CLEVELAND, Tenn. - Half a millimeter can make or break a successful joint replacement.
"When something doesn't fit perfectly, it doesn't feel right," said Dr. Lee Radford, an orthopedic surgeon at Tennessee Valley Bone and Joint.
Radford said he became fascinated with total joint reconstructions during his residency, completing a one-year fellowship and mastering the robotic-assisted surgical approach for knee and hip replacements. So when he came to the region, he pushed to bring that same technology to Tennova Healthcare-Cleveland.
"I get a CT scan ahead of time, which allows me to custom fit the components to the actual patient's anatomy, as opposed to putting them in the way that we conventionally did, which is cutting on averages," Radford said. "The idea is that we can recreate the anatomy to give you a better-fitting, better-feeling knee or hip replacement."
During surgery, the robot uses information from the prior CT scan to precisely guide the surgeon's cuts.
Radford performed Tennova's first robotic-assisted partial-knee replacement on Brian Naipavel's left leg in April. Naipavel was so pleased with the results that he went back for a total right knee replacement in June.
"I had been told I had a little arthritis in both my knees, but the car wreck I was in just exacerbated everything," Naipavel said. "Because I was hobbling around with my right leg bothering me so bad, I was putting so much stress on my left."
Tennova CEO Coleman Foss said he's excited to bring the technology to Southeast Tennessee and grow the orthopedic program, which is already the hospital's largest source of patients.
"We want to get the word out that we're doing this, we are the first in the region to do it and the results are absolutely incredible," Foss said.
Radford said since incisions are smaller and the implants fit better, robotic-assisted joint surgery is less invasive with faster recovery - usually four to six months - than conventional joint replacements, which can take a year or more.
"It allows for them to not feel nearly as much stretching of all of those ligaments and tendons and having to get used to the knee or hip replacement," he said.
People with degenerative joint disease that hinders their lives who are healthy enough for surgery are potential candidates for a joint replacement. The surgery time is slightly longer than traditional joint replacements and poses the same small risks, such as infection.
"The reason to have this procedure done is because the patient's quality of life is so poor that they're unable to do the things that are appropriate for them to be able to do at their age," Radford said.
Dr. Todd Grebner, an orthopedic surgeon with the Center for Sports Medicine and Orthopaedics who also performs the robotic surgery at Tennova, said aside from general apprehension, the question he hears most from patients is, "Does the robot do the surgery?"
"I get that a lot, and the robot doesn't do the surgery," Grebner said. "As far as the implants and everything else, it's the same surgery [as before]. The robot just helps us, as the surgeon, to ensure optimal alignment, optimal placement it helps us keep within the lines."
And while it's important not to rush into surgery, he said most people wait too long to seek relief from their joint pain.
Jay Neidich, 74, is already walking and feeling "a big difference" two weeks after his robotic-assisted knee replacement.
"I waited four months, and then I said, 'Well, it's time,'" he said. "I could've sat around the rest of my life in that chair and not have any pain, but when I got up and started moving, that's when it hurt, because I had bone-on-bone."
Now that he's on the mend, Neidich said he's looking forward to having his life back and riding his endurance horse, an Arabian he affectionately calls "Bill."
Contact staff writer Elizabeth Fite at efite@timesfreepress.com or 423-757-6673.