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Joint Replacement Surgery: Minimally Invasive to Life and Limbs - 11/01/2006

“I’m ready to try cartwheels,” says Tom Macca, 62, of Newington, who had two total hip replacements at The Hospital of Central Connecticut’s Center for Joint Care.

Macca says he’s walking perfectly, without pain, for the first time in years, and he attributes it to the Center, and to Drs. Richard Froeb and Robert Carangelo, two of the Center’s affiliated orthopedic surgeons.

A machinist for 46 years, Macca, suddenly started feeling “unbearable” pain in his hips at age 60. The problem was osteoarthritis. Dr. Froeb replaced Macca’s right hip in early December 2005 and the left hip seven months later.
“I think the Hospital is better than any other I’ve seen... It’s something about the way everyone works together, the way they get things done, and the way they attend to your personal needs. Everyone cares,” he says. “My doctors are fantastic.”

Joint replacement surgery has been a specialty at the New Britain General campus for many years, but has evolved steadily to keep pace with the leading edge of the field. It is now known as the Center for Joint Care, one of the hospital’s Centers of Excellence, which offers a comprehensive program of seminars, patient education, and post-operative physical therapy.

Much like a joint needs bones, ligaments, and muscles to work properly, the staff of the Center for Joint Care work as a well-synchronized team. “The key is preparation, education, coordination, and consistency,” says Dianne Vye, RN, the nucleus of the team and manager of the program, which specializes in knee, hip, and shoulder replacements. Vye coordinates all patient care between the orthopedic surgeons, the nursing staff, physical therapists, occupational therapists, and volunteers.

Knee and hip replacements are now among the most common orthopedic procedures in the U.S. and are also among the most successful. According to the National Institutes of Health (NIH), more than 435,000 people have knee or hip replacements every year. The steady rise is attributed to an increasing population of seniors and, in particular, the wave of baby boomers reaching their sixties.

Surgical techniques have undergone a revolution. “I’ve been practicing for 29 years,” Dr. Froeb says, “so I’ve seen dramatic improvements in the practice of joint replacement. The materials we use, as well as instruments and techniques, have changed radically for the better.” Dr. Froeb has so much confidence in the procedure that his partner, Dr. Robert Carangelo, performed a partial knee replacement for him last year. “The result was excellent and I was back to work in 10 days,” said Dr. Froeb.

“Total hip and knee replacements have evolved over the last 30 years,” explains Dr. Carangelo, who has been in practice for 10 years and performs 300 joint replacements each year. “Surgical techniques, implant design, and computer-assisted surgery have all combined to significantly improve patient outcomes. Patients are also better educated and have greater expectations than ever before, which works to their benefit.”

Dr. Robert Belniak, chief of orthopedic surgery for the New Britain General campus at The Hospital of Central Connecticut agrees. “Minimally invasive surgical techniques have improved things significantly for patients. We can do so much more now with joint repair and replacement through a much smaller incision than previously possible. This has many advantages: quicker recovery, less scarring, less pain, less damage to surrounding healthy tissue, less blood loss, shorter hospital stay, and less chance of infection.

“The procedure can be customized to the specific problem that exists. There have been huge advancements in the miniaturization of instruments and in the design of prosthetics; only the damaged part of the knee needs to be replaced,” explains Dr. Belniak, who has more than 15 years of experience in the care of arthritis and sports-related injuries. His partners at Grove Hill, Drs Frank Gerratana and Stephen Pillsbury, both have more than 25 years of experience in orthopedics.“Now, we can get a better result with less pain, a smaller incision, and more rapid healing. The same is true of hip replacement, shoulder and rotator-cuff surgery, and most other orthopedic procedures,” says Dr. Belniak. “Procedures are more customized to specific problems. Patients can get on with their lives much more quickly,” adding that when patients experience less pain, they have a more optimistic attitude about the procedure, which in turn influences total recovery.

“Everyone on the staff was excellent,” says Robert Baehr, an active 78-year-old who was not ready to slow down, despite the increasing pain of osteoarthritis in his knees. “Dr. Belniak told me, ‘You’ll walk when I’m finished.’ I wasn’t nervous at all.” Just a day after Dr. Belniak performed a partial knee replacement in October 2005, Baehr said he was feeling “sore, but good” about the surgery. Baehr’s recovery went so well that he underwent a total right knee replacement the next spring. Four months later, he reported that he could bend both knees and could walk up the stairs. Baehr, a World War II veteran, lives alone, but has two sons and three grandchildren who live nearby, so his independence is particularly important to him.

The Center for Joint Care’s positive team approach is essential to such successful outcomes. According to Dr. Robert Waskowitz, who has been in practice for 12 years, patients are the beneficiaries when the team works closely together. Although technology drives the advances in the field of orthopedic surgery, Dr. Waskowitz believes it’s the human and collaborative approach that makes the Center, its staff, and its surgeons truly unique. “The Center allows us to keep up with the pace of orthopedics; to stay current and to use state-of-the-art equipment.”

Elliott Cohen of Kensington, a retired pharmacist, was ready for a hip replacement three years after he was diagnosed with osteoarthritis. Waskowitz performed the surgery in October 2004.“It was a walk in the park,” says Cohen. “My incision was about 6 inches… I was out of bed after 16 hours. Within about 25 days of the operation, I was walking without a walker.”
“Everyone here was just fantastic — the nurses, the aides, the physical therapists, and of course Bob Waskowitz.”
Cohen says his surgery has “changed my way of living,” adding that he has three grandchildren who live nearby and that he and his wife still love to travel. So enthusiastic are they about the hospital and its programs, Cohen and his wife, Marsha, funded the Cohen Goodlife Center, a fitness and rehabilitation gym, where they work out at an average of a few times a week.

The Center for Joint Care sees close to 600 patients per year, most of whom stay in the hospital for three days post-operatively. Two registered physical therapists work exclusively with joint replacement patients in the Center’s exercise/ rehabilitation room. Occupational therapists also work with patients to help them adjust to daily living in the post-operative period.

By January 2007, the Center will move to a new space at the New Britain General campus, where it will have its own dedicated facility with 12 private rooms and a new rehabilitation gym. This fall, the Center is establishing a unit at the Bradley Memorial campus.

“When patients come to the Center for Joint Care,” says Dr. Waskowitz, “they’re getting state-of-the-art care from a really cohesive unit of dedicated professionals.”

And that, says hip replacement patient Elliott Cohen, is the reason he wouldn’t go anywhere else.