Atlantic General's Center for Joint Surgery is a specialized in-patient unit dedicated to caring for patients undergoing joint replacement surgery, fracture repair surgery and other orthopaedic procedures.More
In November 2004, Atlantic General Hospital celebrated the one-year anniversary of its Center for Joint Surgery. Atlantic General's Center for Joint Surgery is a specialized in-patient unit dedicated to caring for patients undergoing joint replacement surgery, fracture repair surgery and other orthopaedic procedures.More
Our program is designed to prepare patients for surgery and support them throughout the entire recovery process. The procedures available at Atlantic General Hospital meet the highest standards.More
Our program is designed to prepare patients for surgery and support them throughout the entire recovery process. Orthopaedic Surgical Procedures available at Atlantic General Hospital include: total hip replacement, total knee replacement, total shoulder replacement, revision of total knee replacements, fracture repair, reconstructive knee surgery, arthroscopic surgery of the knee and shoulder, and so much more. More
Our goal is to provide our patients with the most advanced techniques possible to assist them with smooth recovery from surgery and the most benefit from healthy, long-lasting implants. More
Our goal is to provide our patients with the most advanced techniques possible to assist them with smooth recovery from surgery and the most benefit from healthy, long-lasting implants. Our physicians use the latest tools in sophisticated surgical techniques such as arthroscopy and other minimally invasive procedures. More
The most common question patients ask prior to having knee or hip replacement surgery is how long will it last.
This is a difficult question as, much like tires on a car, the life span of a total joint depends on how much the total joint is being used. Because younger, more active, healthier people take more steps than older, more debilitated patients, their joint replacements will last a shorter period of time.
Atlantic General Hospital's Center for Joint Surgery has addressed the needs of our young and more active patients with an exciting new procedure that was recently performed for the first time in Worcester County by Dr. Thomas Beck of the Center for Joint Surgery and Atlantic Orthopaedics. New revision procedures, previously available only in large university hospitals, allow people, once their original joint replacement fails, to have repeat joint replacements in the same limb over and over again.
More than 500,000 joint replacement surgeries are done in the United States every year. In the early days of joint replacement surgery, patients who were of younger age, those less than 60 years old, were told they were too young for joint replacement surgery; these patients were doomed to live with pain and decreased function. The main reason joint replacement surgery was reserved for older patients was the lack of procedures to offer patients once the original knee or hip replacement failed. Revision surgeries have become more and more prevalent over the years as technology has advanced.
When a joint replacement fails, the most common reason for failure is aseptic loosening. This means the joint replacement comes loose from the bone due to debris that is generated from normal wear. Wear debris causes cells in the body to be recruited to the area; these cells then give off substances that cause bone to melt away. As the bone around the prosthesis disintegrates, the bond between the patient's host bone and the prosthesis loosens, and the joint replacement fails.
When a patient who undergoes revision surgery for aseptic loosening is evaluated, there are usually massive areas of bone loss that need to be dealt with during the surgical procedure. There are several ways to overcome this bone loss. One method is to put a longer, thicker prosthesis into the hip or knee past the area of lost bone, and hook the prosthesis into good bone that may be further up or down the leg. Another method, impaction bone grafting, takes cadaver bone and uses it in a specialized surgical technique to form new bone, where bone did not exist before.
Impaction grafting is an exciting new technique that has been done in the United States since the late 1990s, but usually only in large university centers. In the past year, however, Atlantic General Hospital has also performed impaction allografting for revision total hip replacements.
Impaction grafting revision surgery includes many steps. The first step is to remove the loose prosthesis. Sometimes this can be a very difficult problem because the surrounding bone loss makes the bone around the prosthesis very thin and brittle, which means removing the prosthesis can cause further damage to the bone. After the prosthesis and bone cement has been removed, any defects that are seen in the bone are covered with a stainless steel wire mesh. This mesh covers over any holes that may have occurred due to loosening of the prosthesis and provides a stable area for a bone graft to be placed.
The next step is impaction. Morselized spongy bone graft obtained from cadavers is broken into 3-5 mm pieces. These pieces are then impacted into the patient's bone in a meticulous process that requires significant patience. The morselized cadaver graft then actually forms new bone where bone did not exist before.
After the new bone has been formed by the use of this mesh and graft composite, a new hip replacement prosthesis can be cemented into place. The cement anchors the prosthesis in the cadaver bone graft bed and provides immediate fixation of the prosthesis. After surgery, patients are allowed to walk as tolerated using crutches or a walker, and then a normal post-operative physical therapy regime is instituted.
What then happens, studies have shown, is that the patient's own blood supply provides cells and nutrition to the bone graft, transforming the cadaver bone graft into new living bone. The benefit of this is two-fold: first, the prosthesis is hooked into strong living bone and, second, if the second prosthesis fails there is a regrowth of new bone allowing a third revision prosthesis could be placed in.
In the past, patients requiring revision surgery for hip and knee replacement would have to travel to Philadelphia or Baltimore to have their procedures done. With the opening of Atlantic General's Center for Joint Replacement, the expansion of surgical services and the addition of fellowship-trained orthopaedic surgeons specializing in joint replacement, Atlantic General Hospital is able to offer cutting-edge technology to residents of Worcester County and the surrounding area.
For information about the Center for Joint Replacement, please contact Karen Christmas, RN, clinical leader, at 410-641-9131.