Nakul Karkare, MD, an orthopedic surgeon at St. Charles Hospital, completed his fellowship in total joint replacement at the Hospital for Special Surgery, NY. He is also fellowship-trained in orthopedic trauma and metabolic bone disease. Here, Dr. Karkare provides some insight into the surgical techniques used at St. Charles Hospital.

What are some of the latest surgical techniques for total hip and total knee replacement?
Dr. Karkare: Total joint replacement for hip and knee pain is one of the most satisfying surgeries of modern times. The procedure provides excellent relief of joint pain, restores joint motion, and gets patients back to their activities of daily living.

In recent years, there have been numerous advances in treatment, implants, and minimally invasive operative techniques. Two techniques in particular have dramatically improved patient outcomes — anterior hip replacement and custom knee replacement.

What is “Direct Anterior hip replacement”?
Dr. Karkare: The direct anterior approach is a minimally invasive technique that allows hip
replacement to be performed without detaching or cutting through muscles or tendons. Traditional hip replacement is performed by cutting muscles, which means patients follow several precautions after the surgery to allow those muscles to heal. Patients are advised not to cross their legs, bend the hip more than a right angle, or turn feet excessively inward. They are also advised to use a pillow between their legs when sleeping.

Since no muscles are cut with the anterior approach, patients do not have the restrictions associated with traditional hip replacement.

What is “Custom knee replacement”?
Dr. Karkare: Custom knee replacement utilizes modern technology which allows the surgeon to preoperatively match the size and placement of the knee implant to each individual patient. This technology ensures accurate and reproducible placement of the artificial knee joint. The need to drill holes in the bones is eliminated, making the surgery less invasive. With custom knee replacement, there is increased efficiency and fewer steps during the surgical procedure, which can decrease time in surgery.

How can each of these surgical approaches benefit the patient?
Dr. Karkare: As always, each patient and their experience is unique. However, these
approaches offer patients the potential for:

• Reduced pain after surgery
• Less tissue trauma
• Smaller incision and less scar tissue
• Less blood loss
• Shorter time in surgery
• Faster healing and return to activities
• Earlier mobilization
• Shorter rehabilitation time
• Fewer restrictions following surgery
• Shorter hospital stay

For more information on the latest surgical techniques for total joint replacement at St. Charles Hospital, please call (631) 474-6797.