As More Baby Boomers Head to the Operating Table, Virtual Reality Aids Surgeons in Joint Replacements

Monday, March 16, 2009

The number of hip and knee replacement surgeries has skyrocketed in the last 10 years, according to the American Academy of Orthopaedic Surgeons. The growth and aging of the population, particularly baby boomers, and improved diagnosis and treatment options will continue to critically influence those numbers.

In 2005, 285,000 total hip replacements and 523,000 total knee replacements were performed in the United States. A new study was presented at the 75th Annual Meeting of the American Academy of Orthopaedic Surgeons in March 2008. It said by 2030, these two procedures are expected to jump to 572,000 and 3.4 million, respectively.

Baby boomers are requiring surgery earlier and more often than previous generations because they lead more active lives and want to continue being active. New technology, better materials and improved surgical techniques have made this possible.

Orthopedic surgeons at Baptist Medical Center in Jackson, Miss., are among the first in the Metro Jackson area to use computers to help pinpoint perfect alignment for knee and hip replacements, and more recently, hip resurfacing procedures. Like global position systems (GPS) help drivers arrive at exact destinations in the world, a similar computer-assisted surgery helps surgeons align the patient's bones and replacement implants with a degree of accuracy not possible with the naked eye or traditional instrumentation.

Orthopedic Surgeons Jeff Almand, MD, and Brian Johnson, MD, of Mississippi Sports Medicine & Orthopedic Clinic have performed over 500 knee replacements with a 100 percent success rate to date, according to Dr. Almand. The first computer-assisted total hip replacement and hip resurfacing were performed the week of May 12, 2008. Dr. Almand said computer navigated joint replacement surgery allows the surgeon to make smaller incisions instead of the traditional larger openings.

"Small-incision surgery, most often referred to as minimally invasive surgery, offers the potential for faster recovery, less bleeding and less pain for patients," Dr. Almand added. "We can position new knees and hips with greater accuracy than ever. When patients have perfect joint alignment, they have improved range of motion and shorter rehabilitation times."

While using the computer to assist with the joint replacements and hip resurfacing, an infrared wireless tracker sends signals to a computer. The computer receives information from trackers providing details of position, alignment, range of motion, and movements. Then, three-dimensional images display range of motion, angular alignment, joint distraction and compression, and rotation plot the perfect coordinates where the new joints go. At the close of surgery, the system shows the patient's range of motion prior to surgery and following surgery.

Hip resurfacing is the newest alternative to treating hip arthritis. "Surface replacement of the hip has gained high interest in the treatment of hip arthritis in young patients," according to Dr. Almand. "Hip resurfacing is a type of hip replacement which replaces the two surfaces of the hip joint. Now, using computer assistance, it just adds greater accuracy in alignment."

In the hip resurfacing procedure, the head of the femur is retained, as opposed to the hip replacement, when it is removed. The head is reshaped and resurfaced with a metal mushroom-like cap and is secured in-place with a type of bone cement. Once the diseased cartilage of the socket portion of the hip joint is removed, a cup is press-fitted into place. Dr. Almand added that hip resurfacing leaves more natural bone in place and does not remove the thighbone (femur) neck shaft.

"Joint replacement using computer navigation has been a great breakthrough in joint replacement surgery to put these prostheses in a better position," Dr. Almand said. "Visibility is much more clear. The computer sees things for us."

For more information, call the Baptist Health Line at 601-948-6262 or 1-800-948-6262.

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