New Endeavors

By Amanda Millward

Moving along at the rapid pace by which area residents have come to call life, local hospitals are foraging their way into the realm of the latest technology when it comes to medical advances. Whether it be through intergrated electronic monitoring; use of robots for surgeries or prescription filling; advancements in heart disease, cancer or gastroesophageal reflux disease; state-of-the-art hybrid operating rooms; new FDA-approved treatments; or multi-million dollar expansions, each locale in Northern Virginia is seeing a boom in what our healthcare providers are offering their patients.

 

Virginia Hospital Center
1701 N. George Mason Drive, Arlington, VA 22205
703-558-5000 |  www.virginiahospitalcenter.com

By the year 2015, all healthcare providers will need to have medical records electronically stored. In less than five years, gone will be the days of filling out or updating the tedious patient history forms or talking to the doctor about new medications. All the necessities will be online for any healthcare provider to see and change.

The future may be closer than anticipated at Virginia Hospital where they implemented the electronic medical records system, or EMR system, in 2010.

“We made the decision [to go to an EMR system] because it was the right thing to do for our patients,” says David Crutchfield, vice president and CIO of Virginia Hospital. The EMR system will provide patients with better quality of care by having all information, films and lab work available instantaneously, as well as safety for the patients by providing bar-coded medication dosages.

The EMR system is implemented as soon as the patient is admitted to the hospital. First, all the registration information, such as insurance and reason for admittance, is collected and entered into the system. Then the patient is assessed, and more detailed information such as symptoms of illness, family and medical history, vital signs and current medications are gathered. The patient then receives a band with a bar code that is unique to that patient.

Physicians use the EMR system to place any kind of order, from medications to films and lab work to patient discharge. The system is backed up daily and is highly secure—all staff working with the patient must have password access—following HIPPA protocols.
Working in conjunction with the EMR system, Tommy the Robot, a robotic arm, can measure and seal medication for every patient at the hospital.

During the summer of 2010, Tommy the Robot—named after The Who’s “Tommy” opera—works by a prescription coming through the EMR system; a pharmacy technician then enters the information into Tommy’s system; and Tommy goes to find, package and seal the medication.

All this time, Tommy verifies the patient information and medication, making sure it is going to the correct person. After sealing, a pharmacy technician delivers the medication to the patient’s room and locks it in a cabinet.

Again, when the nurse comes to administer the medication, s/he scans the patient’s bar code and the bar code on the medicine to make sure it is going to correct patient.

“Tommy the Robot provides a level of safety. If there is any discrepancy, the nurse will get an alert to not distribute the drug,” says Dana Anderson, pharmacy director at Virginia Hospital. To date Tommy the Robot has never dispensed the wrong drug. Tommy undergoes weekly routine maintenance to make sure all the parts are working correctly.

Also, this past March, Virginia Hospital Center performed its first two cases on patients suffering from symptomatic paroxysmal, or self-correcting atrial fibrillation—the most common and one of the most undertreated heart rhythm disorders in American patients—using the Arctic Front Cardiac CyroAblation Catheter system.

Treatment, using the recently FDA-approved system, is for those patients who have failed standard drug therapy and continue to experience symptoms such as heart palpatations, shortness of breath, fatigue, light-headedness, and in some cases, passing out. If left untreated, these patients could suffer from stroke or heart failure.

“CyroAblation is a very effective way to isolate the circular organ, and when the procedure is used it is proven to be effective and less dangerous than radio frequency,” says Haroon Rashid, M.D., F.A.C.C.

The procedure uses a catheter that travels from the femoral artery to the area of the heart in need of treatment. Then, a burst of cold air is used to freeze and destroy the abnormal tissue.

Patients are observed overnight and are able to resume normal activity within two to four days.

This procedure is only available at certain hospitals on the East Coast.

- Artic Front Cardiac CryoAblation Catheter
- Tommy the Robot
- EMR (electronic medical records system)

 

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Children’s National Medical Center
111 Michigan Ave., NW, Washington, DC 20010
202-476-5000 | www.childrensnational.org

In memory of Sheikh Zayed, the founder of the United Arab Emirates, the crowned prince Sheikh Mohammed Zayed wanted to honor his father’s contributions and legacy of taking care of the world’s children. He made a large donation to Children’s National Medical Center starting The Sheikh Zayed Research Institute.

“We have a very focused goal to eliminate pain in children, and we are doing clinical research to do that,” says Kurt Newman, M.D., director of the institute.

The institute, which launched in 2009, is allowing for physician-scientists to be on-site not only working one-on-one with the patients but also allowing them to continue their research—focusing on four key initiatives: pain medicine, bioengineering, immunology and systems biology. “We want to be multidisciplinary, and sharing research and ideas to help children,” Newman explains.

Four floors from the institute, Children’s National Medical Center is also in the process of making a hybrid operating room with the latest technologies where the hospital can export real-time video of surgeries for teaching medical students, or for surgeons across the country to consult on the surgery.

Children’s is also proud to have the only Level IIIc Neonatal Intensive Care Unit in the region, which opened in 2009—the highest distinction available by the American Academy of Pediatrics guidelines. Children’s team includes neonatologists, neonatal neurologists, pediatric surgical and medical subspecialists, radiologists and specially trained nurses. The 54-bed unit helps babies who need care from ventilators to oscillators to extreme measures of total body cooling, as well as provides MRI equipment.

And moving a little closer to home, last year Children’s National Medical Center opened Children’s National Specialists of Virginia, an affiliated office located in Fairfax. The private, physician office-based practice offers specialty care in the following areas: hearing and speech; otolaryngology; ophthalmology; gastroenterology; hepatology; nutrition; orthopedic surgery and sports medicine; physical medication and rehabilitation; plastic and reconstructive surgery; diagnostic imaging and radiology; and urology.

- Sheikh Zayed Research Institute
- Hybrid operating room
- Level IIIc Neonatal Intensive Care Unit
- New NoVA location

 

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Mary Washington Healthcare
www.marywashingtonhealthcare.com

Mary Washington Hospital
1001 Sam Perry Blvd., Fredericksburg, VA 22401; 540-741-1100

Stafford Hospital
101 Hospital Center Blvd., Stafford, VA 22555; 540-741-9000

Joining forces with the University of Virginia Health System, Mary Washington Healthcare is bringing two new cancer treatments to the Fredericksburg area at their Mary Washington and Stafford Hospitals.

Stafford Hospital welcomed a new radiation oncology center in May featuring RapidArc, a linear accelerator used to treat patients with breast, prostate, lung and gastroenterological cancers, that delivers enough radiation to the affected area while saving healthy tissue—all while providing faster treatments and recovery.

And later this summer, the new Regional Cancer Center is expected to open on the Mary Washington Hospital campus. It will offer the sophisticated new stereotatic radiosurgery (SRS), or gamma-knife radiosurgery, through TrueBeam technology. Doctors will be able to provide targeted radiation to brain tumors, all while significantly avoiding damage to the surrounding healthy tissue.
With the addition of these new centers the Cancer Center of Virginia in Spotsylvania County will close, with its staff moving into the new center in Fredericksburg.

- University of Virginia Health System
- Radiation oncology center featuring RapidArc
- Regional Cancer Center
- TrueBeam

 

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Fauquier Hospital
500 Hospital Drive, Warrenton, VA 20186
540-316-5000 | www.fauquierhospital.org

New medical innovations are coming to Fauquier Hospital including Provenge, a breakthrough for treating type 4 prostate cancer—a treatment that was approved by the FDA last year.

“A couple of clinical trials have shown that [Provenge] prolonged the life of patients that had metastatic prostate cancer for a good four to five months, which doesn’t sound like a lot, but in the world of cancer treatment, that’s actually a significant amount,” says Dr. Syed Salman Ali of Fauquier Health Hematology/Oncology Department.

During the treatment, a patient’s blood is drawn to extract the white blood cells, and then sent to a lab for processing and culturing in order create antibodies. Once returned, the cells are re-infused into the patient over a month-long process, allowing the patient’s own cells to work and fight off the cancer.

Along with major medical breakthroughs in cancer treatments, Fauquier Hospital is also making strides in their treatment of less threatening, though equally as important, ailments through two new tests that help determine the causes and, through that, the treatment of gastroesophageal reflux disease, or GERD. The classic GERD symptoms may include a burning in the chest, hoarseness and scratchy throat.

“There were people who were suffering with acid reflux and we would have a negative study, but they were refluxing other stuff such as bile or digestive enzymes,” says gastroenterologist Darren Baroni.

The first test, Esophageal pH-Impedance Monitoring, is quite invasive because a tube is guided through the patient’s nose to the stomach. The patient is then asked to have this tube in for about 24 hours and asked to do normal activity. The monitoring’s purpose is to see if there is any resistance in the stomach or if fluid is coming up the esophagus.

Second, the doctor may also perform an Esophageal Manometry. Again, the patient will swallow a tube, but this time the test will consist of swallowing liquids to make sure food and liquids are moving through the esophagus normally. This test lasts about 10-15 minutes.

In the summer of 2009, Fauquier Health partnered with National Healing and opened its Wound Healing Center, offering treatment to slow-healing wounds caused from ulcers, bone infection, gangrene and radiation burns, to name a few.

The center also is the only facility in the area to offer hyperbaric oxygen therapy, where patients are placed in a chamber and breathe 100-percent oxygen, facilitating the healing process.

- Provenge (for treating type 4 prostate cancer)
- GERD (gastroesophageal reflux disease) tests
- Wound Healing Center

 

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Sentara Potomac Hospital
2300 Opitz Blvd., Woodbridge, VA 22191
703-670-1313 | www.potomachospital.com

For years, Sentara Potomac Hospital’s responsibility to its cardiac patients was to provide enough care to withstand the long journey up I-95 to another hospital with the technology and staff to handle cardiac emergencies. However, this has changed with the May opening of the Sentara Heart and Vascular Center.

“The opening provides patients access to state-of-the-art diagnostic and treatment options as well as safe, quality, compassionate care” says Tricia Hill R.N., M.S.N., associate director of nursing, who adds that prior to this approximately 2,500 cardiac patients were transported to another facility each year.

The 12,000-square foot facility will house: catheterization and radiology suites, each with the capability to perform noninvasive and invasive treatments depending on the patient’s needs; stress test labs; echo labs; a nuclear cardiology lab; noninvasive vascular labs; exam rooms; eight pre- and post-procedure rooms; dedicated parking; and a cybercafé in the reception area.

“When it comes to cardiac and vascular disease, our collaborative multidisciplinary approach truly spans the continuum of care. From prevention to diagnosis, noninvasive to minimally invasive to interventional treatment options, our clinically expert team is committed to ensuring an extraordinary patient experience, each and every time,” Hill explains.

The Heart and Vascular Center will not only help those having a STEMI (ST-elevation myocardial infarction, the most lethal form of heart attack), but also will educate patients on their next level of care, which happens in the home. “It’s more about having them come in for their treatment. We really have to look at the whole continuous care, and so in essence we look at the patient and transition them to the next level,” explains Hill.

In addition, the center offers community seminars about heart healthy living, as well as EKG days where residents can get their baseline information prepared on a card. Patients can carry the card with them wherever they go. Sentara has also moved to an EMR system.

- Sentara Heart and Vascular Center
- Community seminars and EKG Days
- EMR

 

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Culpeper Hospital
501 Sunset Lane, Culpeper, VA 22701
540-829-4100 | www.culpeperhospital.com

Opening its doors on March 2011, the Radiation Oncology Department of Culpeper Hospital gave Culpeper residents a place to receive treatment close to home. In addition, University of Virginia has joined into a partnership with Culpeper Hospital to bring radiation oncology and other services to the community.

“In 2007, as a small community independent hospital, we recognized we needed an exclusive strategic partner—simply because we needed greater access to expertise, technology and capital to be able to sustain going forward,” says Lee Kirk, president and CEO of Culpeper Hospital. UVA and Culpeper are working on bringing other services in urology, gastroenterology and breast health to the hospital.

In the Radiation Oncology Department, UVA and Culpeper doctors work together, through video conferencing, to discuss patients’ illnesses and view all tests and films as well as treatment plans. Changes or concerns are brought up, and the best possible plan is made with the hospital’s doctors as well as faculty physicians from UVA.

“Things have switched from 2D planning to 3D treatment planning where [patients] would get a CT scan of the treatment position and [doctors] upload it to a computer. It gives us a new way to look at the site and make suggestions for the treatment,” says Shiv Kandelwal, M.D., medical director of Radiation Oncology at Culpeper Hospital.

At this time, Culpeper oncology patients undergo Thomotherapy. Unlike other radiation therapy machines that treat tumors from seven different directions and from a fixed point, Thomotherapy treats a tumor from about 51 different directions using about 4-20 million volts to kill the tumor. It can also target just the infected area and miss healthy organs and tissue. Patients may have skin irritations, depending on the type of treatments, and may experience other side effects from Thomotherapy.

The Culpeper and UVA doctors have treated many patients in their local area instead of patients traveling great distances to receive cancer treatments.

“We have a large area around Culpeper that is underserved for radiation therapy. So we are making it available to patients in Culpeper and in Northern Virginia,” says Kandelwal.

- Partnership with UVA
- Radiation Oncology Department
- Thomotherapy

 

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Reston Hospital Center
1850 Town Center Parkway, Reston, VA 20190
703-689-9000 | www.restonhospital.com

Given the green light in early 2010 by the Fairfax County Board of Supervisors to move forward with a major expansion—a phased process bringing in 380,000-plus square feet—Reston Hospital Center is continuing to forge ahead through “smart growth” on both medical technology and partnerships.

“We have grown from a small, community hospital to a community-based hospital with tertiary capabilities,” says Joanna Fazio, director of communications at Reston Hospital.

The latest addition to its resume: the da Vinci Si Surgical System, offering a minimally invasive alternative to traditional open or laparoscopic surgery used for gynecological, urogynecological, urological and thoracic surgeries. Da Vinci-trained surgeons control the device, making small, precise incisions resulting in shorter recovery times, fewer complications and reduced hospital cost and trauma to the patient.

Reston Hospital is also advancing its offerings for cardiac patients with their Chest Pain Center, which is connected to the emergency department and its cardiac cath lab. When a patient comes in with chest pain, they are immediately transferred to the center where tests are performed and, if necessary, treatment is provided. The steps Reston has made in cardiac treatment gained them membership into the Society of Chest Pain Centers, the only hospital in the region with the distinction.

“The goal of the Society of Chest Pain Centers is to significantly reduce the mortality rate of these patients by teaching the public to recognize and react to the early symptoms of a possible heart attack, reduce the time that it takes to receive treatment, and increase the accuracy and effectiveness of treatment,” says Fazio.

The hospital’s affiliation with Washington Hospital Center has allowed the Reston heart and vascular team training and education, access to the WHC cardiac cath lab training center, and a transfer agreement for patients in need of cardiac surgery, explains Fazio.

- da Vinci Si Surgical system
- Chest Pain Center
- Overall facility expansion

 

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Dominion Hospital
2960 Sleepy Hollow Road, Falls Church, VA 22044
703-536-2000 | www.dominionhospital.com

Before the Reflections Treatment Center was available in the Northern Virginia area, people who were suffering from eating disorders had to travel to another state to receive treatment. In 2009, staff at the hospital realized this need for the D.C.-Metro area and decided to investigate treatment options for the diseases. They visited other treatment hospitals, talked to former patients of the treatments hospitals and consulted local therapists on the needs for the area.

“Rather than just having doctors design the program, we asked former patients [of other facilities] to contribute,” says Dr. Gary Litovitz, medical director of Reflections Center and Dominion Hospital. His team asked the patient focus group about what were the most helpful, most comfortable and most distressing parts of their treatment.

After the research, Dominion Hospital worked to make the center as quickly as possible, but they did not want the patients to feel like they were in a hospital. Instead, the staff wanted the eating disorder patients to feel as if there were at home, with soothing wall colors and deco art.

Voluntary patients—either inpatient or partial hospitalization (coming in 12 hours a day)—undergo an evaluation with nurses, psychiatrists, dieticians, a primary care physician and internists to determine the best possible care. Patients participate in a series of group therapy, individual therapy, expressive therapy, family therapy, nutrition and fitness education classes.
Reflections staff also hold seminars and talks with area doctors and the community. Eating disorder support groups are also available for non-patients on Wednesday nights.

- Reflections Treatment Center

 

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Prince William Hospital
8700 Sudley Road, Manassas, VA 20110
703-369-8000 | www.pwhs.org

In January 2011, Prince William Hospital opened the Heart Catheterization Lab, which is the only lab in Prince William County to provide vital services for patients suffering from cardiac problems.

The 4,000-plus-square-foot lab features the most advanced technology for heart diagnostics, allowing doctors to perform diagnostic heart catheterizations, permanent implantable cardioverter-defibrillator, pacemaker insertions and pacemaker battery changes; and is fully equipped to offer interventional cardiology services in the future.

“Before opening our lab in January 2011, our patients in Manassas and Western Prince William County had to travel out of the area to receive a heart catheterization procedure,” says Melissa Robson, president of Prince William Hospital. “Now they have the convenience of receiving care and services close to home.”

In addition to the Heart Catheterization lab, Prince William Hospital is also renovating their orthopedic and oncology units, offering patients and their loved ones a more therapeutic environment by changing the wall color to a more soothing palate and building private rooms so family members can spend the night.

“Having families and loved ones involved in care provides a smoother transition to the home environment,” says Robson.
The orthopedic unit, which opened in June, increases the number of rooms, provides new beds that help relieve pressure on the spine for orthopedic patients, and bigger bathrooms for more maneuverability.

The orthopedic unit also houses a new state-of-the-art gym for patient rehabilitation and therapy services, as well as a computer system reporting real-time progress of the appointments to those waiting for the patient in the waiting rooms.

- Heart Catheterization Lab
- Renovation of orthopedic and oncology units

 

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Inova Alexandria
4320 Seminary Road, Alexandria, VA 22304
703-504-3000 | www.inova.org/iah

In 2009, the FDA approved a new treatment to fight certain cancers, and Inova Alexandria Hospital is the first hospital in the D.C.-Metro area, and one of less than 20 centers nationwide, providing it. Nanoknife, a minimally invasive cancer treatment, is used on just about any soft tissue cancer including those of the liver, lungs, kidney and pancreas; however, it cannot be used on skin or brain cancers at this time.

To use Nanoknife, doctors insert very small needles, about the size of IV needles, through the skin to the tumor site. Watching either through a CT scan or and ultrasound, doctors poke holes into the tumor cells and then attack the cells with short bursts of high-voltage low-energy electrical pulses. The tumor cells rupture and die.

“Nanoknife has given us the technology to kill tumors around arteries and veins or important organs,” says Dr. Sandeep Bagla, an interventional radiologist specializing in minimally invasive oncology therapies.

The treatment can be used either as part of a multi-step treatment plan, first trying other therapies to reduce the tumor size, or as the only method of cancer treatment. Usually, for tumors below four centimeters, radiologists would perform the Nanoknife procedure, giving a 90-percent success rate of patients only needing one session to destroy the tumor. However, a tumor more than five centimeters and other therapies may be used before Nanoknife can be productive.

There are no incisions or stitches involved in the procedure, and patients make a full recovery within one to two days. To ensure that the tumor has been ablated or that other tumors have not grown, radiologists check with the patients in intervals of one day after the procedure, to one month all the way up to one full year.

At this time Nanoknife treatment is being studied on its effectiveness on brain tumors.

In addition, Inova Alexandria has revamped their Cardiovascular and Interventional Radiology Department. The CVIR will provide non-invasive cardiac treatments along with electrophysiology.

- Nanoknife technology
- Cardiovascular and Interventional Radiology Department renovation

 

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Inova Fairfax
3300 Gallows Road, Falls Church, VA 22042
703-766-4001 | www.inova.org/ifh

A leader in many aspects of healthcare, The Inova Heart and Vascular Institute at Inova Fairfax Hospital is one of just 40 hospitals in the country chosen to participate in the Medtronic CoreValve U.S. Clinical Trial. The investigational Core Valve System is used to treat high-risk patients with severe aortic stenosis. During the procedure, doctors advance the CoreValve System, composed of a catheter with a porcine, prosthetic valve, through the patient’s femoral artery to reach the heart. There, the system self-expands to replace the diseased aortic valve. The procedure is completed without open-heart surgery or surgical removal of the native valve.

Doctors successfully implanted the device in a patient in April, becoming the first hospital in the Mid-Atlantic region to do so as part of the clinical trial.

“There is significant need for new treatment options for high-risk patients with severe aortic stenosis,” Bryan Raybuck, M.D., medical director of catheterization laboratories at Inova Heart and Vascular Institute, stated in a recent press release. “Currently, open-heart surgery is the only effective treatment option, but not all patients are candidates for surgery. This will hopefully be an alternative option for patients who require a less invasive procedure.”

Another endeavor putting Fairfax on the map, hybrid operating rooms at Inova Fairfax’s Inova Heart and Vascular Institute, offering a combination of a traditional OR with the technological advances of a catheterization lab—what Alan Speir, M.D., medical director of cardiac surgical services for Inova Health System, calls “the most sophisticated cardiac interventional facility in the region, if not the country.”

The hybrid OR, exclusively for cardiac surgeons, electrophysiologists and cardiologists to collaborate and perform combined surgeries, will have a Philip’s 3D Heart Navigator that combines 3D CT scan images to a single image.

Finally, Inova Fairfax will undergo a $161 million renovation later this year, building a new patient tower with 174 private rooms, neuroscience ICUs, traditional ICUs, as well as renovations to the existing building—estimated to be completed in 2012.

- CoreValve System
- Hybrid operating rooms
- $161M renovation

 

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Inova Loudoun
44045 Riverside Parkway, Leesburg, VA 20176
703-858-6000 | www.inova.org

Until recently, Inova Loudoun Hospital did not have the capability to treat heart attack patients. Although a heart catheterization lab was onsite, patients needing surgery would be transported to Inova Fairfax.

All that has changed with the new minimally invasive percutaneous coronary intervention procedure at the 15,000-square-foot Schaufeld Family Heart Center on the hospital’s Lansdowne campus.

“People of Loudoun County are very proud. They have always wanted their hospital to do as much as possible,” says Dean Pollock, M.D., medical director of the Catheterization and Electrophysiology Lab at Inova Loudoun.

In the 1980s, heart attack treatment was a simple clot-dissolving medicine helping about 60-70 percent of heart attack patients; the other 40 percent would go on to have heart attacks. Around the mid-’90s, studies showed that if a patient directly enters the catheterization lab for diagnosis, doctors could quickly spot the problem and fix it using coronary intervention treatments, usually stents or balloon angioplasty.

“There was less damage to the heart, more people survived, the length of the hospitalization was less and [coronary intervention] gradually became the standard of care for heart attacks,” says Pollock.

Unfortunately, there were a small percentage of heart attack patients that would have complications to coronary interventions. If coronary intervention did not help, patients would then have to be transported to have bypass surgery. At this time most coronary interventions were done at hospitals that had surgical capability.

In 2009, after research was released on the importance of time in terms of heart attacks, Inova Loudoun opened its Catheterization and Electrophysiology Lab.

“When a patient comes in with a heart attack, time is of the essence. We need to get patients to the cath lab and open the artery as soon as possible. If we can open the artery quickly, little damage is done to the heart. If a patient waits three to five hours to seek treatment, significant damage to the heart is done,” Pollock explains.

Loudoun’s average wait time from when a patient first walks in with signs of a heart attack to treatment is approximately 66 minutes. The national average is 90 minutes. Since opening the lab, the doctors have performed over 750 catheterizations, 300 interventions; and about 125 were heart attack patients.

“It is important for people to know that we can’t start to open up the artery until the patient gets to the hospital,” Pollock stresses. “Patients should not put up with chest pain for hours and hours before they finally decide to come to the hospital. The sooner they get to the hospital, the sooner we can get started with treatment and save heart muscle.”

And along with all the new treatments of cardiac patients, Inova Loudoun is also taking steps to benefit all patients in the area. The Inova Medical campus in Leesburg has started on a major renovation—expanding the existing emergency department, laboratory and outpatient diagnostic imaging areas, and constructing a new inpatient behavioral medicine unit—with an estimated 2014 completion.

- Precantaneous Coronary Intervention unit
- Catheterization and Electrophysiology labs

 

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Inova Mount Vernon
2501 Parker’s Lane, Alexandria, VA 22306
703-664-7000 | www.inova.org/imvh

Due to high patient demand, Inova Mount Vernon Hospital is proposing a $43.6 million expansion project that will consist of a new patient tower, two operating rooms, private rooms, upgrades and additional space for future growth. The project will also include a revamp of medical and surgical spaces, orthopedics, joint replacement and rehabilitation care.

At this time, the project is being discussed on the local and state regulatory boards for approval. Inova Mount Vernon expects to receive approval sometime this year. Once approved, construction is expected to start in 2012.

 

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Inova Fair Oaks
3600 Joseph Siewick Drive, Fairfax, VA 22033
703-391-3600 | www.inova.org/ifoh

Inova Fair Oaks Hospital’s newest foray is in the partial knee replacement arena with the MAKOplasty procedure, where an orthopedic surgeon replaces one or two compartments of the knee with the help of a robotic arm.

The procedure is ideal for people who live an active lifestyle and who have arthritis in either one or two compartments of the knee.

The incision for the procedure is smaller and the recovery time is much faster than for a total knee replacement. In addition, rehabilitation time is shorter as well.

“Patients can return to fairly normal activity. I have patients returning to tennis and skiing, but returning to running depends on the surgeon,” says Dr. James Reeves, orthopedic surgeon at Inova Fair Oaks Hospital.

“The benefit is that [surgeons] don’t have to remove the anterior or posterior compartments [of the knee], so the patient can keep all of the ligaments and keep the healthy cartilage for a more normal feel.”

Before surgery, the patient has a CT scan, allowing the surgeons to make a 3D model of the knee and construct a replacement. During surgery, a robotic arm removes the affected bone and precisely inserts the knee implant—avoiding healthy tissue and bone.
“[This program] allows us to position replacements very precisely based on how we remove the bone,” explains Reeves. “We’re essentially positioning the implants by using the computer program.”

Patients stay in the hospital overnight and have to attend physical therapy to strengthen the knee.

Orthopedic doctors and surgeons follow up with patients to make sure there are no complications. Reeves see his patients at intervals of two weeks and six weeks after surgery, then four months and then a year. The intervals depend on the doctor, but most patients must follow with up the orthopedist for the rest of their lives.

Similar to full knee replacements there are risks of blood clots, stiffness in the implant area, and infection in the implant area; however, since partial and full knee replacements are common practice, the chances of having such risks are low.
Patients are able to return to work and activity within about two weeks, faster than full knee replacement, and the pain from the arthritis is virtually gone.

- Makoplasty procedures

 

(August 2011)