Thammasat University Hospital Renovates Knee Osteoarthritis ‘Surgery’ for Seniors

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“Knee Pain” is a common concern for seniors. Over the years, every step adds a little wear and tear. It affects their walking behaviors and quality of life. Knee replacement is one of the most effective surgical procedures. However, many people think that it is a hazardous and painful way. Therefore, many patients decide not to get a knee replacement.

In the last 5-6 years, Orthopaedics department of Thammasat University Hospital introduced a new knee replacement technology. Many patients were willing to get knee replacement surgery. They told other people that it was a life-saving technology.

Assoc.Prof. Natthapol Thammachot, Specialist in Hip and Knee, Faculty of Medicine, Thammasat University, Assistant director of physical therapy department,Thammasat University Hospital, is an innovator of Knee Replacement. Annually, hundreds of patients have been waiting for him to help them get surgery.

 Assoc.Prof. Natthapol says that in the past few years, I have seen many patients with severe knee Osteoarthritis. Many of them get surgery by removing damaged knee surface and replacing with an artificial one. However, after the surgery, some of them are still in pain because they don’t exercise their knee so it takes a longer time for recovery.  There are many pain management methods, including subarachnoid space (spinal block), nerve block, continuous epidural analgesia, and knee joint analgesia. It helps relieve pain and patients will stay at the hospital for just 3-4 days instead of one week. However, half of the patients are still in medium to severe pain after recuperation at home. 

Assoc.Prof. Natthapol invents a new pain management method by injecting “Triamcinolone acetonide” in continuous epidural during wearing “lumbar back support” to relieve pain. After injection, patients will take off the back support. This method reduces 30-40% pain during 2 months after the surgery.  This project is well supported by Thammasat University. Thammasat University Hospital aims to be a professional in medical specialist and supports medical research. We also promote research work to be published in the Journal of Bone and Joint Surgery-American Volume. Moreover, this innovation was chosen to be presented in European Knee Society 2018.

With the interprofessional working environment, including surgeons, Anesthesiologist, heart doctor, and surgical assistant, knee replacement patients can get this pain therapy method efficiently. Surgical team has been using this method since 2015. For 5 years, about 500 patients get treated with this method without complications.

Assoc.Prof. Natthapol emphasizes that 90% of patients can effectively go through this pain management method. However, patients who have done back surgery and patients with severe heart disease cannot use this method. Overall, patients can get operation both knees at the same time with this new technique. Therefore, this method also works well with patient with distorted legs.  Knee replacement technology received a good response from seniors so it becomes Product Champion of Thammasat University Hospital. We plan to build knee and hip center to enhance health services. It will be opened in 2020. Currently, we raise funds for this project. It will improve the hospital’s service system. Annually, the center can support 3,000 knee and hip Osteoarthritis patients and 800-900 knee and hip replacement patients.

Moreover, it will enhance learning and teaching potential in new generation doctor. There will be quality treatment method, including medical check up until after patients get treatment. It will reduce complications and risks in patient care.  Annually, only about 15,000-20,000 of Thai people get knee replacement compared to the US with 300,000-400,000 patients, 80,000-100,000 patients in Korea and 100,000 patients in Japan. It is because Thai people are afraid of pain and long recovery. Some people get surgery and surgical error happens. Therefore, we guarantee that this innovation will help patients gain more confidence and decide to get knee replacement.  

This innovation is created by Assoc.Prof. Natthapol Thammachot under the support of Thammasat University Hospital and Thammasat University. It brings patients with knee Osteoarthritis hope to have a good life again. We will continue researching and developing new remedy for the benefits of Thai population.  Due to the good response among seniors, knee replacement technology is seen as Product Champion of Thammasat University Hospital.