Minimally Invasive Surgery (MIS)
Jordan on the Cutting Edge
Joint Replacement surgery has become one of the most common types of surgery performed at Beth Israel Deaconess - Plymouth. Advances in orthopedic implants and surgical techniques have greatly reduced recovery times for patients undergoing joint replacement. An exciting new technique known as minimally invasive surgery, or MIS, is being used for hip and knee replacement with considerable success.
R. Scott Oliver, M.D., a member of the active staff at Beth Israel Deaconess - Plymouth since 1982, and current division chair of orthopedics in the department of surgery at Beth Israel Deaconess - Plymouth, is spearheading the new technique, which uses a smaller incision than conventional surgery. In some MIS procedures, the amount of soft tissue (muscles and tendons, etc) that is disrupted during surgery may also be reduced. Even though MIS procedures have been used for many other surgical areas including cardiac, gall bladder and spinal surgery, MIS is a relatively new development for joint replacement.
Dr. Oliver, who has performed more than 400 MIS knee procedures and thus far, says, “It’s very exciting because we are seeing a 6-8 week recovery time down from three months. This is very good news for patients.” He has traveled to Chicago and Houston where he discussed his results with physicians from around the world.
MIS surgery is conducted with the use of special navigational equipment that requires two small incisions with a probe in the femur and the tibia, which allows the surgeon to view a geometric image on a computer screen to assist the physician in pinpointing the exact location of surgery.
Similar to a GPS (global position system) which is standard equipment in many high-end automobiles, the computer assisted surgery provides a virtual road map of the joint and the patient’s unique anatomy. The highly sophisticated system, developed by Stryker Navigation of Kalamazoo, Michigan, allows the surgeon to make adjustments to within a fraction of a degree, ensuring the best possible “fit” for the prosthesis and best hip or knee motion.
Dr. Oliver said, “Total knee replacement has been an extremely successful way to treat patients suffering from severe knee pain. This new surgical navigation technology enhances our ability to restore range of knee function and return patients to normal activity quicker and with less pain.”
Dr. Oliver has performed over 100 hip replacements and says, “The navigation system allows me to be incredibly accurate in terms of positioning the hip, which results in precise control of leg length, and better range of motion post-surgery.”
The Stryker hip surgery navigation system uses an infrared camera and markers along with unique instrument tracking software to continually monitor the position and mechanical alignment of the implant components based on the patient’s anatomy. In fact, it provides the surgeon with a comprehensive understanding of the patient’s hip mechanics before any bone is cut. Wireless “smart” instruments send the data pertaining to the knee kinematics (movements) to a computer.
Dr. Oliver also pointed out that the incision for traditional knee replacement can be as long as 10 inches, but with MIS, the incision is reduced to 4 inches. “This means fewer complications in terms of the risk of infection or other complications,” Dr. Oliver continued, “and it can mean less pain during recovery and physical therapy, which begins almost immediately after this type of procedure.”