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Tigard man first in Oregon to undergo new type of knee replacement surgery

Legacy Meridian Park Medical Center in Tualatin is now using a robot to assist in total knee replacement surgeries.

TIMES PHOTO: ADAM WICKHAM - Dr. Chris Nanson demonstrates the Mako robotic arm during a dry run of the total knee replacement surgery Tigard resident Jack Swartwood underwent last month.Jack Swartwood went to the gym on Sunday and had a good workout.

Even at 73, that's not unusual for the Tigard resident — he's an outdoorsy kind of guy, with a house full of wood carvings that he's done, many of them based on wildlife photographs he has taken, and a bicycle propped up against the sliding glass door to its back patio.

The more extraordinary part is that Swartwood just underwent a total knee replacement surgery on Jan. 27.

Legacy Meridian Park Medical Center in Tualatin, Swartwood's local hospital, is the first in Oregon approved to perform a new, robotically assisted knee replacement procedure. Swartwood was the first patient to undergo the procedure — months after his left knee was replaced in a more traditional arthroscopic surgery in October.

So far, Swartwood is bouncing back faster from the right knee replacement than he did from the left.

"The swelling went down much faster than this one, on the new robot surgery," he said, indicating his left knee.

Swartwood is a healthy and active man — his wife, Grace, described him as "a very young 73" — who clearly doesn't like to let a medical procedure put him down. After his first knee replacement last year, he said, he used a walker for a few days before switching to using a cane. After the second, though, he said he has hardly needed either at all.

Jack Swartwood.Dr. Chris Nanson performed both of Swartwood's knee replacements, using the two different methods.

Nanson and his team of doctors demonstrated the way the Mako robotic arm works during a "dry run" the evening before Swartwood's surgery.

"Because it's an accurate tool and allows us to do a lot of this preplanned before we make any cuts on the bones, this potentially has the capability to enhance the patient's recovery, just by reducing the amount of tissue damage that we have to do in surgery," Nanson said.

Stryker, the company behind the Mako robot, was approved to use it for total knee replacements by the U.S. Food and Drug Administration in 2015, although it only began rolling out the operation at hospitals more recently. The robot is also used for hip and partial knee replacement surgeries.

Nanson said the advantage the Mako provides is better precision in making cuts. Even before Swartwood's surgery, he said he had seen that accuracy in other types of surgeries he has done with the robotic arm.

"The one thing that's just been indisputable throughout the six years that we've been using Mako is the accuracy and the reproducibility of doing this," Nanson said.

In a total knee replacement, the joint itself is removed — meaning the surgeon must saw through the bone on either end of it — and a prosthetic made of metal and plastic is inserted to function as the new knee. Any variance can lead to joint instability, one of the most common sources of complaints from post-operative knee replacement patients, the doctors explained.

Using the Mako provides "the potential to do a good surgery better," Nanson added.

As Nanson suggested, Swartwood said the machine precision also meant less of the soft tissue around his knee joint was affected by the surgery. That means faster healing and less pain for him.

"Just all-around, it's really good," Swartwood said.

Meridian Park is accredited by The Joint Commission for hip, knee and shoulder replacement surgeries.

Hospital spokesman Piseth Pich said the joint center at the hospital places an emphasis on preparing patients for surgery and rehabilitating them afterward, starting almost immediately.

"Part of why we want patients up as quickly as possible is that you want to re-engage those muscles that are providing stability, too," Pich said. "The longer you're down, the more your muscles atrophy, and then you have less stability, right."

Swartwood said nurses had him up and walking around hours after his surgery last month. He stayed overnight at the hospital and was sent home the next day. He continues to see a physical therapist, and he said he takes pain medication at night to help him sleep or as needed during the day, but he said that overall, he's "doing pretty good."

"We're very active in mountain hikes, you know, to get pictures of birds and animals, and so that's one of the reasons I really, really appreciate getting new knees," Swartwood said.

Meridian Park Medical Center is located at 19300 S.W. 65th Ave. in Tualatin.

Editor's note: An earlier version of this story misnamed the surgeon who performed the knee replacement. His name is Chris Nanson. The story has been updated.

By Mark Miller
Assistant Editor, The Times
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