Tag Archive: best knee replacement

MACI – A New Regenerative Technique for Knee Problems

MACI for Knee ProblemsCartilage regeneration has been a long debated issue for orthopedic surgeons. In the case of runner’s knee, this problem can cause a lot of irritation where the kneecap rests on the thighbone.

Together the kneecap and the thighbone form a third joint known as the patellofemoral joint. It is at this junction that cartilage denegation or damage happens resulting in a sharp and sudden pain or one that is dull and chronic. The pain may affect one or both knees with symptoms including the following:

• Tenderness behind or around the kneecap.
• Pain located at the back of knee.
• Sense of cracking that the knee is giving out.
• More discomfort when treading on uneven terrain or climbing stairs.

In addition to cartilage getting damaged in this area from sports injuries, the same can also happen due to auto accidents as well as arthritis.

New Re-Generating Techniques

As the regenerative technology constantly evolves, it makes available a range of orthopedic surgery treatments for the prevention of bone, joint and muscle ailments.

A latest advancement is in the surgical methods is Matrix-Induced Autologous Chondrocyte Implantation. This invention was approved for use by FDA in 2017. It is a new cartilage regeneration procedure which allows the growth of chondrocyte cells on a biologic scaffold.
The new technology uses cells from the patient’s own cartilage to generate the scaffold and as opposed to earlier treatments, can be affixed to the cartilage.

The treatment has only recently surfaced in the US but has been operational in Europe for at least a decade with very promising results.
Basics of MACI include the following:
• In the first step of the MACI procedure, healthy chondrocytes are harvested on a sponge-like area of the bone.
• These cells are sent to the laboratory for 4-6 weeks to be cultivated over a sterile collagen membrane.
• The enriched scaffold is comparatively easier to implant and requires a minimal incision.
• The procedure is less painful with fast recovery.
• More than 6 weeks are required for the growth of the new cartilage cells.
• After the surgery, the cells grow to cover the defected area of the knee.
• The recovery period, as is true with most knee surgery procedures, is long and demands minimum movement to prevent damage to the new cartilages.
MACI appears to be an effective alternative for cartilage regeneration, compared to microfracture. If the quality of the cartilage used is good, MACI may be able to give surgeons a new technique at hand to prevent osteoarthritis.

Conclusion:

Cartilage damage can severely paralyze knee movement. The holes caused as a result of damaged cartilages can lead up to osteoarthritis. Compared to the old surgical techniques, new innovations in technology like MACI may prove effective as a procedure that requires a minimum invasion.
MACI, with the use of high-quality cartilages and minimal incision, places an implant on the knee to enable growth of new cells. FDA approval makes the effectiveness of this treatment promising for many suffering from runner’s knee and other knee issues.

Customized Knee Replacement in Arizona

The knee is a complex, mobile joint. Knee joints are the largest joints of the body, and they differ in shape and size from other joints. A customized knee replacement uses specially designed implants that are made to fit the unique knee of the patient. Traditional knee replacement requires the surgeon to attempt to match prostheses to fit the knee.

How many knee replacements are performed each year?

In the United States, around 4.7 million people have a total knee replacement. Prevalence increases with age, with around 8% canstockphoto11809008have a history of total knee replacement. Women are more likely to have this operation than men (3 million: 1.7 million).

Why are customized knee implants important?

Once the Arizona knee surgeon selects the implant, the technique requires precision structuring so the implant fits snugly with your individual bone structure. An improper implant fit could result in residual issues that may cause problems after surgery.

Customized knee replacements are an innovative approach to correctly knee problems. The need for a precision implant fit has driven this new trend. Manufacturers now offer customized and personalized implants that are appropriate for gender and the individual knee. In a 2010 study, customized implants were found to reduce sizing problems during surgery, and also, found to replicate the curvature of the patient’s knee, giving a more natural feel to the replacement.

How are customized knee prostheses made?

Customized knee implants are created from CT and MRI scan data obtained from the patient. This assures the implant iFit-Designmatches the natural curves and shape of the knee. Knee implant manufacturers use specific technology to change the images of the knee into a 3D model, which is used to make an implant that matches the patient’s knee. Using scan data, the manufacturer can customize the implant using computer-assisted surgical instrumentation utilized by the surgeon during the procedure.

Why are women’s implants different than men’s?

Called gender-specific knee replacement, women are more petite and require special sized implants. A regular, traditional implant is designed for men, which means the implant for a woman could overhang on the bone at the sides. This could cause soft tissue interference or mid-flexion instability. For some patients, over-sized implants may cause pain and discomfort long after healing is complete. For this reason, new implants are used to accommodate the knee, which is smaller top-rightin women from side-to-side and from front-to-back. This reduces implant misfit and persistent knee pain.

Why do the differences between men and women make knee replacement difficult?

Researchers have found many differences between women’s knees and men’s. The gender-specific implants are based on research that shows:

  • Women’s knees have a thinner profile at the front.
  • Women’s knees have a distinct shape that accommodates the different angle between the knee and hip.
  • Women’s knees have a different contour.

Some researchers believe the differences in knee shape and size have less to do with gender and more to do with genetics. Certain ethnic influences tend to determine knee joint sizes.

Orthopedic and Sports Performance Institute offers customized knee replacements that have an amazing fit with exceptional outcomes. The total knee replacement surgeons in Arizona work with patients from all over the Valley including Gilbert, Mesa, Chandler, Queen Creek and Maricopa AZ.

Most insurance is accepted, call today to meet with the top knee specialists in AZ!

Resources

Bourne, et al; Patient Satisfaction after Total Knee Arthroplasty. Who is Satisfied and Who is Not? Clinical Orthopedics and Related Research; 2010, 468: 57-63.

Mahoney, et al; Overhang of the Femoral Component in Total Knee Arthroplasty: Risk Factors and Clinical Consequences. The Journal of Bone and Joint Surgery; 2010, 92: 1115-1121

 

Life after a Total Knee Replacement

Pain and suffering from severe degenerative joint disease of the knee can compromise a person’s ability to maintain gainful employment, as well as perform usual activities of daily living. A total knee replacement (TKR) is a successful procedure for keeping people active and working. Returning patients to a higher level of functioning is the goal of knee arthroplasty, along with eliminating the chronic knee pain.

Returning to Work after Surgery

Around 98% of total knee replacement patients who were working before their surgery are able to return to work after surgery. Knee pain 3In addition, 90% of these patients are able to resume their previous position. A total knee replacement, also called total knee arthroplasty (TKA), is one of the most widely performed procedures in the world, and it is used to relieve pain and restore function in patients with advanced knee arthritis.

According to an independent survey center that interviewed more than 660 TKR patients 1-5 years after surgery, patients resume normal activities after the procedure. Their finding revealed that around 75% of patients were employed before surgery, and almost all of these people returned to work after the procedure. Men were more likely to have worked during the 3 months before surgery than women (83% vs. 70%), but of those patients, the rates of work return after surgery were similar.

A recent study out of Sweden evaluated joint replacement patients through self-reported assessments and physician evaluation. The researchers found that at 5- and 10-years post-surgery, most patients reported an active lifestyle. Surgery durably and substantially improves physical activity levels for men and women of all age categories.

Quality of Life Studies

canstockphoto11809008In a review of studies regarding quality of life among people who underwent total knee replacement surgery, and the various associated factors that impact recovery, researchers found several factors that were associated negatively with an active lifestyle. These factors were obesity, comorbidities, advanced age, persistence of pain, and lengthy wait for surgery.

Another study evaluated the self-reported outcomes after a total knee replacement to determine factors that influenced quality of life at 6 weeks, 3 months, 6 months, and one year post-surgery. Of the patients, 162 females and 40 males had a mean age of 69 years. At 6 weeks post-surgery, physical function was satisfactory. However, significant improvement was noted at 3 months postoperatively. Patients had decreased VAS pain scores, as well.

This quality of life study has proved that patients can return to previous level of functioning and enjoy an improved functional status. Researchers found that at one year post-operative, most patients reported that they had a significant improvement in quality of life. The researchers concluded that quality of life after TKR was noticeably different, with patients experiencing significant improvement for all parameters measured.

Longevity of the New Knee

It is difficult to predict how long the total knee implant/prosthesis will last, as lifespan depends on several factors. For a few patients, surgical complications occur which affects the longevity of the new knee. However, the majority of new knees last for 20 years, giving patients pain relief and improved function.

Surgeons, researchers, and prosthesis manufacturers all continue to work to improve the long-term outcomes of total knee replacement. The life of an implant depends on the use and wear. In addition, uses of new high performance material had shown to decrease wear by as much as 60%.

Orthopedic and Sports Performance Institute offers top knee replacement surgeons in Arizona. The procedures are often able to be performed on an outpatient basis, with most insurance being accepted. Call the top orthopedic surgeons in Gilbert and Chandler today!

Resources

American Academy of Orthopedic Surgeons. (2013). 98 percent of total knee replacement patients return to life, work following surgery. ScienceDaily. Retrieved from: www.sciencedaily.com/releases/2013/03/130321082857.htm

Da Silva RR, Santos AA, de Sampaio CJJ, & Magos MA (2014). Quality of life after total knee arthroplasty: systematic review. Rev Bras Ortop, 49(5), 520-527.

Papakostidou I, Dailiana ZH, Papapolychroniou T, et al. (2012). Factors affecting the

quality of life after total knee arthroplasties: a prospective study. BMC Musculoskelet Disord, 13, 116.

Recovery after Total Knee Replacement in Arizona

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Each year, thousands of people undergo total knee replacement (TKR) surgery. This procedure is done to replace damaged portions of the knee, including cartilage and bone ends. The most important part of surgery is the recovery.

Hospital Recovery

  • Bandages/drains – The knee will have a bulky elastic bandage dressing on it. Depending on the situation, some patients have a small drain inserted at the surgical site to remove excess blood and fluid that accumulates. The bandage is removed 1-2 days after surgery, and the drain is usually removed within 3 days of surgery.

 

  • Incisions – The incisions must be kept clean and dry. Sutures or staples are removed in 7-14 days.

 

  • Continuous passive motion (CPM) – A CPM machine is used to move the knee in physical therapy1regular motion. This helps the knee regain flexion.

 

  • Activities – Nurses will help you get out of bed and back in bed while in the hospital. You are encouraged to walk to the bathroom using a walker, crutches, or cane.

 

  • Deep breathing – After surgery, you must perform deep breathing exercises to rid your airway and lungs of mucus. This involves taking several deep breaths every hour.

 

  • Physical therapy – The physical therapist works with you to improve range of motion and strengthen muscles. The therapist assists with sitting at bedside, transferring in and out of bed safely, climbing stairs, walking with a cane or walker, and performing exercises without the CPM.

 

  • Pain management – The nurses will administer pain medicine to keep you comfortable.

 

Home Recovery

  • Preparation – Before going home, you need to arrange for a ride home, and have someone available to help you for a few days. It is a good idea to have plenty of gauze and tape ready, as well as pre-made meals, ice, and water. You will need to have a recliner or an ottoman so you can elevate your leg. In addition, you should remove all loose cords and rugs from walkways.

 

  • Physical therapy – The therapist continues to work with you after you go home. As the days progress, you will increase your frequency and distance of walking. Most patients are on a straight cane within 3-5 days of surgery.

 

  • Pain management – To control pain, take prescribed medications before pain gets too severe. In addition, avoid any alcoholic beverages while you are taking these medicines. We recommend taking pain medicine at least 45 minutes before physical therapy sessions, so the medicine will take effect.

 

Dos and Don’ts after Knee Replacement Surgery

 

  • Do position the knee comfortably as you perform daily activities.
  • Do use an ice pack if swelling occurs.
  • Do walk and perform range of motion exercises each day.
  • Do elevate the leg often to reduce swelling.
  • Don’t twist the knee.
  • Don’t jump or put any sudden stress on the knee.
  • Don’t put a pillow under the knee.

 

Fast-Track Recovery Protocol

 

During the last decade, many medical facilities have implemented fast-track protocols for total knee replacement. A fast-track protocol will reduce the length of hospital stay.

 

In a recent study involving fast-track recovery, researchers evaluated patients during the first 6 weeks after total knee replacement. They found that 28 of the 30 study participants were satisfied with a short hospital stay. It was determined that quality of life at 6 weeks discharge was the same for fast-track patients as those who stayed longer at the hospital.

OSPI in Gilbert AZ offers top knee replacement surgeons providing rapid recovery procedures. Most insurance is accepted, call today!

Resources

Van Egmond JC, Verburg H, & Mathissen, NMC (2015). The first 6 weeks of recovery after total knee arthroplasty with fast track. Acta Orthop, 86(6), 708-713.

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