By Cherry Odom, BSN, RN-BC
Seasoned triathlete and retired Mars Hill University sociology professor Tom Plaut knew nine years ago that the pain in his left knee meant his many years of running, biking and swimming had taken a toll on his body.
“The wear and tear on my knee resulted in bone landing on bone,” said Plaut. After partial knee replacement surgeries performed by S. David Jarrett, MD, orthopedic surgeon with Asheville Orthopaedic Associates, on the left knee in 2010 and the right knee in 2013, Plaut said, “It’s a terrific procedure and made a real change in my mobility.”
No Stopping Him Now
Plaut added that science and technology have fostered many advancements in replacing knees. “The knee surgeries enabled me to continue biking,” he said. “A generation ago, I would not be very mobile and instead would be rocking on a porch.”
At nearly 82 years old, Plaut completed a 32-mile trek in the June 2019 WNC Flyer biking event near Mills River. His ride included a climb of over 1,300 feet. Earlier in the year, he and his wife of 48 years, Marian, went on a walking tour of France. He stays in shape by biking 15 to 20 miles once or twice a week and climbs of one to two thousand feet.
Robotic Equipment Improves Accuracy
“The manufacturer of the robotic equipment trialed the robot in several centers for a few years before making it available to hospitals in general. I knew immediately when I saw it that it would help me do a better partial knee surgery,” said Dr. Jarrett. “The robot can improve the accuracy of bone removal to within a tenth of a millimeter and enables us to work through a smaller, more minimally invasive incision. Using the robot adds more details to the surgery, but the outcomes make it worth it. Happy patients are the priority.”
The precision of the surgery, Dr. Jarrett explained, is possible by creating a digital template via a mapping CT scan and verifying the template intraoperatively prior to bone preparation. “A burr on a robotic arm is moved over the surface of the bone by the surgeon until the designated bone is excised,” he said. “The robotic arm will not let the surgeon move the burr over bone not programmed to be removed.”
Depending on the time of day when surgery is completed, many patients are discharged home the same day. Dr. Jarrett said that these patients who recover well in the postoperative area and go home with either home health or outpatient physical therapy. Both of Plaut’s knee replacements involved overnight stays in the hospital.
Progressive mobility allows immediate weight bearing on the knee with the use of a walker, then a cane and finally independent movement. Driving does not damage the knee, but is only encouraged after the patient no longer needs narcotics for pain and has adequate range of motion to safely operate a vehicle.
“Plaut did amazing with both surgeries,” said Dr. Jarrett. “It’s people like him who make me proud of what I do for a career.”
Plaut attributes his excellent recovery and mobility to Dr. Jarrett’s willingness to perform the partial knee replacement at a time when robotic-assisted surgery was relatively new. “Dr. Jarrett was really courageous in doing this procedure in 2010,” he said. “The way Mission Hospital looked at new technology and got on it early made a great success story. My hat’s off to Dr. Jarrett for pioneering this.”
S. David Jarrett, MD, is an orthopedic surgeon with Asheville Orthopaedic Associates.