Andrew Pepper, MD, an orthopedic surgeon at Gulf Breeze, Fla.-based Andrews Institute for Orthopaedics and Sports Medicine, examined the past, present and future of total joint replacements in the Andrews Institutes' newly created video series.
Here, Dr. Pepper talks about the improvements made to implants and theorizes how biologic treatments could advance the procedure further.
Note: Transcript was edited for style.
Dr. Andrew Pepper: Physicians providing joint replacement treatments have seen a revolution over the past 40 years. When we first started doing these surgeries, patients were spending weeks at a time in the hospital recovering. It was a big deal for patients to have these surgeries because the recovery was prolonged and full of complications. Now, we've made drastic changes on a variety of fronts:
1. The implants have changed dramatically to give patients less pain and better outcomes. The longevity of a hip or knee replacement is much better than it was when we first started.
2. We've improved pain and recovery [protocols] after the surgery so that patients can get up and move right away. We've also found that getting the patients to move postoperatively decreases complications after surgery and improves their recovery.
3. We've also decreased our complication rate by studying complications and the things that lead to them. One example is requiring patients to go through a preoptimization process to try and improve their health before we agree to proceed with the surgery. This process has made a big difference in outcomes; it also decreases complications and gives patients relief from hip and knee pain.
We've seen such a great change and improvement since these surgeries were first developed. We hope to carry that into the future. Some of the things that are going to make big differences for patients who need hip and knee replacements are things like outpatient procedures where patients don't require a hospital stay and they can recover at home more comfortably. Another thing is doing surgery in a more minimally invasive fashion to decrease pain and complications.
I also see on the forefront of what's happening right now is the introduction of robotics or computer navigation to help assist us during surgery. Beyond that, there's an active field of research, right now, looking at regenerating cartilage, using stem cells to try to decrease arthritis or try to regenerate lost cartilage. Unfortunately, we don't have an absolute answer right now, but that research into regenerative medicine or stem cell medicine is probably going to revolutionize the future, hopefully, for arthritis care.
To view the video, click here.
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