Senior patient with pre-existing comorbidities successfully undergoes complex knee replacement surgery using hand-held orthopaedic technology for the first time in Abu Dhabi, reducing surgical time and enhancing recovery

Dr Feras Ya’ish, Orthorpedic Surgeon at SSMC

Abu Dhabi, United Arab Emirates: The orthopaedic surgery team at Abu Dhabi-based Sheikh Shakhbout Medical City (SSMC), one of the UAE’s largest hospitals for serious and complex care and a joint-venture partnership between Mayo Clinic and Abu Dhabi Health Services Company (SEHA), has successfully completed knee replacement surgery on an 85-year-old, female patient with a complex case using minimally invasive computer-guided technology. The technology was used for the first time in Abu Dhabi.

The surgery was conducted using a hand-held computer navigation system. This is an accelerometer navigation system that aids in hip and knee replacement surgeries, making them more streamlined and time efficient.

Dr Feras Ya’ish, Orthorpedic Surgeon at SSMC said: “Our patient had difficulty walking due to the heavy pain in both her left and right knees, and she also had severe arthritis in her right knee. The patient has existing metalwork inserted into her thigh bone which was from a years-old fracture that would have made the knee replacement procedure difficult. She did require the surgery to restore her mobility, but her case was considerably complex, which is why she was referred to SSMC.”

A secondary challenge was that the patient is of an advanced age with preexisting comorbidities including ischemic heart disease, lung disease, and renal failure. To ensure maximum benefit from the knee replacement, the patient’s knee was initially injected for temporary pain relief for a few weeks, which also helped restore a certain degree of mobility. Once the pain improved, the patient’s walking improved, which was a key indication that performing the knee replacement surgery would be effective in improving her overall mobility.

Another element the surgeons needed to consider was the existing presence of metalwork in the patient. The usual process of a knee replacement surgery requires the placement of metalwork to be used as a guide inside the canal of the bone. In this patient’s case, this couldn’t be done due to the existing metalwork. Removing the first set of metalwork would have presented a significant risk of the bone breaking where the metal was situated, as the patient is osteoporotic and this would have also required that the patient undergo a second surgery, which, given her age and preexisting conditions, was not recommended.

“The best option for her was to do the knee replacement while keeping the existing metal. This was the catalyst for us exploring the hand-held accelerometer device, as it doesn’t require penetration of the bone, which is much safer for patients, especially those who are older. It also gives accurate bone cuts and bone alignment, which is research-proven. Applying the device typically takes about four minutes, and we applied it on the knee itself, moving it as the technology learnt the orientation of the bone to give us the alignment where the bone needed to be cut, without breaching or penetrating the bone itself. From cutting to dressing, the surgery took one hour and ten minutes, and was a success. The patient was able to stand the very next day and was walking by the following day,” continued Dr Ya’ish.

The patient was in the care of a multidisciplinary team at SSMC and is now walking independently with the support of a walking aid. 

The hand-held accelerometer technology is available at SSMC and will continue to be utilized for complex cases in similar patients.

About Sheikh Shakhbout Medical City (SSMC):

Sheikh Shakhbout Medical City (SSMC) is a joint venture between Abu Dhabi Health Services Company (SEHA), the UAE’s largest healthcare network, and Mayo Clinic, a non-profit global leader in medical care, education and research headquartered in the United States of America. Established in 2019, SSMC is the largest tertiary hospital in the UAE and serves to elevate the provision of healthcare services in the nation under the mandate of the Abu Dhabi Economic Vision 2030.

Supported by the latest diagnostic and treatment modalities available, SSMC offers care in 24 specialties. A team of locally and internationally trained physicians and allied health staff work seamlessly together, which promotes comprehensive interdisciplinary learning, allowing SSMC to become a leading hub for integrated patient-centric medical services in the region.

As the region’s leading tertiary facility, SSMC has 742 patient beds, 18 operating theatres and includes a hybrid operating room, 26 neonatal intensive care units and the UAE’s largest pathology lab.

About SEHA:

The Abu Dhabi Health Services Company PJSC–SEHA – is an independent, public joint stock company created to develop the curative activities of the public healthcare system in Abu Dhabi. The company owns and operates all the public hospitals and clinics of the Emirate of Abu Dhabi.

SEHA is part of ADQ, one of the region’s largest holding companies with a broad portfolio of major enterprises spanning key sectors of Abu Dhabi’s diversified economy.

SEHA is committed to continuous improvement of customer care to recognized international standards and providing the community with world-class healthcare. SEHA operates 13 hospitals with 3,385 beds, 70 ambulatory care, family care and urgent care centers and 2 blood banks. Its facilities accommodate 117,162 inpatients annually and conduct 43,262 surgeries, as well as treating more than five million outpatients. SEHA is one of the largest integrated healthcare providers in the Middle East with more than 18,000 doctors, nurses, ancillary care, and administrative personnel.

About Mayo Clinic:

Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and Mayo Clinic Facts for more information about Mayo.