June 14, 2023

Joint Replacement: A Convo With Dr. Ryan Jaggers (Part 2)

Welcome back! In part 1, we sat down with Dr. Ryan Jaggers, board-certified orthopedic surgeon at Central Indiana Orthopedics, and asked him about arthritis (specifically osteoarthritis) and what people can do to take control of their pain. You can read all about that interview here. In part 2, Dr. Jaggers takes a deeper dive into joint replacement, a surgical treatment for end-stage arthritis. Read on to see what he had to say.

What types of issues are arthritic patients generally having?

Common symptoms of arthritis include pain, stiffness, swelling, loss of mobility and limited range of motion. In the beginning stages of arthritis, someone may not have any symptoms, but signs of the disease may be visible on an x-ray. As the surface of the smooth cartilage covering the joint softens, the cartilage begins to lose the ability to absorb the impact of movement and is easily damaged from excess use or injury. Large sections of cartilage may wear away completely with time, causing pain and stiffness from the bones rubbing against each other. Someone with arthritis at this stage will most likely have more noticeable symptoms, with those symptoms affecting their quality of life. Due to pain, they may be less active, no longer participate in their favorite activities or have difficulty getting a good night’s sleep.

Who is a candidate for hip and knee replacement?

Someone is a candidate for joint replacement if they have end-stage arthritis or failed conservative treatment and arthritic symptoms are affecting their quality of life. Perhaps the most important factor is determining if someone is healthy enough to undergo surgery, which is why it’s essential to have a detailed conversation with an orthopedic surgeon before deciding.

Can hip and knee replacements be performed as outpatient? If so, what are the benefits of outpatient surgery for those patients?

Hip and knee replacements are often performed as an outpatient procedure, where the patient has surgery and goes home the same day. In general, people enjoy recovering in the comfort of their own home. As long as they have adequate help and support at home and are an appropriate candidate in regard to their medical status, outpatient joint replacement is an ideal option for a lot of patients.

Something that our patients benefit from when they have an outpatient hip or knee replacement is having pre-and-post joint education and support from our Patient Navigator, Natalie McClintick. Natalie, a Nurse Practitioner with over 20 years of orthopedic experience, provides one-on-one joint education with the patient before surgery, and 24/7 support during the patient’s recovery. Read more about Natalie’s role and pre-and-post surgery support she provides to joint replacement patients.

We understand that outpatient surgery is not appropriate for all patients needing a joint replacement, which is why our surgeons can also perform in-patient procedures at local hospitals. Patients undergoing a hip or knee replacement as an in-patient procedure will also benefit from Natalie’s post-operative support.

What is robotic-assisted joint replacement?

Robotic-assisted surgery is a newer technique for hip and knee replacement that provides many benefits, including less pain and quicker recovery than traditional joint replacements, reduced risk of surgical complications and precise placement of the implant enabling better post-surgical movement and flexibility. Central Indiana Orthopedics is proud to be the first orthopedic practice in the region to utilize Mako SmartRobotics™ robotic-arm assisted surgery for better outcomes in total hip and total/partial knee replacement. With our early adoption and experience, we’ve helped over 2,000 patients get back to doing what they love with Mako-assisted surgeries.

What happens during robotic-assisted surgery? How does it work?

Prior to a robotic-assisted surgery, the patient obtains a CT scan that allows the surgeon to have a digital 3D model of the patient’s anatomy. From there, the surgical team creates a digital “map,” taking measurements of the patient’s unique anatomy to determine the exact size of the replacement components and the exact position of the implants that will be the most optimal. During surgery, the surgeon uses AccuStop™ technology, which guides the surgeon to stay within pre-determined boundaries and cut precisely what is planned (including the exact angles of those cuts) to help protect the patient’s healthy bone. In fact, with AccuStop technology, the robotic-arm will stop if it begins to enter an area outside of the pre-determined boundaries. Overall, this technology allows for a more predictable surgical experience and precise procedure than traditional joint replacement. Learn more about how robotic technology works in the video below.

Why do you, and other CIO surgeons, prefer a robotic-assisted surgical approach for joint replacement?

In my opinion, the biggest benefits are the precision the robotic-arm allows during surgery and the preoperative and interoperative planning. As a surgeon, to know exactly what your cuts and balancing will be like before you even touch the patient is so valuable. This technology allows our surgeons to perform a more accurate procedure than the traditional approach to joint replacement. We do see people tending to recover a little bit quicker due to less soft tissue releases, which results in less pain.

What do joint replacement patients need to know about recovery? What can they expect initially and over time?

An important part of the decision-making process to have a hip or knee replacement is making sure patients understand what they’re getting into and what their outlook looks like, as everyone is different. Recovery can be painful the first couple of weeks, which we try to control with pain medication. Physical therapy is critical, almost as important as the operation. Patients should understand the importance of pushing through the uncomfortableness the first few weeks and continue moving to avoid stiffness. By six weeks, patients seem to have “turned the corner” and are feeling better, realizing the surgery was a good idea, but they have a little more recovery and work to do. By three months, most patients are back doing the majority of their day-to-day activities. Planning a trip or vacation is typically reasonable around this timeframe. By a year, things are about as good as they will be. CIO joint replacement surgeon Dr. Jamie Kay had both of his knees replaced using Mako technology and shared his personal recovery experience. While everyone’s recovery is different, you can read about his experience here.

We encourage those suffering from arthritis pain to not delay scheduling an appointment. Discussing goals and concerns with your doctor will help determine if conservative treatment options or surgery would be best. If you are interested in meeting with a CIO joint replacement surgeon and learning more, visit ciocenter.com or call 800-622-6575 to schedule an appointment. Learn more about robotic technology at ciocenter.com/mako.