greenvalley
new member
I am debating between two noted orthopedic surgeons. One uses computer aided surgery and the other does not. Does anyone have any background or had computer aided knee surgery?
Computer aided knee surgery
- Thread starter greenvalley
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United KingdomHey, greenvalley - welcome to BoneSmart!!
Personally, I'd go for CAD surgery every time. The majority of long term prosthesis associated problems arise from faulty alignment- loosening, displacement and some functional problems. As a whole, surgeons do get pretty good at eyeballing the preparation of the bone, choosing the right size prostheses and positioning. But they can still be a few degrees off here and there. Many would argue that a few degrees probably wouldn't make that much difference but I figure why pass up on the chance accurate placement if you have the choice?
Downside is that it takes an awful lot longer, turning a 1-1¼ operation into a 2½ hour marathon. Thus, if you have any health problems, it's probably not a good idea from the anaesthetic point of view.
Personally, I'd go for CAD surgery every time. The majority of long term prosthesis associated problems arise from faulty alignment- loosening, displacement and some functional problems. As a whole, surgeons do get pretty good at eyeballing the preparation of the bone, choosing the right size prostheses and positioning. But they can still be a few degrees off here and there. Many would argue that a few degrees probably wouldn't make that much difference but I figure why pass up on the chance accurate placement if you have the choice?
Downside is that it takes an awful lot longer, turning a 1-1¼ operation into a 2½ hour marathon. Thus, if you have any health problems, it's probably not a good idea from the anaesthetic point of view.
summerwind
junior member
I am not a medical expert but the Tourniquet time was 75 minutes at 300 torr(assume that is the amount of pressure applied) for my TKR. I don't know if this is partial or full stoppage of blood flow. Blood loss during the procedure was only 100ml. (Yes I get the hospital records with all of the info for my records
)The CAS method would have increased the amount of time the blood supply was stopped from my leg.
I don't know what an additional hour of no blood flow does to your lower leg tissues.
The OS that did my TKR is trained in CAS but reserves it for extremely complex situations and prefers to not use it most of the time as she opt's for less time the knee area is open for the procedure over the benefits of CAS.
When I said the op would be a 2½ hr marathon, that does not mean the tourniquet would be applied the entire time so I wouldn't worry about that.
Besides which, the tourniquet is only needed for part of the operation. When embarking upon a case we know would take some time, we would place the cuff on the thigh and then paint and drape, only inflating the cuff at the last possible moment moments before surgery if commenced. Once the crucial part is completed, i.e., implanting the prostheses, the tourniquet is released so the surgeon can make sure there are no problem 'bleeders'. This is pretty much standard practice.
And yes, the stoppage is total. The reasons for the tourniquet are two fold - one is to minimise blood loss but the other is to provide a bloodless operating field for the surgeon. You might be interested to know that it is about 85% for one reason and 15% for the other. Care to guess which is which?
Most otherwise healthy bodies can stand stand the lack of blood supply in a lower limb for up to 2 hours or even more. For an arm it would be less. The reason this is so is because the limb is emptied of blood before the tourniquet is applied so there is no static blood in the tissues or the vessels. This means it is much safer to keep the tourniquet in place for prolonged periods.
Is this too much information? I'll stop if it is!
Besides which, the tourniquet is only needed for part of the operation. When embarking upon a case we know would take some time, we would place the cuff on the thigh and then paint and drape, only inflating the cuff at the last possible moment moments before surgery if commenced. Once the crucial part is completed, i.e., implanting the prostheses, the tourniquet is released so the surgeon can make sure there are no problem 'bleeders'. This is pretty much standard practice.
And yes, the stoppage is total. The reasons for the tourniquet are two fold - one is to minimise blood loss but the other is to provide a bloodless operating field for the surgeon. You might be interested to know that it is about 85% for one reason and 15% for the other. Care to guess which is which?
Most otherwise healthy bodies can stand stand the lack of blood supply in a lower limb for up to 2 hours or even more. For an arm it would be less. The reason this is so is because the limb is emptied of blood before the tourniquet is applied so there is no static blood in the tissues or the vessels. This means it is much safer to keep the tourniquet in place for prolonged periods.
Is this too much information? I'll stop if it is!
summerwind
junior member
I would guess the 85% is to provide a bloodless operating field??
Not too much info as I have acquired Data Compulsive Disorder from 38 years of project management
Week 6 1/2 and am able to do the stationary bike without a problem and am working through the stiffness issues. Things are going the right direction and looking forward to the 3 month milestone which I hope will see most of the stiffness behind me. Am out with the dogs on walks and driving (was my driving leg that had the TKR). Have a trip planned at the 6 month milestone so am working hard to get my knee ready for it.
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