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April 22, 2014 > Seminar to Highlight Advancements in Knee Surgery

Seminar to Highlight Advancements in Knee Surgery

New Surgical Techniques Improve Quality of Outcomes

According to the Centers for Disease Control and Prevention (CDC), knee replacement surgery is among the most commonly performed and clinically successful surgical procedures in the United States. In 2010, the last year for which figures are available, more than 719,000 total knee replacements were performed, along with a significantly growing number of partial knee replacements.

The most common reason for knee replacement surgery is osteoarthritis Ð caused by the breakdown of the cartilage that cushions the ends of the bones in the knee joint Ð which can produce debilitating pain and limit mobility. Knee pain caused by arthritis often can be relieved by non-surgical treatments such as medications, physical therapy and knee braces. For more severe pain, patients may get short-term relief from injections of cortisone or hyaluronic acids. When there is dramatic loss of cartilage, however, the patient may be a candidate for either partial or total knee replacement.

To help people in the community learn more about osteoarthritis and the latest advances in knee replacement surgery, Washington Hospital is sponsoring a free Health & Wellness seminar featuring Co-Medical Director of the Institute for Joint Restoration and Research (IJRR) at Washington Hospital, Dr. Alexander Sah. The seminar is scheduled for Friday, May 2 from 2 to 4 p.m. in the Conrad E. Anderson, M.D. Auditorium in the Washington West Building at 2500 Mowry Avenue in Fremont.

At the seminar, Dr. Sah will discuss the treatments available for osteoarthritis in the knee, as well as the range of options now available for partial and total knee replacements. He also will explain new surgical techniques that are improving the quality of outcomes in knee replacement surgery.

ÒPartial replacement would be an option for patients with cartilage damage on only one part of the knee,Ó Dr. Sah explains. ÒIt is a good option for younger patients whose arthritis has not spread throughout the knee or for elderly patients with other conditions that limit their ability to recover from total knee replacement.
Total knee replacement would generally be performed if the cartilage is badly damaged on both sides of the knee and under the kneecap, or on one side of the knee and under the kneecap.Ó

Dr. Sah recently returned from the national convention of the American Academy of Orthopedic Surgeons (AAOS) in New Orleans, where he presented the results of current research studies in joint replacement at the IJRR.
ÒOne of the new developments in surgery is ÔknotlessÕ dissolving sutures that have tiny ÔnicksÕ or ÔbarbsÕ of the same fabric as the suture,Ó he notes. ÒThe nicks eliminate the need to tie knots in the suture to secure it in place. Because the nicks are located all along the entire suture, the tension is evenly distributed across the length of the incision, rather than just at the ends, which allows us to start rehabilitation of the joint sooner.Ó

Another development is the use of a new local analgesic, Exparel, which can provide non-opioid pain relief following surgery.

ÒExparel is similar to Novocaine, but it lasts longer Ð up to three days,Ó Dr. Sah says. ÒWe can inject it around the surgical site for local pain control with no side effects and better post-operative pain control.Ó

A new, specialized surgical wound dressing also is improving the outcomes of knee replacement surgery by reducing the chances of post-surgical infections.

ÒThis surgical dressing is more like a second skin,Ó he notes. ÒIt is flexible and watertight, and it doesnÕt need to be changed for a week. This makes infection less likely because you donÕt change the dressing as often. All these little improvements in surgical techniques and post-operative care can make a big difference in the quality of surgical outcomes, with faster and better recoveries.Ó

Dr. Sah adds that one of the big topics of discussion at the conference in New Orleans was that of beginning to perform joint replacement surgeries as outpatient procedures. ÒIt is likely we will soon be doing some partial knee replacement surgeries as outpatient procedures at facilities such as the Washington Outpatient Surgery Center,Ó he says.

As a member of the Knee Committee for AAOS, Dr. Sah graded presentation abstracts submitted by other physicians to determine what topics would be presented at the national convention. He also moderated a session on infections in knee replacements.

ÒBeing active in research and national organizations such as AAOS is definitely a benefit for the people in our community because we continually improve the quality of patient care through these experiences,Ó he says. ÒPlus, our local facility is making a difference in improving the quality of joint replacement surgeries throughout the country.Ó

Learn More at Upcoming Seminar

To register for this seminar on May 2, visit

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