Partial Knee Replacement Surgery with Ronald Hillock, MD
Jan 04, 2016
Ronald W. Hillock, M.D.
If you would have told me 4 years ago that I would be performing partial knee replacements (Uni) today I would have laughed. Traditionally this was a very technically demanding surgery with widely varied outcomes. Technical errors in cutting the bone and positioning the implant have previously been a major source of failure in Uni Knee Replacements[1]. Due to the irregularity of predictable success I had opted not to preform Uni Knee Replacements. That was until my wife Deb opted to have partial knee replacements and had an outstanding success.
Deb had tried everything prior to surgery. She tried injections, pills, physical therapy and braces with little or no relief in her knee pain. She gave up hiking with our dogs. She gave up almost every leisure activity we had enjoyed due to the pain in her knees. The pain was so severe that she avoided going to the store for fear of having to walk in her painful knees. Stairs were an impossible barrier under any circumstances. Her life was being dictated by her knee pain. Taking matters into her own hands Deb researched the options and decided to try Uni knee replacements (against my advice).
Needless to say the surgery was a complete success. Her recovery took about 8 weeks. Since the time of her the partial replacements Deb has been able able to resume her active lifestyle. This lead to a serious re-evaluation of my position on the Uni Knee Replacement.
I then began to research the topic and found that advances in robotic surgery and surgical planning have dramatically reduced the chances of error and increased the probability of success in Uni Knee Replacement surgery. I contacted the manufacturer of the latest version of the Uni Knee Replacement, Mako, and began the process of educating my self on the techniques and planning for this surgery.
Unicompartmental (Uni) Knee replacement is a surgery where only the diseased or damaged portion of the knee is replaced with metal and plastic, allowing the normal portions of the knee to be retained and removing the damaged portions. All the ligaments are retained allowing for more natural motion, function and most importantly it feels like a normal knee.
Published medical research has shown that robotic surgery for Uni Knee Replacement leads to greater accuracy in implant position. A study completed in the United Kingdom looked at the benefits of robotic knee surgery in the setting of Uni knee replacement[2]. They found the robot resulted in 100% accurate implant position while matched traditional methods resulted in only 40% accurate implant position. With robotics the surgeon makes a plan and can then execute the plan with complete precision and confidence.
When considering surgery I am often amazed when patients don’t ask how many of these surgeries of the type being discussed I have completed. I am told by the implant manufacturer that I have performed more MAKOplasty Uni Knee Replacements in Nevada than all other surgeons combined. Experience counts, when it comes to the MAKOplasty system I have learned through practice how to deliver a partial replacement with outstanding results.
Another factor that is often taken for granted is the hospital within which a surgery is preformed. A study published out of Sweden showed a direct relationship between quality outcomes and surgeon experience in partial/Uni Knee Replacement[3]. This study demonstrated what should have been common sense, the more partial knee replacements performed the less likely to have the need for additional surgery. High volume surgeons had a revision rate of less than 1% over a 5-year period while surgeons that preformed less than 8 Uni knees per year had revision rate of 6%. Stated another way, the low volume surgeon’s patients were 6 times more likely to need additional surgery within 5 years.
The Makoplasty Robot is located in Centennial Hills Hospital and Medical Center. The staff and leadership of this facility have devoted their efforts toward delivering the highest quality care attainable. In a recent published report by Consumer Reports showed that Centennial Hills is one of 37 facilities in the nation to achieve the highest level of safety scores for 10-key surgical care related measures. Compared to other facilities in Nevada, Centennial Hills Hospital and Medical Center scored highest for surgical safety issues.
All factors taken together if you have arthritis and have been advised that knee replacement is indicated I would be more than happy to help you consider your options. My team, facility and staff are truly expert at Uni knee replacement and I would be honored to help recovery your actively lifestyle.
Are you a candidate for Unicompartmental/ Partial Knee Replacement?
Schedule a visit with Ronald W. Hillock, MD at Nevada Orthopedic & Spine Center to discuss your options.
Learn more about MAKOplasty here
References
[1] Tregonning R, Rothwell A, Hobbs T, Harnett N. Early Failure of the Oxford Phase 3 Cemented Medial Uni-Compartmental Knee Arthroplasty: An Audit of the NZ Joint Registry over Six Years. J Bone Joint Surg Br 2009
[2] Cobb, J.; Henckel, J.; Gomes, P.; Harris, S.; Jakopec, M.; Rodriguez, F.; Barrett, A.; and Davies, B.: Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Joint Surg Br 2006
[3] Robertsson O, Knutson K, Lewold S, Lidgren L. The routine of surgical management reduces failure after unicondylar knee arthroplasty. J Bone Joint Surg Br 2001