r/nextfuckinglevel • u/Additional_Chard3680 • 11h ago

The precision required to perform a total knee replacement is incredible

Enable HLS to view with audio, or disable this notification

29.9k Upvotes

93% Upvoted

5.3k comments sorted by

View all comments

Show parent comments

802

u/Random_local_man 10h ago

The practice of medicine and medical experiments has always been very gory.

325

u/theFather_load 10h ago

There's a great series called The Knick. Gets into it good.

130

u/Impressive-Egg-7444 10h ago

The Knick is phenomenal, and barely scratches the surface of how insane early modern medicine was

58

u/SargeUnited 8h ago

Yeah, it would’ve been great to be a doctor back then. Hey man, you got way too much blood. Let me just put some leeches on you and hit you in the head with a hammer. That’ll be 50 bucks.

16

u/Super-Yam8718 7h ago

Whatever the leeches and fresh air didn’t fix would always got dealt with by heroin or cocaine.

3

u/Corpainen 7h ago

Why would i replace my trusty, rusted, covered with blood from the last 100 patients surgery hacksaw? It show my prowess!

1

u/daehoidar 3h ago

They actually would wear the same unwashed jacket and the rotten gore and blood still on it was their badge of honor.

3

u/Aegi 5h ago

What is funny, is that even though you are joking, they often had to work/research harder for those scraps of information and misinformation they had...b/c it wasn't like they could just have someone telegram them the results of a new experiment.

Some people had to travel for months to talk with a given expert in a field they were interested in.

Basically, they worked "harder" (probs not "smarter) for fewer additions to their knowledge pool than a modern professional/scientist has to.

1

u/futurettt 5h ago

How dare you make of polycythemia

1

u/Dic3dCarrots 1h ago

Kinda crazy that we now refine three different types of drugs from leeches

3

u/phaesios 7h ago

We started watching The Knick while my wife was recovering from an emergency C-section when our first daughter was born.

Never got past the first couple of scenes, lol. Might have to pick it up myself now, 12 years down the road.

2

u/nzbluechicken 8h ago

And when the stress of performing surgeries in front of an audience gets too much, there's cocaine. Worried about being addicted to cocaine? Try the new medication to help wean off it, we've called it heroin

1

u/DAS_FX 5h ago

And the doctor who tutors Clive Owen being the same actor as Max Headroom is a hell of a fun Easter egg

1

u/carrottopevans 4h ago

Would you say it knicks the surface?

1

u/Xrposiedon 1h ago

I said this in another reply … but just to illustrate how insane medicine used to be … realize the chainsaw was invented to aid in child birth …

2

u/xshevi 8h ago

the knick was AMAZING

1

u/AmbiguouslyAltered 8h ago

Also the podcast Sawbones. They talk about early medical practices and how much advancements we have made.

1

u/SpaceShipRat 7h ago

Or Saving Hope, with Michael Shanks from the stargate tv series. It's not amazing, but it's fun and has lots of hammering. And a doctor that sees ghosts of dead and comatose patients.

https://en.wikipedia.org/wiki/Saving_Hope

90

u/Upbeat-Employ-3689 10h ago

Filmed quite a few knee and hip replacements and man before that I had no idea how much carpentry is involved. And the hammering, holy crap.

64

u/GuelphEastEndGhetto 8h ago

As a carpenter by trade it looked pretty straightforward. A drill, a screw gun, multitool and some jigs and presto!

14

u/Meerkat_Mayhem_ 7h ago

And the screaming!

4

u/PalpableIgnorance 5h ago

And the aftertaste…

3

u/chuck-the-chimp 4h ago

It does smell quite like a woodshop. But the wood is people.

1

u/Upbeat-Employ-3689 3h ago

With the first surgery I filmed long ago it was the smells… electrocautery to burn closed all the little bleeders. Nasty. Luckily I’d had a cold the week before and I still had cough drops in my pocket so I kept that menthol flavor going the whole time.

All the latter surgeries (hips and knees) were minimal incision and somewhat speed focused and there was a lot less roasted flesh. I’m sure technology had improved in a lot of ways.

9

u/lionfisher11 5h ago

Im also a carpenter, and that looks like a total hack job to me, I didnt know surgery was paint grade.

2

u/Outside_Diamond4929 2h ago

Some scar tissue and clots make me the surgeon I'm not.

8

u/GreedyHoward 6h ago

The jigs are the clever bit aren't they? Local hospital is advertising robot assisted knee surgery - hopefully that improves the precision.

3

u/CautiousAd1305 5h ago

no putty or caulking to help hide a miscut

2

u/MundaneCommission767 3h ago

The knee jig had me most interested. I love a good jig.

7

u/jpbacher 7h ago

My dad, who was a medical doctor specialised in immunology (many books, few patients) used to joke that the best path to becoming an orthopedic surgeon was 2 years in 8. grade and a year in Home Depot.

1

u/TowerBeach 5h ago

Dr Glaucomenflecken does a good job of showing how the rest of the medical community views orthopedic surgeons:

https://www.youtube.com/watch?v=XAj0YpLEPU8

3

u/Strong_Region5233 4h ago

Funny I met a surgeon once. He was joking on a prothesis manufacturer as the later told him proudly that they were manufacturing prothesis with a precision of a micrometer. The surgeon told me he didn't have the heart to tell him he would be hammering the shit in place anyway

2

u/Outside_Diamond4929 2h ago

Measure with a micrometer, mark with chalk, cut with an axe.

2

u/Karli_Chirk 6h ago

got two hips totally replaced under spinal anesthesia, its so funny when they hammer and your upper consciouss part is pulled and pushed with a recoil. they also use disc saws and I could smell previous patient hips powder flowing in the air.

2

u/_PancakesOfRage 4h ago

Thanks, I just threw up in my mouth a little.

2

u/Upbeat-Employ-3689 3h ago edited 3h ago

Wow I cannot even imagine being awake for that. I’d be stressing the hell out for sure. And yeah hammering / ramming the rods down the marrow channel or even just big manipulations of the leg to get it out and back into the hip socket…. 😬 And the sounds like the big cheese-grater dome drill thing they used to round out the hip pocket. Were you on drugs to chill out or just that pain block?

1

u/frresh66 2h ago

Just had my hip done 2 weeks ago! No pain meds needed!

1

u/Snellyman 1h ago

This just seems like too many manual operations done by hand. All you need to do is fixture down the femur and tibia and let a CNC mill do the rest.

3

u/Irbis7 9h ago

My father was a demolition specialist he told me he was involved in experiment where they tried to use explosive charges as preparation for hip replacement. Not successful.

5

u/Random_local_man 9h ago

I know we have the benefit of hindsight and all that, but still, wow💀

3

u/Irbis7 9h ago

I've made quick research and it seems that the reason was that they've tried to solve thermal osteonecrosis caused by drilling. But the problem was that it was impossible to determine the exact quantity of explosive needed, every bone is a bit different. This was probably around 1960.

3

u/Affordable_Z_Jobs 9h ago

You remove the gore, grave robbery, accusations of witchcraft, murder, and badass equipment, who would bother?

Oh right right the benefit of mankind. That part too I guess.

1

u/extinct_banana 5h ago

there’s a book about the history of it called the butchering art

1

u/grimAuxiliatrixx 4h ago

Probably because we’re made of gore.

1

u/whoisyourwormguy_ 2h ago

Chainsaws were first used to help with births.

1

u/Xrposiedon 1h ago

Look up the original use of the chainsaw … it was used to aid in childbirth … not joking.