Joint replacement best practices: anchorage doctor recommends 'tried and true'.

• Author: Dischner, Molly
• Position: SPECIAL SECTION: Healthcare

An estimated nearly 1 million Americans have a joint replaced each year, whether they want a knee that doesn't hurt so much or a hip with better mobility. It's a way to improve quality of life when certain body parts are no longer performing at their peak. As Alaska's population ages, those surgeries are more and more common here, too. But every surgery comes with the possibility of complications, and even those that go smoothly require a purposeful recovery.

Anchorage orthopedic surgeon Stephen Tower believes there's a way to ensure a higher rate of success in joint replacements: keep it simple. Innovation might be what drives much of the world, but when it comes to joint replacements? Tower says the old way is often safer and more reliable.

"We know what works in hip replacement; we know there are proven designs out there," he says. "Avoid new technology and avoid new surgical techniques."

According to Tower, some of the best hip replacement technology is from 1975, and that design is still in use today. Tower put the failure rate for that method at about half a percent per year. In fact, it even predates the first joint replacement surgery he attended, despite his long history with orthopedics in the state. "The first operation I ever saw was a total hip replacement in Fairbanks in 1979," Tower recalls.

And the rule applies to other joints as well, he says.

Getting to Now

Generally speaking, a joint replacement is when one part--most commonly a hip or knee, with shoulders occurring less often--is swapped out for new hardware, usually using plastic or metal components. They've become fairly common in the United States, but they are not without risk. With any surgery there is room for complications. But keeping it simple reduces the likelihood of those, Tower says.

He saw that first joint replacement in his first year of medical school. Tower, now a professor in the program, was a WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) student in the 1970s. The program had a slightly different structure then, but the basic goal was the same: prepare Alaskans to work as doctors here. To that aim, the program's first year was held in Fairbanks. He was paired with Dr. George Brown.

Tower described that first procedure as "classic orthopedics," with blood on the ceiling. He'd spent a couple summers building homes and thought the surgery was fascinating. So he turned around to tell a classmate how cool it was--and he was stone cold on the floor...