Retired Genesis Hospital Orthopedic Nurse, Mary Chilberg, is gratified for the front row seat she’s enjoyed providing orthopedic care to tens of thousands of Quad Citians over her 43-year career. As a former orthopedic charge nurse, she worked with respected local surgeons such as ORA Orthopedics’ Dr. Joseph Martin, treating and caring for the arthritic, injured, and those who underwent total joint replacements.
“I absolutely enjoyed taking care of our patients. Dr. Martin and I had worked together over 25 years, helping to ease terrible pain and getting people back to a more active life.
“Then, it was my turn!”
Life Happens
Like many of her former charges, Mary is an active grandparent who likes to keep up with the youngsters. “I was at a local playground, playing with the grandchildren, when I fell and fractured my left femur.” After her broken leg healed, Mary was able to undergo her first knee replacement on the right knee by Dr. Martin, a fellowship-trained total joint surgeon. However, the rod in Mary’s left femur was an obstacle to replacing her painful left knee.
“I was in tremendous pain and was anxious to get my second knee replacement. I couldn’t sleep well at night and was taking pain medication.”
But, as what often happens in life, further circumstances delayed the surgery: Mary’s annual mammogram had revealed a lump. “I had just retired in 2018 and my second knee was scheduled for early 2019. It was just a spot on the mammogram. The breast cancer was so small, I couldn’t even feel it.” The lumpectomy took priority so her knee would have to wait. Early detection and radiation ensured Mary could move on to her next physical challenge. “I was just so grateful for everyone at the Genesis Breast Health Center. It was such a tough time, and I had also turned 65 that year. I asked myself, ‘What next?’”
Her successful cancer treatment meant her second knee replacement could finally be scheduled. The impending surgery provided its own set of challenges.
Computer-Assisted Surgery
“Mary’s femur from her previous accident was treated with a rod in the bone, which can pose a challenge in knee replacement surgeries because it ends just inches above the knee,” Dr. Martin explains. To ensure proper alignment, Dr. Martin used what is called “computer-assisted surgery”, or CAS, to ensure her knee lined up properly.
“Normally we use a patient’s femur as a guide to center the knee, but the rod meant I would need to align the knee differently.” Dr. Martin has used computer-assisted surgery in these difficult circumstances for many years. It involves a special tool that uses computerized sensors to line up the knee properly for replacement on the repaired femur.
“The computer helps us to accurately make bone cuts at the proper angle even when we can’t use our regular cutting guides. If there is deformity from a previous fracture, or hardware from previous surgery in the way, we can still do the knee replacement in perfect alignment.”
Computer-Assisted Surgery or Robotics: What’s the Difference?
“The technology is similar, but Robotic surgery sometimes involves taking CT scans prior to surgery, then the machine may perform the bone cuts as the physician directs it, depending on the robot used. In CAS, the computer helps line up the cutting jigs, but the physician actually performs the bone cuts. With CAS, I maintain control of the cutting tool, and that can be a good thing, especially if a patient has a lot of bone deformity or hardware from a previous injury, like Mary’s knee.”
“And it’s not just about the bone cuts, we also release soft tissue, and remove bone spurs to properly balance the knee to its pre-arthritic state. The robots cannot do this. The surgeon’s experience is important to do this correctly.”
“Orthopedic technology is improving all the time. We’ve had many advancements throughout my career: implants for broken bones, better materials, long-lasting joints, new ways to spare muscle and minimizing incisions, just to name a few.
“At ORA, we are constantly evaluating new hardware, machines, drugs, techniques, and therapies. We believe patients should not only have cutting-edge choices, but safe and proven options — what’s best for them.”
Technological advancement is not just about computers. Throughout ORA’s Centers of Excellence, patients and their partner physicians consider an astounding array of advancements in treatments.
High-Tech Treatments at ORA
For example, significant advancements have been made in pain management. ORA uses new approaches to pain management by using different medications in smaller doses for potentially better pain relief and fewer side effects. In particular, opioid reduction and its associated side effects is a key element of this approach. Cutting-edge pain management has allowed ORA to reduce hospital length of stay, speed patient recovery and to even develop its outpatient joint replacement program.
In joint replacements, surgeons may use, depending on the patient, cementless knee replacements made of synthetic components with crystals that allow the bone to grow onto and bond directly with the new joint.
Technology also has made possible the growing practice of regenerative medicine, including orthobiologics and platelet rich plasma (PRP) therapies which harness the regenerative potential of the cells in the human body.
ORA also employs ultrasound imaging that allows orthopedic physicians to quickly and accurately diagnose issues. Getting an accurate diagnosis more quickly means that you can begin treatment sooner, and avoid pain and complications that may come from delaying treatment.
“Patients’ bodies are unique and require a customized approach. The skeletal structure of bones, muscles, tendons and ligaments are a complex system that allows each of us to move and enjoy life. Our goal is to find the right approach for each patient.”
California Sunsets
For Mary, following her successful breast cancer treatment, she finally underwent her second total knee replacement, with Dr. Martin’s experienced hands wielding computer-assisted surgical tools to guide her new knee into place. Two months later, she was able to visit family in California. “I was so grateful to walk along the Pacific Ocean with my daughter.
“As I had worked with Dr. Martin for decades, I knew him to be a respected professional, and as a patient, he was indeed an excellent surgeon. He did the best job for me. I wasn’t disappointed.”
“We want patients like Mary to get the best result and to have options. Joint replacement is one of the most successful surgeries out there. Patients are really satisfied. We are always critically evaluating new technology, because we want to make sure the outcomes are even better,” adds Dr. Martin.
Surgery is an art and a science and new technologies are successful, especially when in the experienced and trusted hands of ORA surgeons.