NUFFIELD HEALTH

THE NEXT GENERATION IN JOINT REPLACEMENT SURGERY

Nuffield Health Cardiff and Vale Hospitals are the first hospital in Wales to offer robotic arm assisted surgery for joint replacement.

Two Pioneering patients undergo this Incredible robotic joint surgery, and share their story and experiences.

Mrs Pamela Chapman, of Dinas Powys, was the first patient in Wales, with the surgeon using Mako robotic arm-assisted surgery, to have her hip replaced. A few weeks now since her November operation, Mrs Chapman says she frequently forgets she has had either a painful hip or the surgery, as her right hip is so much improved.

When the option to have Stryker Smartrobotics at Nuffield Health Cardiff and Vale Hospitals was mentioned, Mrs Chapman said she felt confident that this was the right way to go. Pamela said, “ It was so reassuring to hear how very precise the procedure would be, with quicker recovery and reduced pain. It was all very impressive and exciting. Compared to my friend who has had a conventional hip replacement, my wound was less messy, seemed cleaner and healed more quickly. I would firmly recommend it.”

A joint replacement can help people return to every-day activities like walking, bending, sleeping and driving, without pain or stiffness. The Stryker Mako system offers a high level of alignment and positioning of the new hip or knee joint during surgery. Using a detailed individualised plan, with a 3D virtual model of the patient’s anatomy, devised from their CT scan before surgery, the surgeon is able to implant the joint replacement in the best position for the patient with a high degree of accuracy.

Mr D Phillip Thomas was Pamela’s orthopaedic surgeon and the 79 year old selected him to do the hip replacement, following advice

from her physiotherapist. Her GP had referred her for physiotherapy when her knee was giving her pain. The Nuffield Health physio Adrian Brown, who had treated a neck problem previously with miraculous results, recommended referral to an orthopaedic surgeon and a hip x-ray, as he wasn’t convinced it was the knee which was causing the problem.

When she came in for surgery with Mr Thomas, Pamela said everything and everyone she came across was excellent. Whilst the surgeon still performs the surgery, the robotic arm is there to be guided by the surgeon to accurately remove diseased and damaged bone and cartilage. The new implant, which the robot has helped size, is then fitted precisely into the space created. The process is failsafe, as the robot prevents anything being done which isn’t exactly right.

Mrs Chapman said she loved being at the Nuffield Vale hospital for three nights and wanted to stay for a week! Physios Nicky and Christina have helped her immensely and she was out of bed on a frame early in the morning, just hours after her hip replacement in the late afternoon.

It took a while to get going, as her muscles were weak but she was very quickly able to function again and has been seeing her physiotherapist fortnightly with good progress. She has her 18 year old grandson living with her who helped after the operation, along with her daughter who came over to assist. A final x-ray and consultation is due at the end of January.

Suffering with arthritis in various joints, sadly Pamela had to give up her beloved horse riding 15 years ago, as she was finding it difficult to get onto her horse. Since the hip replacement, simple day to day things are making her life immeasurably better – being able to bend to put on her socks herself or trim her own toenails, for example, and simply getting about the house or going for a short walk. She says she now feels ‘fit and able’, with just a little discomfort now only occurring towards the end of the day. Pamela only takes painkillers when needed and that isn’t often anymore. Her right hip was the more deteriorated of the two and now that has been fixed, Mrs Chapman and her surgeon Mr Thomas are planning for the left hip to be replaced - with robotic arm- assisted surgery, of course!

THE NEXT GENERATION IN KNEE REPLACEMENT

Cardiff resident Robert OwenConway is delighted with his robotically assisted Mako knee replacement that well-known knee surgery specialist Mr Christopher Wilson implanted for him in November, as the first robotically assisted Stryker Mako knee in Wales. A keen sportsman, cyclist and walker, at 76, Mr OwenConway says his days of running the Cardiff marathon are now behind him but will soon be back on his bike, cycling 15 miles every other day around the city and in picturesque Solva, West Wales. For now, with a huge reduction in discomfort, he and his wife are enjoying daily threemile walks and he recommends the robotic procedure, which involves precision measurement for accuracy and consistency. Rob says, “Walking is absolutely perfect. Before the op, my wife was always ahead but now she can’t keep up with me!”

A slow progression of arthritis over a 10 year period, possibly as a result of over-use and working at heights as a lighting and service engineer, caused Robert to consult his GP two years ago, where subsequent x-rays showed the initial damage. This got much worse during lockdown, to the point that he couldn’t walk without severe pain, slept badly and couldn’t get off his bike, so could no longer cycle. A GP friend recommended Mr Wilson as a superb knee surgeon and Robert made an appointment with him at the Nuffield Health Cardiff and Vale Hospitals.

Consultant orthopaedic knee surgeon Mr Christopher Wilson explains, “When I met Mr OwenConway, his left knee was out of shape, being severely affected by arthritis. He struggled with daily activities, had a limited range of movement, getting comfortable to sleep was a problem and his knee scores indicated severe symptoms. X-rays showed significant arthritis, which only a total knee replacement would resolve. Being an active gentleman, we discussed the possibility of the Mako roboticallyassisted knee replacement, which would allow him to return comfortably to his hobbies of cycling and walking. Already he is doing really well with a much better range of movement.

This next generation knee replacement appears to be the way forward, as in every case there is great precision and this may offer more consistent results and a more rapid recovery with and less discomfort. The robot does not replace the surgeon but is used as an aid to increase accuracy during the operation, based on scans performed before the surgery.”

Robert went in for his new knee on the morning of Friday 19 November and was already able to stand with a frame the same day. After he managed the stairs, using crutches and encouragement from the physiotherapists, Robert was home again after just two nights in the Vale hospital. He said everybody was very helpful and he appreciated the direct instruction that made sure he was up and about quickly. He says, “The improvement has been in very definite stages and has been quite dramatic. I used to go to the gym until recently and played squash and rugby and went running in my 40s. I particularly enjoy cycling and that is what I am looking forward to returning to the most. It was a big investment but it is important for me and my wife Lynn for me to get back to living an active life, whilst I am in my mid 70s and still fit. I am really glad I found Mr Wilson, as he certainly knows his stuff and inspired confidence in me for the new robotically-assisted option. Life is just getting better and better.”

To find out more about Stryker Mako for hip and knee replacement surgery at Nuffield Health Cardiff and Vale Hospitals, please call 02920 836714 or see www.nuffieldhealth.com/ hospitals/cardiff-and-vale