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Leading Medicine Magazine, Vol 7, No 1 - 2013

He’s been happy with the results. “I was through jogging 10 years ago. But I still walk, do stairs, use the treadmill, and go out and walk — because I still like to work out. It obviously took a lot of pain away, and I really walk now without a limp.” BETTER APPLIANCES The improving quality of the prosthetic joints themselves is another reason for the increased number of joint replacements in younger patients. Simply put, the joints are less likely to need early repair or replacement — even when the initial surgery is performed on a relatively young patient. “I’ve been here at Methodist 22 years, and there have been dramatic improvements in the materials,” says Mathis. “We have better ability to fi x the implants to the bone, so they don’t come loose. And we have much better materials that have dramatically lowered wear. So we have greater expectations that I can put a hip or a knee in a younger patient, and it lasts longer than if I’d done that 10 or 15 years ago.” A particular advancement has come in the plastics used on the weight-bearing surfaces of prosthetic joints. Today’s standard is a very dense high-molecular-weight crosslinked polyethylene — strengthened during manufacturing through the application of focused doses of radiation. These innovations are the result of close collaboration between surgeons and designers, and Methodist is one of only a few hospitals nationally to encourage and support such endeavors. Methodist surgeons have been instrumental in the development and use of 25 hip and knee replacement procedures, three generations of hip replacement devices and more than 20 hip implant projects. Seventeen percent of all hip and knee replacement and revision surgeries in Houston — and fi ve percent of those in Texas — are performed at Methodist, more than at any other hospital in Texas. SURGICAL IMPROVEMENTS Joint replacement surgery was once a highly invasive process. Improvements in surgical methods and tools, however, have made the surgical process more minimally invasive than conventional surgery. “The surgery has defi nitely become more refi ned; although, the general concepts are still the same,” Incavo points out. “You expose the joint, you take out and repair the damaged areas, then reconstruct it with the replacement parts — we just do it in a much more sophisticated manner; the surgical approach is much less invasive than it used to be.” Dr. Kenneth Mathis Another important development — and one that has helped to make joint replacement surgery more acceptable to many patients — is better pain management. “We’ve had dramatic improvement in pain, just in the last fi ve to seven years,” says Mathis. “With the newer (pain) blocks that we’re doing, what’s called multimodal pain management, we’ve eliminated IV narcotics from the orthopedic joint replacement fl oor. We’ve got people all night, the next day, saying, ‘Hey, I’ve got no pain.’ With something that used to be incredibly painful. So that’s exciting.” These improvements in surgery have translated into speedier recoveries as well. “The pain management we’ve had, and the smaller incisions that we’ve had, have led us to be able to do rehab much quicker,” adds Dr. Carl Hicks, an orthopedic surgeon at Methodist Sugar Land Hospital and chairman of Methodist Orthopedic Specialists of Texas. “People are up and moving and going again more quickly.” Dreyfus started with walking. “The minute I got back from the hospital, I got up and went up and down my block several times a day,” she says. “I started getting back on the bike at the gym about three weeks after surgery, and I increased my workout every day by fi ve minutes.” RETURNING TO ACTIVITY The trend toward joint replacement in younger patients refl ects differing expectations, better appliances and better surgeries. Given demographic and lifestyle trends, the shift shows little sign of tapering off. Younger patients like Debby Dreyfus are putting their new joints to active use. In fact, she works several days a week as a personal trainer — leading spin classes and training clients in proper resistance training technique. Dreyfus describes the results of her hip replacement surgery in simple terms. “I got my life back,” she says. “I can do, for the most part, anything I want to do. I’m not supposed to do yoga, and I’m not supposed to do anything high-impact. But I can adjust my workout to my personal needs. “And having looked at when I did the hip replacement versus how many years I let pass, had I known how much better I would have felt — how I feel now, after the surgery — I probably should have done it earlier than I did!” n To learn more or to schedule an appointment with a specialist, visit methodistorthopedics.com. 38 methodisthealth.com/leadingmedicine


Leading Medicine Magazine, Vol 7, No 1 - 2013
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