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Vail health feature: Exploring total joint replacement

Dr. Nathan Cafferky, of Vail Summit Orthopaedics, is a fellowship-trained orthopedic surgeon who specializes in joint replacement surgery.
Special to the Daily |

in an active population, such as the one that skis, hikes and bikes throughout the Vail Valley, joint wear and tear is an inevitable outcome of years spent exploring the mountains. For certain parts of the population, this wear and tear might eventually develop into more chronic pain that can become debilitative, which can be detrimental to activity level and quality of life.

Total joint replacement surgery is an option to alleviate this problem, and while potential patients for the procedure formerly had to look at medical options in Denver, Vail Summit Orthopaedics’ addition of a surgeon specializing in total joint replacement surgery has expanded options for countless members of the community.

Medical improvements

Joint replacement surgery is a major procedure for anyone thinking of the option, but patients looking at having a joint totally replaced are not alone. The National Institute of Arthritis, Musculoskeletal and Skin Diseases points to 1 million Americans each year who have a knee or a hip replaced.

Dr. Nathan Cafferky, of Vail Summit Orthopaedics, is a fellowship-trained orthopedic surgeon who specializes in joint replacement surgery, making him the only surgeon in the area with expertise in total joint replacement. Cafferky said that while surgery is never a benign procedure, medical advancements in total joint replacement have led to vast improvements in the procedure from even a decade ago.

“We’ve seen a lot of improvements over the last 10 years, particularly in terms of the materials we’re using for joint replacements,” he said. “The materials are much more biocompatible than in the past, and we’ve turned away from using metal on metal.”

In addition to advancements in surgical materials, the operative process for total joint replacement has changed, as well. Preoperative preparation is stressed just as much as post-surgical treatment, as patients are mentally and physically prepared for the stress of undergoing a surgical procedure, which can take a toll on the body similar to running a marathon.

Patients are also encouraged to seek out physical therapy before surgery to prepare their bodies for the physical demands of having a joint replaced. The post-operative part of recovery has changed, as well, with patients finding that they’re encouraged to begin using their new joint more quickly than before.

“My grandmother had both her knees replaced years ago, and she was in bed for a week after surgery,” Cafferky said. “Nowadays, we now know that it’s important to start using the new joint right away, as part of the rapid recovery protocol. We also understand pain control better today. With the use of multi-modal pain control, we can improve the patient’s pain control satisfaction and help them get moving faster and more comfortably.”

Similarly, computer navigation and the use of robotics in surgery have helped to create more baseline results throughout different demographics of patients.

Choosing the right option

Cafferky’s presence in the Vail Valley has made the prospect of joint replacement surgery far more viable for residents in the area, as patients previously had to head down to Denver for medical care. This made associated appointments and having nearby support of family and friends difficult for patients, particularly in regards to follow-up appointments.

While the procedure is easier for many Eagle County residents to undergo in terms of location, many patients might not be ready to pursue surgical options for recurring joint pain and arthritis. Younger, athletic populations with more wear and tear on their joints may be drawn to the surgery, as well as older demographics who are experiencing chronic pain and debilitative conditions, but Cafferky stressed that non-operative options should be exhausted before potential patients pursue joint replacement.

In particular, activity modifications to reduce pain, physical therapy and anti-inflammatory pain relievers are all avenues that should be explored before potential patients look toward surgery.

“We like to see patients coming in to explore surgical options who have tried and exhausted non-operative treatment first. The full benefit of a total hip or knee replacement is best experienced after the appropriate non-operative treatments have been attempted,” he said, “While age is only a number, we do like seeing patients who are a little older because while the technology with these joints has vastly improved, they can potentially wear out over time.”

If potential patients feel they have exhausted non-operative resources to alleviate joint pain, Cafferky said it might be the right time to look at surgery as the next step.

“Realistically, there is no exact time frame to have joint replacement done,” he said. “Having a joint replacement is about improving your quality of life; it can be done at any time it is convenient for the patient.

“Ultimately, the patients are the ones that need to make the decision. If a patient has exhausted all of the non-operative options, I can guide them through the risks and benefits of total hip or knee replacement surgery and help them decide if this process is right for them.”


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