My mother has been told she needs a knee replacement and my father has been told he needs a hip replacement. I am wondering what new technologies might be available to them as they consider surgery. William, Billings

There are several new topics being discussed in Total Joint Replacements surgery. Some of these ideas have outstanding potential. They include the following:

  1. Alternative Bearing Materials
    (Hard on hard surfaces for hips)—metal on metal, ceramic act… These new implants are designed to wear slower than older generation hip replacements. Theoretically, the hip will wear out slower and last longer than other materials. The polyethylene (plastic) has also improved dramatically with regards to the wear compared to the past.
  2. Larger heads in Total Hip Replacement
    This reduces the wear in the hip replacement as well. In addition, it has the added advantage of reducing the dislocation risk of the hip replacement.
  3. Computer Assisted (Navigated) Surgery
    Navigation in surgery is not new. It is here to stay. Second and third generation computers are now being used. The technology is very similar to GPS (Global Positioning Systems) that are used in vehicles and the military. The neurosurgeons have been using this technology for quite some time. European surgeons have also used it to increase their accuracy. Numerous studies have now shown that a computer navigated total knee replacement has a higher likelihood of being aligned properly. Longevity of knee replacement is directly related to alignments as well as other variables. Recently, the newest generation computer navigations systems allow the surgeon to precisely balance the ligaments in a way that should also add to longevity. Although patients having total knee replacement have had and continue to have excellent surgical outcomes even without the use of computer navigation, orthopedic surgeons are continually improving surgical techniques and longevity of total knee replacements. In my opinion, this technology will be mainstream and the gold standard in joint replacements in the future. We have been using it for nearly 3 years and the European surgeons for 5-10 years.
  4. Minimally Invasive Surgery
    Having a smaller incision that heals faster for your total joint sounds very appealing. It is being done in many centers around the country. Numerous unique and novel approaches have been tried. Some have remained and others are already proven to be fraught with complications. In my opinion this will be the future. However, it remains unproven and potentially will lead to higher complications.
  5. Gender Specific Knee Replacements
    Recently, orthopedic manufacturers and providers have been promoting and advertising gender specific knee implants, specifically marketed towards women. However, the question remains whether these "new designs" are necessary or revolutionary at all. Females, who experience severe arthritis at three times the rate of males, are also far less likely to proceed to reconstructive knee or hip surgery according to a study conducted in the April 6, 2000 issue of a popular and widely consulted health journal. Furthermore, due to the longevity of the average woman's life in comparison to the average males, orthopedic physicians as well as product manufacturers anticipate an increase in "do over" joint replacement surgeries in their patients' futures. Thus, two leading manufacturers introduced knee replacements specifically created for women. Yet, at this years American Academy of Orthopedic Surgeons (AAOS), other companies arranged exhibits dedicated to female orthopedic solutions. Although gender is a crucial factor determining specific components, orthopedic surgeons must address every aspect of patients for accurate selection of components.

All of this information is just one surgeon’s opinion. Every patient should discuss his/her unique situation to their own physician. I hope this information helps.

Dean Sukin, MD