In the first week of February 2021, the new technologies help people and doctors make life better.

In the first week of February 2021, the new technologies help people and doctors make life better. Here are some of the news of the week:  

Don't Lose Weight Before Knee Osteoarthritis Surgery

Suppose you are a patient who wants to proceed the knee osteoarthritis. In that case, you have to know about the newest study of Alberta University published in Joint Bone Spine because you may have received your doctor's prescription to lose your weight before the surgery. Researchers of the Rehabilitation Medicine of Alberta have found that weight loss is not beneficial for the patients and does not have a good outcome for them.

The surgeons' first advice is to lose weight for having a successful knee osteoarthritis surgery, especially for people who have a BMI of 30 or higher.

The lead author and Postdoctoral Fellow of the Occupational Therapy at the University of Alberta, Kristine Godziuk says: "While there's evidence that a higher BMI equals a potentially higher surgical risk, that doesn't mean that if a patient reduces their BMI, even a point or two, that it would be good for them."

The researchers have studied the results of the surgeries from the past ten years. They say it is believed and wrote in every clinical guideline to lose weight before the knee surgery, but the fact is that we didn't find any helpful results in it.

Obesity and aging are the reason behind the osteoarthritis of 300 million people who attend knee surgery worldwide. In Canada, patients with regular BMI should wait more than a year for knee surgery.

Kristine Godziuk says: "Patients with a higher BMI wait even longer because they're told to go try to lose weight first, so by the time they go to get the surgery, they're maybe in worse condition than if they hadn't tried that first."

She also mentions that: "It's very challenging to lose weight and keep it off."

She believes that: "We're not saying that everyone with a high BMI should have knee surgery, but we're calling into question the way it's being assessed, that BMI alone is missing some things."

Reference: Godziuk, K., et al. (2020) A critical review of weight loss recommendations before total knee arthroplasty. Joint Bone Spine.

The Study about the New Artificial Hips

The Study about the New Artificial Hips

To have an advanced and robust prostheses design, the engineering lab of Brown School is working on an artificial hip that helps those with replacement joints.

Fred Higgs, the Rice University engineers, reported the results of their new study on Biotribiology.

They believe that we should go further the limitations that use simple walking to evaluate artificial hips without considering higher-impact activities.

They have built a model to predict how long a hip joint may last because when a young and active patient needs the surgery, he can not have multiple surgeries during his life. In this model, they use real patients' walking motion to predict their artificial hip wear and failure points.

Fred Higgs says: "In healthy natural joints, the fluid generates enough pressure so that you don't have contact, so we all walk without pain. But an artificial hip joint generally undergoes partial contact, which increasingly wears and deteriorates your implanted joint over time. We call this rubbing mixed lubrication."   

Nia Christian, the co-lead author of the research, says: "Eventually, they can loosen the implant or cause the surrounding tissue to break down, and they often get carried to other parts of the body, where they can cause osteolysis. There's a lot of debate over where they end up, but you want to avoid having them irritate the rest of your body."

They believe that their model will inspire future studies and novel materials being used in joint replacement.

Reference: Gagan Srivastava, Nia Christian, C. Fred Higgs. A predictive framework of the tribological impact of physical activities on metal-on-plastic hip implantsBiotribology, 2021; 25: 100156

The Future of Knee Replacement Procedure with Robotic Technology

Geoffrey Westrich, the famous orthopedic Surgeon, working on joint replacement surgery for two decades, believes that robotic-assisted knee replacement is the most successful experience to relieve arthritis pain.

He says: "Joint replacement is highly successful in relieving arthritis pain and improving quality of life, and the robotic system allows us to customize the procedure for each patient. The MAKO system allows for optimal alignment and positioning of the knee implant and optimal ligament balancing, all critically important for the best outcome and long-term success of the surgery. Such precision could potentially lead to a longer-lasting knee replacement."

A study in the United Kingdom, published in the Bone & Joint Journal in 2018, shows that the robotic-assisted knee replacement will decrease pain after surgery, improve recovery, and decrease hospital stay.

To operate the surgery, doctors take a CT scan of the patient\s knee. Then they create a 3D model in the Mako system to plan and assist the Surgeon during the surgery.

The robotic arm will be controlled by the orthopedic Surgeon in the operating room using computer-guided mapping software. Dr. Westrich notes that: "With more accurate alignment and positioning, the implant should experience less wear and friction, and it could ultimately last longer."

He also believes that the robotic-assisted knee replacement protects the surrounding soft tissues and more advantages for bone preservation.

Reference: news-medical