting also decreases exposure to other sick patients,” he said. “The bottom line is less pain and less down time for our patients so they can get back to what they want to do.”