New Advances In Total Joint Replacement

DANBURY — While arthritis causes 43 million Americans pain and limited mobility, total joint replacement surgery continues to improve, now helping approximately 600,000 patients each year.

The surgery has become so advanced for arthritic knees and hips that it can be done minimally invasively, which means a smaller incision, less bleeding, less pain, and a quicker recovery.

Danbury Hospital has been a leader in this surgery, according to Robert Deveney, MD, and Daniel Fish, MD, co-directors of the Total Joint Replacement Program, and orthopedic surgeons in the Department of Surgery, Section of Orthopedic Surgery.

The hospital performs about 500 total knee and hip replacement surgeries a year, according to the co-directors, the fifth highest number of all 29 Connecticut hospitals.

 Dr Deveney and Dr Fish spoke to the community about joint replacement, along with Ronald Tietjen, MD, and Craig Foster, MD, from the hospital’s Section of Orthopedic Surgery, at a Medical Town Meeting sponsored by the hospital, “Make Your Next Step a Good One: Modern Concepts in Knee and Hip Replacement Surgery.”

The big news from the surgeons is that joint replacement surgery has become a lot better over the years, with the advancement of minimally invasive technology.  The addition of new joint replacement materials has also improved the prostheses, making them last much longer.

“Minimally invasive surgery has made a huge change for patients,” said Dr Deveney, calling it “revolutionary.” The panel explained how osteoarthritis, a degenerative condition, wears away protective cartilage around a joint, which is like a ball and a cup. When cartilage is worn away, bone rubs on bone and it hurts.

Arthritis is first treated with lifestyle adjustments, medications, and physical therapy, but when that no longer works and the disease interferes with one’s work and activities of daily living, joint replacement is an option.

The new minimally invasive technique reduces the length of an incision from eight-to-ten inches to about three-to-five inches. A smaller incision is less traumatic to surrounding soft tissue, according to the doctors. Recovery time is also reduced, with most people leaving the hospital after three days, and seeing maximum improvement in two to three months.

The artificial joints are also now being made with improved new materials, according to the doctors, which can last longer, possibly up to 30 years.

Joint prostheses used to be made of metal-on-metal and metal-on-polyethylene, but now they include ceramic-on-ceramic, which can last longer for more active and younger patients, eliminating the need for revision.

“New technology is meeting the needs of younger, more active patients,” said Dr Deveney. 

While all this is good news, Dr Fish reminded patients that this is still considered major surgery and involves a commitment by patients to rehabilitation.

Dr Foster discussed how computers are aiding the minimally invasive surgery. He also discussed a new procedure, called unicondylar knee surgery, used when only part of the knee is affected by arthritis. In the “uni-knee” procedure, only part of the knee is replaced.

“Total joint replacement is not a miracle,” he said, “but the joints will last a long time and will relieve pain. It truly gives people a new lease on life.”

For more information regarding minimally invasive joint replacement surgery, visit danburyhospital.org or ask your doctor.