FRESH VOICES: BOLD and BALANCED
Sarasota orthopedic surgeon uses inexpensive, yet highly effective partial knee replacement system
|Specializing in arthritis and joint replacement surgery, W. Kim Furman, MD, FAAOS, joined Sarasota Orthopedic Associates in 1986, with offices in Lakewood Ranch and Sarasota. The former chief of orthopedics at Sarasota Memorial Hospital, Doctors Hospital and Orthopedic Director at Health South Rehabilitation Hospital of Sarasota, Furman earned degrees from Northeastern University in Boston and Mt. Sinai School of Medicine in New York. He trained under the guidance of Gerald Engh, MD, who developed the TGS® (tissue-guided surgery) partial knee replacement system, during a fellowship in total joint replacements/arthroscopic surgeon at Anderson Orthopedic Research Institute in Virginia. Dr. Furman has conducted orthopedic research and publishes articles in medical journals. He has traveled internationally to instruct orthopedic surgeons on total joint replacements.
SARASOTA—“You’ve heard about the latest high-tech partial knee replacement systems, right?”
Kim Furman, MD, FAAOS, asked about high-priced partial knee replacement (PKR) systems many hospitals are challenged to supply community physicians.
“I feel your surgeon should be doing your surgery and not a robot,” said Furman, who specializes in arthritis and joint replacement surgery at Sarasota Orthopedic Associates in Sarasota. “A robot doesn’t guarantee a perfect result. It depends on the technician using the robot. I use a different system for partial knee replacement that I believe will become more the norm because it relies on equipment that’s dramatically less expensive than a $1 million-plus, hospital-acquired robot.”
The minimally-invasive system: the TGS® (tissue-guided surgery) PKR system is guided by the patient’s own tissue sleeve. Developed by Furman’s mentor, Gerald Engh, MD, the system works best for patients with arthritis localized in the medial or lateral side of an interior compartment of the affected knee.
The TGS® PKR system balances a patient’s soft tissue during unicompartmental knee arthroplasty. The instrumentation allows the surgeon to prepare the femoral condyle using the patient’s own unique, natural knee motion to balance soft tissue, resulting in a kinematically-correct, patient-specific resurfacing of only the arthritis-affected areas.
“It’s a great option for patients who have arthritis purely localized to one compartment of the knee joint,” said Furman. “The beauty of a partial knee replacement is that it returns the patient to an almost full range of knee motion in a much shorter period of time, compared to a full knee replacement. It takes only a few weeks to recuperate, 6-8 weeks for full healing, and leaves a smaller scar. It’s much less tissue invasive, has a much lower risk of blood loss because of shorter tourniquet time, and gives a more natural feel to your own knee versus a full knee replacement, where it’s … let’s face it … just not what Mother Nature gave you.”
Specifically, here’s how the TGS system works:
The surgeon makes a small vertical and a transverse resection to remove a thin slice of the top of the inner tibia. This will remove the worn cartilage layer and a small amount of the bone supporting it. the TGS®partial knee system, the surgeon then uses this newly created “shelf” of bone to support the patented instruments designed to separate the femur and tibia under a controlled force and position a cutting element to prepare the femoral condyle. This instrument is set to remove the least amount of bone possible from the femoral condyle as the surgeon extends the knee to prepare a support surface for the femoral implant. This controlled movement is guided by the patient’s own ligaments and results in a final implant-to-implant placement that is patient-specific.
The procedure takes no longer than 45 minutes, said Furman.
“It could be done on an outpatient basis, but my preference is at least overnight in the hospital, and possibly an extra day. If complications are going to arise, it’s usually within 24 to 48 hours. The biggest risk we worry about with any hip or knee surgery is phlebitis, pulmonary embolus and infection.”
So far, Furman is arguably the only orthopedic surgeon in the Sarasota-Manatee-Charlotte area using this particular PKR technique.
“We all (orthopedic surgeons) have access to and use myriad partial knee replacement systems,” he said. “This is a very unique instrumentation system that is a much better fit than other systems I’ve seen or used.”
Editor’s note: This article marks the first in a new hospital advocacy series, Fresh Voices: Bold and Balanced.