Cutting-Edge Surgical Advancements: A Different Approach to Knee Replacement

An innovative new technology is helping people in the northwest suburbs to replace worn-out joints in a way that’s less invasive and faster to heal. It all begins with a unique robotic system.

Dr. Kenneth Chakour of Fox Valley Orthopedics uses robotic assistance to help him replace joints with a higher accuracy than traditional methods.

Sometimes, joint replacement is the only way to eliminate the pain of a worn-out knee.

When surgery is the only option, Fox Valley Orthopedics (FVO) now offers an innovative new approach that’s helping patients to recover faster and return to the active lifestyles they used to enjoy.

Since early March, FVO’s ambulatory surgery center in Geneva has been offering academic center-quality knee replacements using a surgical robot in an outpatient setting. This approach is a radical departure from traditional methods.

“It allows us to plan for implant placement before making any cuts in the bone, although we still have to cut bone,” says Dr. Kenneth Chakour, FVO’s specialist in total joint replacement. “It’s all done in a format that allows me to execute the plan with less than a millimeter accuracy, so the idea is that we are becoming more accurate in placing components.”

How does he achieve such accuracy? Building on the minimal invasiveness of a robotic-assisted surgery, Chakour cuts only what’s necessary to replace the joint. He customizes each operation, implanting the replacement knee in a way that’s close to what was originally there.

While it’s not a perfect match, the technique vastly improves on the more traditional, one-size-fits-all approach.

“Now, what I’m seeing is patients are doing better and they’re bouncing back faster,” Chakour says.
This “kinematic alignment” technique requires less cutting of soft tissue overall, but its real strength lies in the robot’s ability to work in tight spaces. No longer do physicians like Chakour need to rely on large instruments working inside the patient’s body.

“The robot only allows me to cut bone where I want, so it helps to keep me in bounds, if you will,” says Chakour. “It requires much less tissue dissection to get the new devices in and the procedure completed.”

In addition to new surgical approaches, patients can benefit from innovative “pre-hab” routines, where a physical therapist consults before the operation, teaching patients what to expect during and after the surgery.

“The idea is to teach them some of the techniques they will need when they leave the operating room,” says Chakour. “We’ll teach them things like how to use a walker and how to navigate around their home, and we’re even starting to have therapists go to homes ahead of time to do a safety check.”

Long before they go under the knife, patients work with Chakour on other ways to manage their joint pain. This might include modifying certain activities, taking medications or getting injections. When all else fails, the conversation turns to joint replacement.

He places a premium on educating patients and framing their expectations long before the operation.

“I think that’s why we’ve gotten the results we have,” says Chakour. “We have the same expectations and we know that this is our only option.”

With few exceptions, joint replacements at FVO are performed in an outpatient setting, with recovery taking place at home. Patients are typically out of bed and moving the joint within a few hours. Physical therapists work in the home for the first week or so and then meet patients at one of FVO’s clinics in Algonquin, Elgin, Barrington and Geneva.

“It is painful, but after the first two weeks, patients turn the corner and start to get much better,” says Chakour. “With a total joint replacement, recovery is about a year long, but 80% of that is in the first three months.”

Prior to arriving at Fox Valley Orthopedics this winter, Chakour performed robotic-assisted knee replacements at the University of Chicago Medical Center and during his fellowship at University of Louisville, where he was on the cutting edge of research and advancement in this technique.

The results he saw in his academic settings show a promising result for patients here in the western suburbs, where, for the first time, robotic-assisted joint replacement is providing a serious alternative for patients.

“In my experience, it’s been less painful in recovery,” says Chakour. “The literature doesn’t prove that it’s a faster recovery, but our satisfaction rates say a lot. When I was in fellowship, we were getting incredible satisfaction rates using the robot. And I think it allows us to provide a more consistent result, too. I don’t know a surgeon who can say they have less than a millimeter accuracy reliably and repeatedly.”