Surgeons Perform Computer-Assisted Knee Replacement Surgery

DANBURY — Orthopedic surgery at Danbury Hospital is known for using leading edge technology to expedite patient recovery. Operations such as arthroscopically assisted anterior cruciate ligament reconstruction, minimally invasive total knee replacement, and microdiscetomy were introduced into clinical practice in Connecticut by orthopedic surgeons at Danbury Hospital.

Now, a team of orthopedic surgeons is again using modern technology to improve surgical outcomes. Craig Foster, MD, Danbury Hospital Department of Surgery, Section of Orthopedic Surgery, and other orthopedic surgeons now use computers to help them perform minimally invasive surgical procedures.

Global medical device maker Smith & Nephew developed a new minimally invasive total knee replacement surgical application that is currently being used at Danbury Hospital. The device combines an infrared image and a proprietary computer and camera system to track the precise location of the bones, the shape of the joint, and the location of the bones relative to the instruments used during the surgery.

The application enabled Dr Foster to make computer-guided cuts to within one mm and one degree of perfect alignment, a rarity in knee replacement surgery. During the traditional knee replacement surgical procedure the surgeon relied upon cutting blocks, personal estimates of proper joint alignment, and the general feel of the joint to determine the implant placement.

“Implant alignment during knee replacement surgery is vital,” explains Dr Foster. “This procedure not only enables a higher degree of accuracy, but eliminates certain steps required in the traditional surgery. It also is a much less invasive technique.”

In addition, real time images of the instruments and the knee implant itself can be superimposed over the patient’s knee on a comFputer screen. Orthopedic surgeons using the software can now determine the fit and alignment of the new implant even before they make the first cut.

“This is the future of orthopedic surgery,” says Dr Foster. “And fortunately, residents in the greater Danbury area can stay close to home to receive this standard of care today. Contrary to common assumptions about cutting-edge procedures, a trip to the major urban medical centers is not necessary.”

Every year in the United States, approximately 350,000 total knee replacement surgeries are performed. As the baby-boomers are aging but not slowing down, total knee replacement surgery is becoming more and more common. Each year increasing numbers of people are developing arthritis in the knee, and this is becoming even more common as life expectancy is going up and people remain physically active longer than they did in previous generations.

For more than one year, minimally invasive surgical techniques for orthopedic procedures have been used at Danbury Hospital. Ronald Tietjen, MD, Danbury Hospital Section of Orthopedic Surgery, pioneered the technique with Dr Foster through the use of computer-assisted technology that helped champion the procedure.    

This offers the patient less postoperative pain and a quicker return to physical activity and allows patients to get back on their feet more quickly.

When a knee is being replaced, the surgeon removes the top portion of the tibia and replaces it with a metal platform and a plastic liner that replaces the knee’s cartilage. The surgeon also removes the arthritic layer at the tip of the femur and replaces this with a very strong component made of alloy metal. This metal component moves against the plastic piece to restore the now pain-free artificial joint to physical activity. There also is a plastic cap that is inserted on the back of the knee.

In traditional knee surgery, the incision that is normally performed is between eight and ten inches long. Using the new procedure with an incision as small as three and a half inches and combined with the precision of computed-assisted technology helps reduce the margin of error to less than one degree, which is incredibly accurate. The more precise the fit of the prosthesis, the longer the prosthesis will last. There also are obvious cosmetic advantages to a shorter incision and the longevity that precise placement of the components that is a tremendous boost to the increasing number of people who will require the operation in order to enhance their quality of life and to relieve their day-to-day pain.

A minimally invasive joint replacement orthopedic surgery program has been developed at Danbury Hospital by orthopedic surgeons Robert Deveny, MD, and Daniel Fish, MD It is their goal to extend these modern technologies to hip replacement. “Patient safety and satisfaction has always been our goal. Now, with minimally invasive joint replacement and computer assisted surgery, we feel that we can consistently exceed patient expectations,” said Dr Fish.

According to Dr Deveney, modern joint replacement techniques offer rapid recovery, and patients can expect years of painless mobility.

All of the orthopedic surgeons in the Danbury Hospital Department of Surgery, Section of Orthopedics are board certified and offer a full spectrum of orthopedic care, including, sports medicine, hand surgery, spine surgery, trauma, and general orthopedic care.

For more information about the minimally invasive knee surgery, call an orthopedic surgeon, or the Danbury Hospital Department of Surgery at 797-7449.