Doctors at the Hartford HealthCare Bone & Joint Institute at Hartford Hospital are using new technology to customize joint replacements, making recovery easier. Here’s more from Dr. Mark Shekhman, a Bone & Joint Institute orthopedic surgeon:
Q: At the bone and joint institute you use tools to assess the best route for each patient to ensure that they are ready for surgery. What are those tools?
A: Our first and foremost attempt at treating a patient with an orthopedic problem is to treat them without surgery. We try to maximize use of therapies, medications and supportive devices to improve ones function. But if these attempts are exhausted and a person does need to progress to surgery a combination of assessment tools are used. These include a combination of the old fashionedhistory and physical examination, of course, but also the use of questionnaire tools that most orthopedic offices are utilizing these days. Most visits start off with a computerized questionnaire about their problem and function which get processed by the computer program to give us a score and provide us with a better objective assessment of their disability. In addition, the use of xrays, MRIs and other imaging tools will help us create a plan that is unique and specific to each patients needs.
Q: There is talk of a new type of knee replacement – the uni-knee, how is this helping patients?
A: The uni-compartmental knee replacement, also known as a partial knee replacement, is not really new. We have been performing it for over 20 years. However, the technology has evolved over time and improved to make the procedure more successful and reliable. One advancement in this procedure is the use of robotics that has improved the accuracy in which the surgeon can implant the partial knee replacement.
This, in turn, has resulted in better outcomes and faster recovery. In fact, most of the uni- or partial knee replacements that I perform now are done in an outpatient setting. The surgery has become a same-day procedure allowing the patient to be home later that same day. In the past, most patients had to undergo a total knee replacement in the hospital, and some still do, but for those who qualify the partial knee replacement offers the patient the ability to forgo an admission to a hospital and have it performed in a surgical center, like the Hartford Surgical Center, which is affiliated with the Bone & Joint Institute at Hartford Hospital but still a separate entity and just next door.
Q: Many people have had knee replacement surgeries several years ago and are now having to have revisions to that surgery. You specialize in this, how do patients know when it’s time for the revisions?
A: As we all know nothing lasts forever. In the case of our joint that initially needed to be replaced, those replacements also have a lifespan. They are subject to daily wear and tear but despite being made of advanced materials like titanium and ceramics they, too, will eventually wear out. Our earlier generations of joint replacements lasted about 10-15 years. With today’s materials and technology they might last twice that long.
The first sign of a problem is experiencing a change in the usual function of that joint. Pain is common sign but not always. If something seems wrong or different it might warrant a checkup. More importantly is a periodic checkup with your surgeon to make sure the joint is functioning well. Just like bringing your car to the mechanic for periodic tuneups, our joint replacements should also be checked up on. Seeing your surgeon about every 5 years for a checkup with an X-ray might allow them to catch early signs of abnormal wear that might allow for a simpler fix than if one waited until the joint has worn out completely.
For more information about joint replacement surgery at the Hartford HealthCare Bone & Joint Institute, click here.