Dr. Timothy Alton | Fellowship Trained Trauma, Hip, and Knee Surgeon | Renton, Covington, Auburn/Lakeland Hills
The most important factor in hip and knee replacement surgery is how well patients do after the operation. The reason I do hip and knee replacement surgery is to help people return to the activities that give their life meaning, to keep them moving and to decrease their pain. This leads to improved function and quality of life!
There are a lot of different ways to tell how well a patient does after their joint replacement surgery. We think of various questions like...How much pain do they have? Can they walk up and down the stairs? What activities are they able to do? Are they satisfied with their joint replacement? As it turns out, there are ways to measure these factors objectively and study how well patients do after surgery. One of the most common methods for doing this is through surveys we call "patient reported outcome measures" (PROMs).
There are a lot of choices that orthopaedic surgeons get to make regarding the operation they offer patients. What implant do I use? Do I use robotics? How do I access the joint? Do I cut muscles and tendons, or can I avoid that? To me, each of these decisions should be based on what is best for the patient and how I can get the most favorable possible outcomes for the people who trust me to perform their surgery. This is the lens though which decisions should be made. I choose to use robotics, navigation and modern implants in conjunction with muscle-sparing, minimally invasive approaches when I perform joint replacement surgery because I am confident this combination allows me to produce the best outcomes for my patients.
With knee replacement surgery, for example, robotic assistance has changed the way we think about this surgery and has provided surgeons an incredible tool to get the surgery just right. I can now prepare the bone cuts to within 0.5 mm of accuracy, and I can tension the ligaments to the same precision by leveraging modern technology. My phone unlocks by looking at it, my email completes sentences for me based on learned language patterns and it is only logical that technology can help me in the operating room! I lean into technology to improve patient outcomes. It's the same reason I have adopted muscle-sparing total knee replacement and muscle-sparing total hip replacement techniques. I want to do everything I can to give my patients the best outcome possible.
Just this past year, I took on a project to quantify how the combination of these many factors have impacted my robotic-assisted, muscle-sparing total knee replacement patients. I collected PROMs for 100 patients 1 year after their surgery. The national average for patient satisfaction at 1 year is approximately 80%, but I am excited to share that my patients report satisfaction scores of 96% at 1 year, well exceeding and outperforming the national average! Check out this graph of actual patient reported outcomes from my patients 1 year after their robotic total knee replacement surgery.
Collecting patient reported outcomes is a key part of my practice and standard of care for my patients. I use an app to send and collect this critical data allowing me to offer my patients data-driven answers to questions about recovery. I continue to challenge myself to evaluate every decision I make and use every tool at my disposal to help my patients have the best outcome possible.