Geoffrey Westrich, MD

These days you hear a lot about the use of robotics in joint replacement and other surgical procedures. Many orthopedic surgeons who perform robot-assisted surgery find that it improves the accuracy and predictability of a knee or hip replacement.  Indeed, the use of computer-assisted navigation and robotic assistance for total knee replacement has grown tremendously over the past few years and shows no sign of slowing down. Among American Association of Hip and Knee Surgeons attending the 2020 annual meeting, 77% of respondents indicated that they used technology in their surgical cases. The most common reason they cited was to increase surgical precision. A large study we undertook at Hospital for Special Surgery (HSS) found another major advantage of using a robot. Accessing and analyzing a huge national database with information on more than one million knee replacement patients, we found that surgery performed with robotic assistance led to a lower complication rate in the fir...

After multiple joint replacement surgeries, my patient Lorry jokingly calls herself a “bionic woman.” She always enjoyed an active lifestyle, so when arthritis caused by wear and tear started to take an unwelcome toll on her knees and hips, she refused to take it sitting down. Over the last six years, she has received four joint replacements – both knees and both hips – so she could enjoy life without pain. It’s not unusual for patients to have advanced arthritis in two joints. Having four joint replacements is less common, but it does happen. I recommend that people considering multiple joint replacement surgeries do their research to find a high-volume joint replacement center and a highly experienced orthopedic surgeon who takes the time to answer all their questions and with whom they feel comfortable. For someone having more than one joint replacement, timing and recovery are important, and no two patients are alike. If someone has painful arthritis in both knees, for example,...

Hip replacement to relieve arthritis pain is considered one of the most effective surgeries in the United States. Over the past decade, improvements in surgical technique, implant design, anesthesia and pain control after surgery have contributed to its success, says Geoffrey Westrich, MD, an orthopedic surgeon at Hospital for Special Surgery (HSS).  More than 450,000 total hip replacements are performed each year in the United States, according to the Agency for Healthcare Research and Quality. One of the most noteworthy advances is what’s known as a “dual mobility” hip replacement, according to Dr. Westrich, who has conducted several studies on the implant. He and colleagues have found that the dual mobility prosthesis reduces the risk of dislocation, one of the most common complications after hip replacement surgery. While the incidence is less than 2% at Hospital for Special Surgery and other major joint replacement centers, it is significantly higher at some other locations....

Knee replacement surgery is one of the most effective and predictable orthopedic procedures.  Hundreds of thousands of patients have a knee replacement each year so they can enjoy life pain-free and get back to activities they’ve given up.   Over the past couple of years, I’ve seen good outcomes with a newer type of “cementless” or uncemented knee replacement. There is reason to believe that this type of implant could last longer than traditional implants that require the use of bone cement.  The traditional implant used in knee replacement generally lasts a long time—15 to 20 years—but it doesn’t last indefinitely. When the implant wears out or loosens, patients generally need a second knee replacement, known as a revision surgery. The cementless knee replacement could change that.  In a standard knee replacement, the components of the implant are secured in the joint using bone cement. The technique has worked well for decades. But eventually, over time, the c...

Having a hip or knee replacement and going home from the hospital the same day is becoming more common. The surgery is generally performed early in the morning, and the patient goes home at the end of the day. Five years ago, outpatient joint replacement was almost unthinkable. But advances in technology, surgical technique and pain management over the past few years have made same-day hip or knee replacement a viable option for patients who meet certain criteria. During the pandemic, many people find this appealing since they leave the hospital more quickly and can spend their first night after surgery in the comfort of their own home. These days, much smaller incisions and robotic-assisted joint replacement, which allows for ultraprecise positioning of the implant, benefit patients who wish to go home the day of surgery. A study in the Bone & Joint Journal in 2018 by researchers in the United Kingdom found that robotic-assisted total knee replacement was associated with decrease...

Over the past two decades, I have seen many advances in joint replacement surgery that have benefited patients. I believe robotic-assisted knee replacement, which allows for an ultra-precise procedure, is one of the most exciting.  I recently reached a milestone when I performed my 500 th robotic-assisted knee replacement. I use the MAKO robotic system, which is FDA-approved for both total and partial knee replacements. Joint replacement is highly successful in relieving arthritis pain and improving quality of life, and robotic system allows us to really customize the procedure for each patient. The MAKO system allows for optimal alignment and positioning of the knee implant, as well as optimal ligament balancing, all critically important for the best outcome and long-term success of the surgery. Such precision could potentially lead to a longer-lasting knee replacement. Over the past few years, I've seen more patients in their 40s and 50s with arthritis. The main concern for ...