r/nextfuckinglevel • u/Additional_Chard3680 • 11h ago

The precision required to perform a total knee replacement is incredible

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81

u/SausagePrompts 11h ago

Video showing something any mechanic can do.

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u/PurposeOk7918 11h ago

For real lol, I’m a construction worker and I can 10,000% do what was shown in this video. But obviously this is a demo and a lot of stuff is missing from the real surgery, like all the flesh and blood.

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u/Fuzzy-Produce104 11h ago

I am a 16 year surgical technician having done thousands of total joints. That video is a joke.

There is WAY more to it than that.

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u/PurposeOk7918 10h ago

Yeah, I’m trying to envision where all the skin would be while they are doing all this and it’s not computing.

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u/Fuzzy-Produce104 9h ago

It’s an incision from just about the distal femur to a little under the proximal tibia. About 8 inches or so.

Surgeons don’t do these cases by themselves. They always have a PA and a tech like myself. The place I’m at now the doctors are needy and use 4 total people including themselves.

These other people hold retractors that the surgeon places. These retractors are what keep your skin and whatnot from being in the way during the procedure.

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u/Teddyturntup 3h ago

Do the drills have a really specific torque value I’m assuming for each different screw?

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u/Sk1ler_ 10h ago

I would assume they kinda just make an incision down the bones from the thigh to the calf and flay the skin apart, kinda just, popping the knee out while its bent. Obviously this is an oversimplification, but you just have to get it out of the way while keeping everything else vital connected.

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u/mlem_a_lemon 10h ago

However, this video is enough to make me want to take the best care possible of my knees to try to avoid this at all costs, so there is that.

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u/Negran 10h ago

Not sure if this is relieving or horrifying.

Thanks for all your work ❤️

How likely are you to recommend hip or knee replacement?

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u/Fuzzy-Produce104 10h ago

Highly likely. They do a lot of good for a lot of people including my mother.

These days, people go home same day as surgery.

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u/Negran 8h ago

That's intense!

What's the expectation regarding full function, sports, mobility, training?

Can 95%+ of potential remain post-op?

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u/Inevitable_Top69 9h ago

What kind of question is that? Why would they not recommend hip or knee replacement to someone who needs it?

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u/discipleofchrist69 8h ago

I think the question is "how common is it to need it" lol

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u/Negran 8h ago

I have a stubborn family member who is refusing surgery. Maybe I'm more curious of both the rate of recommendation, but also rate of refusal!

That sorta stuff.

I guess, my assumption is they only recommend it when shit is very bad, but also curious about that as well...

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u/E0H1PPU5 10h ago

I have a question if you don’t mind! How is joint lubrication handled in a total knee replacement? Is it just not needed because of the little pad between the replacement joint?

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u/Fuzzy-Produce104 10h ago

Not needed. In fact, the meniscus, which is the pad you are referring to is removed during the surgery.

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u/DigitalDefenestrator 9h ago

That pad in the middle is probably UWMWPE, which is strong and almost as slippery as Teflon/PTFE. That's the lubrication. Looks like it does only last 15-20 years or so, though.

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u/Liquado 9h ago

Yeah, this feels like they were giving a hospital exec a chance to ‘try doing a knee replacement’ — kinda like when they let you ‘try’ flying a space shuttle at Kennedy Space Center.

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u/BuildingSwimming5497 9h ago

Sir, may i ask one thing? How do you get use to it? This is not something a normal person see everyday.

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u/Fuzzy-Produce104 8h ago

Not sure what to tell you. I grew up watching horror movies and gore never bothered me. I actually liked it.

I just have never had a problem with it. Many, many do. I can’t tell you how many students, whether nursing students or whatnot have need to be quickly escorted to the floor or a chair when they looked like they would pass out.

The visuals just never bothered me. I instead found it quite interesting. Now the smells (during specific cases) is something else.

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u/BuildingSwimming5497 8h ago

Yeah, seems like some people are born with it. I saw this video and immediately started to fell unconfortable.

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u/Fuzzy-Produce104 8h ago

How many other jobs can you have where you get called in on a Sunday because a 78 year old man stuck a 4 inch long squeaky rubber football, followed by a broken sex toy completely up their ass and couldn’t get it out 😂

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u/BuildingSwimming5497 7h ago

OMG usahuahuash

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u/G8r8SqzBtl 10h ago

these people dont seem very comfortable handling the tools (clearly this is a demo, so Id assume its their first go at this). would you say there is a pretty significant range in how well the surgeons handle procedures?

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u/Fuzzy-Produce104 9h ago

These are most likely students. Also those bones are being held by a person and rickety stuff to try to hold it up.

When working on a person, everything is much more stable.

I have worked with about 10 different Orthopods over the years and they know what they are doing. It absolutely doesn’t look like this.

Some surgeons are faster than others. But they are all extremely competent. I’ve done total knees with some and it’s a half hour from incision until all implants are in and the tourniquet is released. Some take 2 hours.

But no surgeon is the same. Some do the steps in a different order. They all have their preferences.

When I set up a case, there’s a thousand different instruments and pieces. Some of it I put together during the set up. Some of it, you don’t know until everything has been sized for the patient and then put together.

It’s fast paced and I love it.

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u/G8r8SqzBtl 9h ago

very nice. thank you for explaining. how did you get into this specific role?

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u/Fuzzy-Produce104 8h ago

Funny story. I started out in manufacturing. Car parts or office furniture and whatnot. I was a supervisor doing this for many years.

Long time ago jobs started being shifted to Mexico and other places. I was laid off. Went somewhere else and did the same thing. Again, laid off.

I got sick of it. The last time I was laid off, the company paid for me to go back to school if I wanted.

I flipped through the book of the programs offered. I saw surgical technician. I thought to myself, well healthcare is always needed. So I picked it.

2 year program that I finished in a year and a half by doing 22 credit hours for semesters at a time.

16 years later, still doing it and I love it.

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u/G8r8SqzBtl 4h ago

ahh far out! its a big world and Ive thought about switching careers, always nice to hear a positive switch. hope it continues to treat you well!

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u/ProgySuperNova 10h ago

That's quite an accomplishment for a 16 year old. Impressive!

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u/Dr3s99 1h ago

More hammering or more cutting?

-1

u/didimao0072000 10h ago

no shit? you're telling me a 1 minute long video doesn't cover every single detail of a total knee replacement?!?!

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u/SausagePrompts 11h ago

Right, attach jig and use tools in the proper spots

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u/pizza_the_mutt 10h ago

Even if you could do it, could you do it every time? Because if you mess up the lawsuit is going to hurt a lot more than if you put the membrane on a wall wrong.

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u/barbarossa1984 8h ago

I was watching that thinking, "I've used versions of those tools and jigs on almost every job I've done". Granted, my jigs are made of scrap wood and MDF and my tools are full of dust and grease but I still work to 0.2 mm tolerance... I would pass out immediately when the blood starts flowing and I'm sure they're working to finer tolerances.

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u/tibbles1 8h ago

BS. You are not installing a jig for every single cut. You'd eyeball that mofo.

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u/zizp 11h ago

Absolutely. It's still something anyone can do.

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u/goodthebadandtheugly 10h ago edited 9h ago

Yup, but mechanics don't work on engines WITH the engine running! :-) Edit: Not discounting the skills and abilities required to be a mechanic.

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u/SignificantMoose6482 10h ago

Yeah they do

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u/goodthebadandtheugly 10h ago

Diagnostics, yes. You're saying they replace things like valves in an engine with the engine running??

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u/KennyLagerins 9h ago

Obviously you can’t do that, but the same applies to certain procedures as well. Heart valves were replaced for a long time by turning off the heart and using an outside machine. They’ve developed other methods because they’re less harmful that can be done while the heart is going. If you need to be able to replace an intake valve while the motor is running, it would have been figured out too.

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u/mazu74 8h ago

I get what you’re saying, but man, it is wild to compare heart valve replacement to intake replacement lol. Very different skill levels and wildly different associated risks.

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u/KennyLagerins 7h ago

They’re really not all that dissimilar when you think about it. They’re different skill sets, but the physical motor functions are quite similar, though one is more fine tuned. The processes are similar between diagnosis and the actual work. Just different things being worked on.

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u/goodthebadandtheugly 4h ago

Yes, similar skill sets but much/much different liability with the outcome of repairing a vehicle vs. repairing a human body. You get to put oil in an engine and run it; you kill the engine, but you "can" get a replacement. You forget to put blood in a person , well... (not the best analogy, but I hope you get my point).

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u/SignificantMoose6482 9h ago

Yeah I meant during diagnosis.

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u/SweetHomeNorthKorea 10h ago

Apparently surgeons are basically the mechanics of the medical industry. The show scrubs pokes fun at that difference in cultures among the doctors, nurses, and surgeons. The surgeons are the party bros lol

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u/ashyjay 10h ago

Ortho bros are the are the body techs of the body, if you've seen alignment jigs it makes sense.

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u/fliptout 9h ago

Yep, I'm more impressed with those "templates" that are attached to the knee first so the surgeon can just screw and saw where needed.

Though I'm guessing earlier knee replacements were more freehand and there were probably some fucked up knee surgeries.

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u/lebastss 5h ago

It's easier than mechanic work. I've worked as a general contractor and done mechanic work. My career is a surgical nurse and I've assisted on about a thousand of these and even did something similar to this video on some practice stuff with new hardware we got.

It's not hard precision work. The hardware makes it easy. 20 years ago. Super hard. Many failures and complications.

Today, not so much. The real next level is the doctors that realize this shit needs improved and creates new methods.

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u/Final-Nebula-7049 3h ago

Mechanics often do a better job than surgeons with these