The hallmarks of resurfacing and partial knee replacement, using the robot assist, means a smaller operation, smaller incision, faster recovery and minimal rehabilitation. “You can get back 100 percent of motion, which is important,” Levitt said. The implants can last at least 10 to 15 years.
“People say it feels more like a normal knee,” he added. “Virtually everybody, when I do a partial knee, stays in the hospital one night and is home the next day. Usually, they are walking on crutches or a walker and start physical therapy right away. As soon as they feel they can walk on it, they discard the crutches and walker. The average person, by the fifth or sixth day, most are walking with nothing.”
Jerry Amster, 67, a retired attorney who lives in Coconut Grove, had a hip implant in 1999 on his left side, and in October 2012 had an implant in his right hip. Both surgeries were performed at Doctors Hospital in Coral Gables. “Both came out great,” he said.
But that’s where the comparisons end.
“The technique I had back then, the posterior way, they cut muscles before they came up with smaller incisions. I had a big incision and the risk of infection is always a problem. I was fortunate and never had an infection and it worked out great but there were a lot of restrictions for a number of months — no crossing your legs, tying your shoes, a whole bunch of things I couldn’t do so as not to dislocate the hip. That was then.”
Amster started to feel pain in the right side a decade later and was losing cartilage on the right hip. He opted for surgery with orthopedic surgeon Dr. Alexander van der Ven. He went into the hospital on a Monday morning and was home by Wednesday morning.
“I was not in any pain. Getting out of the hospital means emotionally and mentally you feel 100 times better. I was out in 48 hours; 13 years ago, I was in the hospital almost five days. I said, ‘When I get home, what are my restrictions?’ He said, ‘Common sense, and don’t get in any positions you haven’t been in before.’
“I was literally full-weight bearing one week after the operation,” Amster said.
Surgery is not always the first option. Patients are often counseled on activity modifications, such as weight loss or strength and flexibility training, guided by a physical therapist to improve certain muscles that may be underused. Sometimes medications or injections are recommended.
“Those small interventions can make a huge impact,” van der Ven said.
When surgery is chosen, “the trend is less invasive techniques,” van der Ven said. “We make smaller incisions and can avoid muscle damage by going around muscles rather than cutting. We use different types of implants or prosthetics that really take away less bone and that will last, potentially, for the remainder of someone’s life.”
Dr. Marc Umlas, chief of orthopedic surgery at Mount Sinai Medical Center in Miami Beach, calls the current treatment “a paradigm shift in thinking in hip replacements. In the old days we cut first and ask questions later. Now we start with a small approach and visualize in a much smaller area and have developed a number of instruments for facilitating this. This enables us to replace a hip through quite a small incision with excellent results.”