ORTHOPEDICS
Dr. Shekhar Desai
‘ART’ allows patients to regain mobility faster, heal quicker, and return home sooner—all with considerably less pain.
WHEN ONE of my patients recently faced the prospect of a repeat joint replacement surgery on his left knee, he was very apprehensive. At 62 years old, Duane had his primary knee replacement surgery almost two years ago in Gainesville. He experienced significant pain at the time and had a bad reaction to the strong narcotics typically used to manage postoperative pain.
Today there’s good news for Duane and other total joint replacement patients. A new technique in pain management now offers them the ability to regain mobility faster, heal quicker, and return home sooner—all with considerably less pain.
AS BABY BOOMERS age they will demand better pain management associated with reconstructive surgery like total joint replacement. Accelerated Recovery Technique.
Accelerated Recovery Technique
It’s called the Accelerated Recovery Technique, ART for short, and it provides patients a non-narcotic, nearly pain-free recovery from total joint replacement surgery. The technique begins before the first incision, with the patient receiving non-narcotic pain medication the night before surgery. During surgery, additional pain medications in the form of a specially designed “pain cocktail” are injected into and around the joint, leaving the area essentially pain-free for up to 48 to 72 hours.
In addition to this “cocktail” of pain-relieving drugs, the technique uses a special gel to promote healing. Rich in platelets, the gel contains high levels of growth factors and factors that promote tissue healing. Before surgery, it’s made by “spinning” two ounces of the patient’s blood in a centrifuge into three parts: platelet-rich plasma, platelet-poor plasma, and red blood cells.
The platelet-rich plasma is sprayed into the joint cavity after replacement surgery to help control inflammation and accelerate healing. The platelet-poor plasma helps with clotting, and the red blood cells are discarded.
“There’s No Comparison”
The day after Duane’s revision knee replacement surgery, he couldn’t hold back his enthusiasm. “This is just phenomenal,” he said. “There’s no comparison to the first surgery, when I was in the hospital for five days. I had a bad reaction to the strong pain narcotics, had to use a walker, and needed home care for six weeks. This time around, just the day after surgery, I’ve already walked a mile—without crutches or a cane.
“It’s flat unreal,” continued Duane from his hospital room. “I’ve already gotten a lot of flexibility back in my knee and I feel like walking another mile, which I’ll do right after dinner. What a difference!”
Duane and dozens of other patients who benefited from the immediate local tissue impact of the Accelerated Recovery Technique were able to manage any in-hospital discomfort with Tylenol or mild oral narcotics.
Even more amazing, a full 80 percent of those patients were able to return directly home from the hospital, compared to the other 20 percent who had to recover in a skilled nursing facility or rehabilitation hospital. Not too long ago, before using the technique, 66 percent of my total joint replacement patients had to transition to a skilled nursing facility before returning home.
TODAY there’s good news for total joint replacement patients.
Benefits for Baby Boomers
Pain management is really the last frontier in joint replacement surgery. We perfected the material used for joint replacements and then the actual surgical technique. We’ve also greatly reduced complications from infection. As Baby Boomers age, they will demand better pain management and the Accelerated Recovery Technique represents an important and welcome advance.
THE 411 ON TOTAL JOINTS
- 498,000: Patients that had total knee replacements in the United States. The mean age was 67.1, with women outnumbering men 335,000 to 176,000.
- 32,000: Patients that required revision surgeries for their artificial knee joints.
- 238,000: Patients had total hip replacements.
- 108,000: Patients had partial hip replacements.
- 30,000: Patients required a repeat procedure, or revision, for their total or partial hip replacements.
Dr. Desai specializes in total joint replacement and adult reconstruction and has practiced for more than 15 years in the Melbourne area. Board-certified in Orthopaedic Surgery, Dr. Desai completed medical school at the University Medical College in India. He served his residency at Maimonides Medical Center in Brooklyn, New York, and completed the Harvard Fellowship Program at The Children’s Hospital in Boston, Massachusetts. Affiliated with MIMA, Dr. Desai can be reached at 321-952-4445 and his offices are located at the Par Place Medical Center in Palm Bay.
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