- All right, so thanks for joining us today.
My name is Chelsea.
I'm a physical therapist assistant
here at Center Point Medical Center.
And today we will be talking to Dr. John Eggers
about some of the most frequently asked questions
from patients considering joint replacement surgery.
So what exactly is a knee replacement surgery?
- It's an excellent question.
I've heard answered from patients
when I asked them what they think it is,
across the spectrum that is,
I feel people will be enlightened with this.
So what a knee replacement is,
is depends upon if it's a complete knee replacement.
Now, a partial knee replacement,
you only have half of this.
So you keep the majority of the bone,
both of femur and the tibia,
femur being the thighbone.
Now to complete knee replacement,
you remove the cartilage and arthritis,
which is the only way to actually cure arthritis,
and you place a cap on the top of that.
On the tibia side,
similarly so, you remove the arthritis there.
Then in between, you'll put a fancy piece of plastic,
highly cross-linked polyethylene,
at least for those using newer age components,
that improves your overall wear rate
to improve the longevity of a knee replacement.
(knee model clicking)
Now there's additionally on the back of the kneecap,
what you can't see here,
but if this were our kneecap or patella,
on the backside will be a piece of plastic.
So that way you don't have any arthritis remaining
under the kneecap either.
Now, it looks very simple.
Bend, straight,
what could be complex about a knee replacement?
Well, I will tell you,
the knee is one of the most complex joints of the body.
Here's the reason why, it's a hinge joint.
As it bends back it also translates posteriorly,
meaning towards the back.
There's also a rotational moment to it as well.
It is controlled and its stability from side to side
via your MCL and LCL, which are the ligaments on the side.
Additionally, so there's a PCL
that's retained there along the back
that's there also.
Additionally there are multiple ligaments
from the capsular structures along with additional muscles
such as the the IT band cross in the knee.
Reason being is that with smart robotics
it takes knee replacement to the next level.
And you say, well, how can that be?
Because before I ever make a cut with a knee replacement,
because you need the whole of the knee, the components,
I have a method that's been developed
that allows you to balance the knee.
And what is balancing the knee?
It means it has equal stability side to side,
straight
and also from front to back with a knee bend.
- What are some alternatives
to the traditional knee replacement surgery?
- Knee treatment,
as the goal of everything that we do,
is for alleviation of pain and return to overall
normal function to get people back to where they wanna be.
Some of these things can include something as simple
as activity modifications.
Sometimes utilization of ambulatory aids.
Often physical therapy provides a great relief
of many people's ailments surrounding the knee.
Sometimes we expanded into certain medications
from topical creams to oral medications.
Then beyond that we have the option
for possible intraarticular injections
and things of that nature
if you're an appropriate candidate.
I will say one of the most exciting things though
that we've developed
as an alternative to traditional knee replacement,
which I think we all know having seen mom or grandma
the pain they endured thereafter,
is that we've really been able to harness technology
providing us the ability for better,
more accurate and less painful surgery.
And some of this includes robotic,
smart robotic assisted surgery.
- What are the benefits to robotics assisted surgery?
- Some of the things about
the smart robotic assisted surgery
is the accuracy and the reproduction
of continued exact alignment
without relying upon external jigs
and things of that nature
that have so much error built into 'em.
Beyond that, when you have a system like this
you have the ability for partial knee replacements.
So you don't have to possibly have a full knee replacement,
which I'm sure as you can readily figure out
it means you maintain more of your own ligaments,
your own structures
and much less invasive overall
in order to get your pain improving
with a quicker recovery,
with less complications and less morbidity.
On top of that, let's say that you do end up having
a knee that requires a full knee replacement.
Well, the beautiful thing behind this is that
there's so much less involved.
We have some wonderful studies out there that
when you use a smart robotics platform,
one that's designed for balancing knees,
'cause one of the most important things
in a knee replacement is balance.
You don't have to have as much invasiveness into your cuts,
into the surgery,
into the invasion of the overall bone.
And by doing so, they've actually shown
in some very good studies, less pain,
less hospital length of stay,
improved recovery,
improved function
and quicker return to activity.
- What are the major risks of knee replacement surgery?
- Well, that's a great question.
You know, the risks of surgery, of course anywhere,
there's risks associated with any surgery,
there's risks without surgery too.
Some of the times when I talk to people and they say,
"Well, is it time for me to have surgery?"
And I'll tell 'em, "When your pain is no longer controlled,
"it's affecting your quality of life,
"that's one of those instances."
But a risk of not having surgery is
you might have somebody with arthritis,
when they started to have falls.
And falls are extremely dangerous.
So I think there are risks to surgery
but at times there are risks to avoiding surgery simply
because of the concern that might be associated with them.
Risks of surgery with a knee replacement are very similar
to those that you find with any other surgery.
The risks include the possibility for
damage to the tendons, the nerves,
the blood vessels, the tissue
these are all highly infrequent.
The most common things that you'll see
from a knee replacement though
is you'll see some swelling around the knee.
Another thing that you'll find
in anybody that has an incision
in the front part of their knee
is that they'll have some numbness over the outside of it.
You know, sometimes one of the bigger complaints
you hear from people after a knee replacement early on is,
it's just not my knee.
Well, that's true, it's not your knee
but you'll also hear them quickly say thereafter,
it sure hurts a lot less than my original knee.
- So after surgery
how quickly can I get back to my daily activity?
- That's an excellent question.
And that varies for everybody.
And it depends upon what your daily activities are.
What I tell almost everyone is
I usually expect people to be on a walker
for one to two weeks
and a cane for one to two weeks after that.
Then you have slowly increased overall function, movement.
I'll tell you the spectrum widens vary,
spectrum varies widely between different people
and how quickly they recover.
Sometimes we'll have people at three weeks
who are flying around and you couldn't even tell that
they had a knee replacement done.
At other times they'll take a little bit longer
and it might be two or three months
and they'll still have some aches here and there
but they'll be back to their function.
What I can tell you though, is that over and over,
from my own actual experiences,
and additionally from all of our literature
from the larger studies put together,
we know that with smart robotics
you have a quicker recovery to your overall function.
And by 90 days, your overall function
and quality of activity,
meaning getting closer back to doing what
your now normal activities are,
are much better with a smart robotic system
assisting during the surgical process.
- That's awesome.
What are some of the additional precautions
that we are taking related to COVID-19?
- Additionally so of course,
we're doing all of the other precautions,
screening all people coming into the hospital,
limiting the number of visitors,
limiting the hours present,
making sure that all employees have been vaccinated,
which is an excellent thing that we've been able to do
to reduce risk of transmission
from hospital care workers to patients.
So all of these together really minimized
what you call contact interactions
or hospital acquired COVID cases
secondary to the extensive protective nature going on here,
trying to really care for people all the way around.
- [Chelsea] Thanks for learning more
about robotics assisted surgery options.
To see if you're a candidate for this surgery
please speak with your primary care provider.