Doctors travel to ‘space’ for new surgical technology

With the latest advances in computer-assisted orthopedic surgery, surgeons like Dr. David Rovinsky vid are now able to perform total knee-replacement surgery without cutting a single muscle.

Less-invasive surgery and computer navigation combine for a speedy recovery as well, according to a press release from officials at Wilcox Health (Wilcox Memorial Hospital and Kauai Medical Clinic).

Rovinsky, chief of the Bone and Joint Center at Kauai Medical Clinic, has been helping people with painful joints for the past six years.

As an orthopedic surgeon, he performs knee-replacement surgery every week, and has helped thousands of patients on Kaua‘i.

“The keys to a successful total-knee replacement are getting back to full activity quickly, with minimal pain, and having a knee that lasts a lifetime,” said Rovinsky.

“We have made huge advances in all these arenas, and have combined special techniques to bring total-knee replacement into the future.” According to Rovinsky, traditional total-knee replacement surgery used to require splitting the large quadriceps muscle on the front of the thigh.

This approach caused a lot of blood loss, pain, and stiffness of the knee after surgery.

“We are now able to insert the total-knee replacement with a less-invasive technique without cutting any muscle. This allows greater range of motion and more rapid strengthening of the knee postoperatively,” he said.

“Patients who have had their knees replaced using this lessinvasive approach are up and moving independently right away. My last two patients looked ready to go home just three days after surgery,” he said.

“In fact, one patient was bending her knee 130 degrees the first post-operative day. Previously, the goal was to have 90 degrees of motion at the time of discharge from the hospital, which was usually five to seven days.” Up until now, total knee replacement has had the reputation of being a relatively painful surgery, as well as having the issues of confusion, nausea, and vomiting that can accompany general anesthesia, he continued.

According to Rovinsky, there are now special, regional anesthetics that enable the surgeon to just put the leg to sleep, so that, at the end of surgery, you are awake, alert, and pain-free.

“The insertion of regional anesthetic catheters enables us to provide great management of pain for the first two to three days after surgery,” said Rovinsky.

“We then transition to longer- acting pain medications to enable aggressive post-operative physical therapy with minimal discomfort.” Today, the goal of a knee replacement is to put in a knee that will last a lifetime, he said.

Historically, total-knee replacements lasted 10 to 20 years, and then needed to be revised with another knee replacement.

“At Wilcox Memorial Hospital, we are using computer navigation that increases the accuracy of implanting the total knee to within half of one degree,” he said.

“By precisely restoring the alignment of the leg, we hope to improve the wear and life of the total-knee replacement. In addition, we are also offering rotating- bearing, total-knee replacements that offer a more ‘natural’ feel to the total knee, and may also contribute to increased longevity,” said Rovinsky.

William Ronaldson, 65, of Wailua, was a recent patient, and testifies to the benefits of less invasive knee-replacement surgery.

“In my line of work, I need to be actively getting in and out of the driver’s seat, and the pain in my knees grew so severe that I could work only half a day,” Ronaldson said.

“I am here now, in this hospital bed, only two days after surgery, and virtually pain-free.

I have been out of bed walking since I woke up from surgery, and I can honestly say, I have no pain,” he continued.

“This surgery was ‘heavensent,’ and I feel I have my life back. After I complete my physical therapy and get stronger, I am having the other knee replaced,” he said.

“I am so happy to be active again,” he said.

Rovinsky has been practicing at Wilcox for over six years, and said he feels that, now, by combining all of these techniques, orthopedic surgeons at Wilcox can provide patients with the best total-knee replacement possible, enable a rapid return to activity with minimal pain, and have knee replacements last a lifetime.


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