• WORDS Dr Stuart Mackenzie

Advances in Hip and Knee Replacement Surgery

Over the 50 years since artificial joint replacement became available, there have been many advancements in technology. Over the same time, hip and knee replacement surgery has become increasingly common. With an ageing population, there is expected to be even greater need into the future.

So, what changes have happened in hip and knee replacement technology recently?

Direct Anterior Hip Replacement

There has been a trend over the last few years to perform hip replacement surgery through the direct anterior approach. Although the direct anterior approach has been around for a long time, it has become much more popular recently as equipment advances have made it somewhat easier to do a hip replacement this way.

It has been suggested that the direct anterior approach may allow faster recovery from surgery as the surgeon goes between muscles rather than having to split muscles or detach them from the bone. It has also been suggested that this may lead to a lower risk of dislocation of the hip replacement, which, although uncommon, is a potentially very serious complication.

Direct anterior approach hip replacement is not suitable for all patients, and other approaches for hip replacement are still excellent, very successful ways to do a hip replacement.

Robotic-Assisted Hip and Knee Replacement

Although used in the USA for almost ten years, robotic assistance for hip and knee replacement has only been available in Australia for a relatively short time and is still only available at a limited number of hospitals and used by a limited number of surgeons.

The surgeon uses the robot during the operation to prepare the bone and position the artificial hip or knee. The purpose of the robot is to achieve more accurate positioning of the hip or knee replacement than can be achieved through traditional techniques.

Accurate positioning of the joint replacement parts is critical to the success of hip and knee replacement.

It may affect how long the hip or knee replacement lasts. Poor positioning of the parts in a hip replacement can lead to dislocation of the hip and the need to redo the hip replacement. Robotic-assisted surgery is currently available in Newcastle for total hip replacement, total knee replacement and partial knee replacement.

Partial Knee Replacement

Unicompartmental (partial or unicondylar) knee replacement is suitable for some patients where only part of the knee is affected by arthritis. Up to one in 5 patients who need a knee replacement may be suitable for a partial knee replacement rather than total knee replacement.

The knee is made up of three compartments: medial, lateral and patellofemoral compartments. In a unicompartmental knee replacement, only the diseased compartment of the knee is replaced, and the remainder of the knee is left untouched.

In partial knee replacement the incision is smaller, and, unlike total knee replacement, no ligaments have to be removed. Recovery from a partial knee replacement is usually faster than for total knee replacement and knee function may also be better.

Partial knee replacement has been around for a long time. The popularity of partial knee replacement in Australia is increasing due to the availability of robotic-assisted surgery. The Australian Joint Replacement Registry has reported that partial knee replacement done using robot assistance is less likely to fail early than a partial knee replacement done without robot assistance.

Visit www.drstuartmackenzie.com.au for more info.

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