What's New in Knee and Hip Replacements

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Every year, roughly 790,000 total knee replacements and 544,000 hip replacements are performed in the U.S. But as the population ages, those numbers are expected to soar by over 600% in the next 10 years. A hip or knee replacement can make a huge difference in a person’s comfort, mobility and quality of life. What’s more, today’s prosthetic joints can last for 20 years and more.

Because these surgeries are so common and so life-changing, researchers are always coming up with refinements and innovations. Let’s look at some of the most recent developments in knee and hip replacement surgeries.

Mako® Robotic-Arm Assisted Surgery

Robotics have revolutionized traditional surgery, providing surgeons with greater precision, flexibility, and control than ever before. Used for total hip and total and partial knee replacements, the Mako® Robotic-Arm Assisted Joint Replacement allows your surgeon to customize the procedure to your knee or hip joint.

Nonrobotic-assisted total knee replacement surgery, including procedures using computer navigation, rely on static imaging such as X-rays, CT scans or an MRI taken before surgery to plan bone alignment and the overall implant. However, static imagery does not take into account how the joint moves. This makes it hard to predict how a prosthetic joint will work with surrounding ligaments and tendons. The Mako System utilizes CT-based 3D modeling of bone anatomy to help surgeons create a customized surgical plan that tailors the size, orientation, and alignment of the implant to each person’s unique anatomy.

The surgeon starts by making a small cut in your knee to expose the knee joint. Mako robotic software allows them to see how your joint moves. This data is combined with information from the pre-surgical imaging scan, enabling the surgeon to precisely align the joint and balance the ligaments. Because your surgeon can see in advance how a particular cut will affect the joint and surrounding structures, they don't have to make corrective cuts to get the balance right. If needed, the system also lets the surgeon virtually modify the surgical plan during a procedure and assists them in executing bone resections.

Benefits of Mako robotic surgery include:

• Less physical trauma during surgery 
• A faster, more accurate operation
• A shorter length of stay – most people go home the day of surgery, or the next day
• Reduced pain
• More rapid healing – most people walk unassisted two or three weeks after surgery
• Better outcomes, with a more natural feeling joint

Mako robotic surgery is not appropriate for people who need a previous joint replacement repaired or redone.

Read how a minimally invasive approach to hip replacement put a trailblazer back on track.

The ROSA® Knee System

The Robotic Surgical Assistant, known as the ROSA® Knee System, is a robotic-assisted surgical system designed for knee replacement surgeries. Like the Mako system, the ROSA Knee System employs robotic technology to help surgeons plan and execute knee replacement surgeries. It provides real-time data and precision for more accurate pre-operative planning and more precise alignment and positioning of the knee implant.

The ROSA Knee System has advantages similar to those of the Mako system: customization, real-time feedback and navigation assistance during surgery, enhanced precision, reduced pain, and a faster, more comfortable recovery.

Multimodal Pain Management

Multimodal pain management is a strategy to lower the risk of opioid dependency while improving patient experience. This approach combines several classes of medication that target different pain receptors. The types, combinations, and delivery method of these medications differ based on the patient’s needs.

In the case of hip or knee replacement, medicine may be given before surgery. Spinal anesthesia, which numbs your body below the waist without affecting the entire central nervous system, is preferable. This approach reduces pain and grogginess after surgery for a more comfortable recovery. Anesthesia during surgery may be supplemented with injections to the knee.

A Look at the Future

Research into joint replacement medicine continues apace. Below are just a few enhancements and innovations currently in development.

• Biological Approaches such as the use of growth factors and stem cells, to accelerate tissue healing for a faster recovery
• Regenerative Medicine, a growing field of tissue engineering that can stimulate cartilage growth and could eventually reduce or even eliminate the need for traditional joint replacement
• Smart Implants with sensors that provide real-time data on joint function, load, and wear, allowing for closer monitoring during rehabilitation and early detection of potential issues
• Innovations in surface materials to reduce wear and tear, extending the lifespan of implants
• 3D printing for the design and creation of custom implants in challenging cases such as deformities, bone loss, or unusual hip or knee anatomy

Learn more about the leading-edge orthopedic services offered at El Camino Health, designated as a Blue Distinction Center® for knee and hip replacement surgery. Or, get more information on hip replacement options and knee replacement options.

If you’re considering joint replacement surgery our team of expert orthopedic surgeons is ready to help. Click here to find a doctor.

This article appeared in the Summer 2024 edition of the HealthPerks newsletter.