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New Techniques Revolutionize Hip and Knee Replacement Surgery, Give People with Arthritis a New Lease on Life

(New York, N.Y. September 2004). For someone suffering from severe arthritis, activities of daily living can be difficult, if not impossible. Often affecting the knee or hip, arthritis can make traveling, shopping, even getting around one's own home, a major challenge. Just ask 66-year-old Eileen Leavell of Floral Park, who had nagging arthritis in both hips. By the time she went to see Dr. Geoffrey Westrich at the Hospital for Special Surgery in Manhattan, her pain was so bad she couldn't sleep at night. The examination and X-rays showed that Ms. Leavell's arthritis was so advanced, the only way for her to regain her quality of life was hip replacement surgery.

Now, she says having the surgery was one of the best decisions she ever made. After the operation, subsequent physical therapy and recovery period, Ms. Leavell's pain was gone. "It was great to be able to resume activities I had given up," she says. "I was happy just to be able to walk around my office at work without a problem."

Ms. Leavell had both hips replaced in two separate procedures, about a year apart. By the time she went in for the second hip replacement on the other side, a new, minimally invasive technique had been developed. The so-called "mini incision" hip replacement brought her a quicker recovery, less pain and easier physical therapy compared to her previous surgery.

Mini-Incision Brings Maximum Benefit

"In the past couple of years, major advances have revolutionized joint replacement. These days, patients have more options," says Dr. Westrich, who grew up in South Orange and often sees patients from New Jersey. Dr. Westrich is among a group of highly specialized orthopedic surgeons doing minimally invasive hip and knee replacement. The new technique achieves the same goal as the standard operation, but with a three- or four-inch incision, as opposed to 12 or even 14 inches.

"This is a major advance in the way total hip and knee replacement are performed," Dr. Westrich says. "Aside from the better cosmetic result, the smaller incision results in less pain, a quicker recovery, a shorter hospital stay and easier physical therapy."

The operation entails replacing the painful, arthritic joint with a fully functioning hip or knee implant. Doctors are able to make smaller incisions thanks to special retractors, which are used to hold open the skin and muscle.

Ms. Leavell, who had a standard hip replacement on her right side, and a "mini" on the other hip, ended up with an incision 10 inches shorter and a much faster recovery. "It was like night and day. With the smaller incision, I had less pain and got back on my feet faster," she said.

Another advance concerns the hip implant itself. Dr. Westrich says a new device made of ceramic materials is expected to last longer than the traditional hip replacement made of metal and plastic. "If an implant can last 20 years or more, total hip replacement becomes a viable option for younger patients suffering from arthritis," he says.

"Custom-Made" Knee Replacement

The term "custom-designed" usually brings to mind jewelry, clothing or kitchen cabinets. Now a new option for patients with a specific type of knee arthritis is giving new meaning to the phrase. Some patients, generally in their 40's and 50's, have arthritis limited to just under their kneecap, so partial knee replacement is an option. "We design a custom-made knee implant to replace only the arthritic area to relieve pain," Dr. Westrich says. A high-tech CT scan takes detailed pictures of the patient's knee joint. The pictures are then transferred to a CD-ROM and sent to the manufacturer, who designs a model of the implant and sends it to Dr. Westrich for review. Patients are usually able to walk on their knee the day after surgery.

Never Too Old

A few years ago, a study found that even people in their eighties can benefit from joint replacement. Dr. Westrich performed a hip replacement on a 92-year-old woman who had a fairly active lifestyle and wanted to keep it that way. As people live longer and develop arthritis, he expects more patients will look to joint replacement to improve their quality of life. Anyone who would like more information on hip and knee replacement, can visit: www.westrichmd.com. To make an appointment with Dr. Westrich, call 212-606-1510 or, toll free, 1-877-KNEE-HIP.

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