Partial Knee Replacement: A Growing Alternative For Younger, Active People

Robotics in Surgery Allow for Increased Accuracy and Reliability

NEW YORK—May 7, 2008 

As an avid golfer and hiker, Richard Shippee was not ready to give up his active lifestyle because of knee pain. After learning about a new partial knee resurfacing procedure, Mr. Shippee realized he didn’t have to put down his golf clubs just yet.

After undergoing partial knee replacement surgery, the Manhattan resident was able to return to walking in as little as three days and was golfing within two months.

“I was able to return to work three days after my surgery,” said 57-year-old Mr. Shippee, who had the partial knee resurfacing procedure done at New York City’s Hospital for Special Surgery in June of 2007. “The surgery allowed me to walk a full 18-hole course only two months after.”

“The partial knee resurfacing surgery, ideal for younger, active people, allows for a short recovery time, good mobility post-surgery and a quick return to everyday activities such as work, driving and walking,” said Andrew D. Pearle, M.D., assistant attending orthopedic surgeon at Hospital for Special Surgery.  “Importantly, the procedure is bone sparing so that a total knee replacement, if needed down the road, is not compromised.”

Prior to the surgery Mr. Shippee was experiencing pain in virtually all areas of motion. “I couldn’t walk the golf course and struggled on stairs,” he said, adding “I noticed a marked decrease in quality of life.” He was referred to Hospital for Special Surgery by his orthopedist in Connecticut. After his consultation with Dr. Pearle, Mr. Shippee agreed that partial knee resurfacing was the best choice for him to maintain his active lifestyle.

Partial knee resurfacing is a bone preserving procedure that leaves patients with two-thirds of their natural knee surface allowing individuals to return quickly to enjoying recreational activities. It may also decrease the chances of needing total knee replacement surgery in the future, according to Dr. Pearle. Partial knee resurfacing procedures at HSS are done using regional anesthesia rather than general anesthesia.

“People who are in their fifties, are active, and have isolated pain in part of the knee could consider partial knee resurfacing as an alternative to waiting until the knee ‘gets bad enough’ for a total knee replacement,” said Dr. Pearle.

New interactive robotic technology helps doctors make more accurate and reliable judgments during this technically challenging operation. The robotic system, combined with computer assisted surgical navigation, allows doctors to preoperatively plan the procedure accurately for each patient based on their knee composition and then carry out the procedure with extreme precision. The robotic arm, controlled by the surgeon, guides him or her to remove a precise, predetermined volume of diseased bone such that a minimal amount of natural knee surface is lost. The procedure is less invasive and offers a faster recovery time and with minimal pain. 

“It’s technically difficult to make the surgery as bone sparing as possible while maintaining optimal orientation of the implant,” said Dr. Pearle, who also founded the Computer Assisted Surgery Center (CAS) at HSS, one of the first CAS programs in the country. “The robotic technology affords me an additional level of quality control.”

Dr. Pearle is, himself, no stranger to novel surgical techniques. During his residency at HSS, he traveled to Hadassah Hospital in Jerusalem during the height of the intifada to assist in the care of terror victims. While participating in this care, Dr. Pearle was inspired by the pioneering use of computer-assisted surgery at Hadassah.

The combination of computer-assisted surgery along with the robotics system is a benefit to patients who are candidates for partial knee replacement, said Dr. Pearle. “In order to provide the maximum implant lifespan and durability, the implant has to be placed in a very precise way. The robotics along with the computer-assisted navigation allow me to do just that.”

HSS is one of only a few hospitals in the country currently using this technology for partial knee resurfacing.

The surgeon-interactive robotic system used for the surgery is known as MAKOplasty, an FDA-cleared system, developed by MAKO Surgical Corp., of Ft. Lauderdale, Fla., that empowers the orthopedic surgeon to pre-operatively plan the precise alignment and placement of knee resurfacing components through a small incision. This allows surgeons to make complex cuts with increased accuracy and precision, while also helping them conserve the healthy bone and tissue around the knee joint. The first application for this exciting technology is the surgical execution of a unicondylar knee arthroplasty, commonly known as a partial knee replacement. Because this surgery can be challenging for surgeons to perform through a minimally invasive incision, the MAKO Tactile Guidance System™ is used to help the surgeon optimize the size and alignment of the implant pre-operatively and then execute the surgery through a small incision with the support of virtual visualization and surgeon-interactive robotics.

To learn more about this new technique or to view an animation demonstrating the surgery itself visit HSS.edu or call 1-877-606-1555.

About Hospital for Special Surgery
Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked No. 1 in orthopedics, No. 3 in rheumatology by U.S. News & World Report (2007), and has received Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center. In the 2006 edition of HealthGrades' Hospital Quality in America Study, HSS received five-star ratings for clinical excellence in its specialties. A member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Medical College of Cornell University, HSS provides orthopedic and rheumatologic patient care at NewYork-Presbyterian Hospital at New York Weill Cornell Medical Center. All Hospital for Special Surgery medical staff are on the faculty of Weill Medical College of Cornell University. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at www.hss.edu.

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