A New Era in Joint Replacement Surgery

July 02, 2014
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The orthopedic surgeons, nurses and physical therapists at Providence Saint John's Health Center have earned high honors for their top quality care for many years. They don't spend a lot of time reveling in those plaudits, however. They're too busy. The demand for joint replacement and related hip and knee surgeries is on an upward trajectory, notes John R. Moreland, MD, who has a private orthopedic practice in Santa Monica and performs surgery at the Health Center.

Joint replacement surgery emerged for both hip and knee in the early 1970s. Since then, manufacturers have developed more durable joints, and surgeons have devised operations that are far less traumatic. For example, minimally invasive hip replacement typically results in excellent outcomes while allowing patients to recover faster and with less blood loss and pain.

“When I started my training, hip and knee replacement was basically brand new,” Dr. Moreland says. “I was fascinated by this relatively new field then. Over my career, I've watched both operations improve. Hospitalizations have gone from two to three weeks to two to three days. The joints are more durable, the complications lower, and pain management has improved.”

Patients’ attitudes have driven some of the improvements in the surgery, says Kevin M. Ehrhart, MD, an orthopedic surgeon who practices with the Santa Monica Orthopaedic and Sports Medicine Group.

“Twenty years ago, joint re-placement was done for elderly patients who couldn't walk anymore,” says Dr. Ehrhart, a former president of the Saint John's Health Center medical staff who is on the hospital's board of directors. “Back then, if you were 54 or 55 and you hurt your hip, you just quit doing things. Today people those ages want to stay active. That drove the health care industry to make much better prostheses that allow for fairly high-performance activity. At the same time, it drove the surgeons to come up with better techniques that allow a quicker and more complete recovery.”

“All surgeries have inherent risks. But as a center of excellence, we focus on outcomes, patient safety and technical quality." – Dr. Andrew G. Yun

Patients are offered a range of options for knee and hip problems, and physicians work closely with each patient to personalize their care, Dr. Ehrhart notes. For example, Providence Saint John's Health Center's orthopedic surgeons excel at partial knee replacement, performing more of this type of surgery than almost any other hospital in the Western United States, says Andrew G. Yun, MD. Dr. Yun performs anterior hip replacement surgery as well as total and partial knee replacement.

“Partial knee replacement is only done by those surgeons who have pursued specific training and have made a commitment to mastering the technique,” he says. “The result of partial knee replacement—in appropriate patients and by skilled surgeons—is equivalent to or exceeds that of total knee replacement. Recovery is faster and safer. Patients are often much more active after partial knee replacement compared to total knee replacement.”

Not every orthopedic surgeon offers partial knee replacement, which is also known as unicompartmental knee surgery, notes Dr. Ehrhart, who does partial and full knee as well as hip replacement surgery.

“The knee has three major compartments,” he explains. “For patients with arthritis in just one of the compartments, a partial replacement is the treatment of choice. It's an easier procedure to go through. Unicompartmental knee surgery is great for certain patients.” The orthopedic surgeons at Saint John's Health Center have a storied reputation for innovation and improvements, Dr. Moreland notes. Unicompartmental knee surgery was pioneered by the late Leonard Marmor, MD, a renowned Saint John's Health Center orthopedic surgeon.

“Some of the things Dr. Marmor recommended and devised are very similar to what we use today,” Dr. Moreland says.

Whatever the procedure, the medical team follows state-of-the-art protocols for patient care, adds Dr. Yun. “We are a center of excellence. All surgeries have inherent risks. But as a center of excellence, we focus on outcomes, patient safety and technical quality. The success we have in meeting those metrics is reflected in the numerous awards we've won.”

The Health Center prides itself on outstanding nursing services as well.

“It's a coordinated approach that ensures continuity of care,” says Dr. Yun. “We have an extremely focused and trained team of health care professionals. Everyone knows exactly what they're supposed to do. There are so many back-ups and safety checks. There is very little room for error.”

To learn how you can support joint replacement at Providence Saint John’s Health Center, call Jeanne Goldsmith at 310-582-7344.