Recent advances have allowed our surgeons to perform surgeries through smaller incisions. Improved fiber optic lights bring light to the operative field. Better instrumentation can guide our surgeons to perform the correct procedure through a much smaller incision without directly visualizing all of the anatomy. Smaller incisions with less disruption of the muscles and tendons improve patients’ early function by leading to less stiffness and less pain. Our surgeons have attended several courses to stay updated on the newest techniques to improve results.
Total knee replacement and total hip replacement can now be performed through much smaller incisions. In the past, total knee replacement was performed through a 6-9 inch incision cutting through the quadriceps tendon. Now, the incision is frequently only 4 inches and is performed through a muscle-sparing technique. Similarly, the total hip replacement can be performed through a 4-inch incision.
Partial knee replacement has also allowed many of our patients to achieve an excellent result. Partial knee replacement involves only replacing the inside or the outside of the knee, while preserving the cruciate ligaments, the patella (knee cap), and the other compartment of the knee. Both partial knee replacements and shoulder replacements have been performed as an outpatient procedure at Gulfcoast Surgery Center, which has allowed our patients to avoid entirely an expensive trip to the hospital.
New advances in metals, ceramics, and polyethylene have now improved our ability to make more durable joint replacements for the younger patient. Oxidized zirconium is a new metal alloy that has the strength of metal but the wear resistance of ceramics. It is much more difficult to scratch oxidized zirconium, so patients can be assured that it is much less likely for scratches on the metal to wear out their polyethylene hip or knee replacement surface. Oxidized zirconium is also more slippery than cobalt chrome; so artificial knees do not repel the water and instead wear 8 times less in an artificial knee replacement simulator. Hip replacements can now be made with ceramic on ceramic surfaces so there is no plastic (polyethylene) to wear out.
Our surgeons have been on the frontier of pain management in the recovery period. We have learned that the best pain control actually begins before the patient awakens in the recovery room. Indwelling pain catheters have delivered anesthetic directly to the nerves, minimizing the amount of narcotic our patients need. Preoperative dosing of pain medication and injecting wounds with morphine and local anesthetics have dramatically improved patients’ comfort.