Tag Archive: knee replacement

Current Concepts Regarding Customized Knee Replacement

                  Osteoarthritis is a degenerative joint disease that can affect any joint and is most commonly found among older people. The mechanism of how the disease develops is not fully understood. Currently, there is no known cure for osteoarthritis and research has focused on the knee arthritisprevention and treatment of symptoms for this condition. Osteoarthritis is more frequently found in joints of the lower limb. Risk factors of osteoarthritis include history of injury, increasing age and obesity. Conservative treatment for osteoarthritis includes the use of oral medication to provide pain relief, physical therapy and as a last resort, a surgical procedure known as total knee arthroplasty (TKA). TKA involves the replacement of the entire knee joint and rehabilitation is required after surgery for patients to be able to return to their routine activities.

                  TKA is a highly successful surgical procedure but failures can occur, mostly due to infection and loosening of implants (parts). Poor positioning of the components can contribute to loosening as it creates areas of stress. Some patients such as those who are younger and those with other health conditions may sometimes require a revised TKA. Studies have also shown that the demand for TKA will increase as much as 673% from 2005 to 2030 with a total of 3.48million procedures being required. This necessitates the need to improve the outcomes of TKA especially for younger patients.

                  In a traditional knee replacement surgery (TKA), the surgeon uses a standard implant from a range of different standardized sizes. The necessary adjustments are then made so that it fits the patient during the surgery. Since the standard implants are not designed specifically for each individual patient, it may result in an implant overhang (where the implant is bigger and hangs over the bone) or underhang (implant is too small leaving parts of the bone exposed and uncovered). It iFit-Designcan also result in an implant that does not align exactly. Studies have shown that compromises such as the overhang, underhang and slight misalignment can cause pain after surgery.

                  In customized knee replacement surgery, partial and total knee implants are designed and tailored specifically for each individual patient. This new technology is utilized to create customized implants that are specifically fit to each patient’s natural knee shape and curves. This enables the potential for the patient to feel like they have a more natural knee. Other benefits include optimal bone preservation. The goal of customized knee surgery is to restore the patient’s knee as close as possible to their pre-diseased state.

                  A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan is taken of the patient’s knee and the data is processed in a computer assisted design (CAD) system. The implants are then designed and manufactured specifically for that patient. With customized knee replacement surgery, hospitals benefit due to the improved efficiency of surgery while patients benefit with a shorter surgery and recovery time with improved knee alignment due to a better fitting implant.

OSPI offers the best knee replacement doctors in Arizona who perform customized joint replacement. In addition, the procedures may be performed as an outpatient when indicated. Most insurance is accepted, call us today!

knee replacement

 

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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.

What you need to Know about a Total Knee Replacement

A total knee replacement, also called a knee arthroplasty, involves resurfacing and replacing portions of the bones. The decision to have a total knee replacement is made between you, your family, and your orthopedic surgeon.

The Four Steps of a Total Knee Replacement

There are four basic steps to a total knee replacement procedure. These are:

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  • Prepare the bone – The damaged cartilage surfaces at the ends of the tibia and femur are removed along with a small amount of underlying bone tissue.
  • Position the implants – The removed bone and cartilage are replaced with prosthetic components that recreate joint’s surface. These parts are cemented, or press-fit components are used that grow into the bone.
  • Resurface the patella – The undersurface of the kneecap is cut and resurfaced with a plastic button.
  • Insert a spacer – A medical-grade plastic spacer is inserted between the prosthetic components to create a smooth gliding surface.

Candidates for a Total Knee Replacement

People who will benefit from a total knee replacement include those with:

  • Severe knee pain and stiffness that affects mobility and everyday activities, such as climbing stairs, walking, and risking out of chairs.
  • Moderate to severe knee discomfort with resting.
  • Chronic knee swelling and inflammation that doesn’t improve with medications or rest.
  • Knee deformity, such as bowing out or in of the knee.
  • Inability to improve after conventional treatments (physical therapy, medications, and cortisone injections).
  • Age of 50-80 years.

Orthopedic Evaluation

When you visit the orthopedic surgeon, an evaluation is done. This involves:

  • A medical history – The surgeon gathers information about your past and present conditions and surgeries.
  • Physical examination – This involves assessing the knee motion, strength, stability, and overall leg alignment.
  • X-rays – These images determine the extent of damage and deformity in the knee.
  • Other tests – Includes blood tests, MRI scans, and CT scans.

Preparing for Surgery

The orthopedic surgeon and you will schedule your total knee replacement after reviewing the procedure risks and benefits with you. Several tests are used to determine surgical fitness, including an electrocardiogram, laboratory tests, and urine evaluation. You need to notify the doctor of all your medications, as certain agents that thin the blood must be held for several days.

 

If you live alone, you need to make arrangements to have someone assist you when you come home from surgery. In addition, you should make some modifications to your home. The following items may help with daily activities:

 

  • Secure handrails on stairways
  • Safety bars in the bath/shower
  • A raised toilet seat
  • A stable shower chair
  • A stable chair with a firm seat cushion, a footstool, and a firm back
  • Removing all loose rugs, carpets, and cords

 

The Surgery

 

You will be given general anesthesia, which means you will be asleep and in no pain. After numbing the knee structures to help with post-operative pain, the surgeon makes incisions around the knee. If an arthroscope is used, a small camera and surgical tools are inserted into the incisions. The damaged bone and cartilage are removed, and then new metal and/or plastic implants are positioned. After making all resurfacing changes, the incisions are closed with sutures.

 

After Surgery

 

After the total knee replacement procedure, you are monitored in the recovery room for several hours. Once you wake up, you are moved to a hospital room. Most patients only stay overnight at the hospital, but this depends on your health status, the procedure, and the surgeon’s preference. Rehabilitation begins while you are in the hospital. A physical therapist works with you to help move the nee, and teaches you exercises to restore knee movement, flexibility, and strength.

 

Exercise is an important aspect of home care, especially during the first couple of weeks after total knee replacement. You gradually are able to resume normal activities of daily living, and advance to more rigorous activities after 3-6 weeks.

Knee Replacement Surgery with the Top Orthopedic Surgeons in Gilbert and Chandler

Knee Surgeon Gilbert AZRheumatoid arthritis and osteoarthritis are two conditions that cause people to damage the knee joint and lose knee function. When these things occur, the patient may require knee joint replacement surgery, which is also called total knee arthroplasty (TKA). Total knee replacement, the damaged bone surfaces are replaced with artificial surfaces, called a prosthesis.

When is surgery recommended?

There are a few reasons why your Gilbert orthopedic surgeon may suggest knee replacement surgery. People who will benefit from a total knee replacement generally have:

  • Severe knee stiffness and pain that interferes with usual activities, such as walking, getting up from a chair, and climbing stairs.
  • Moderate to severe knee pain at rest.
  • Bowing or other deformity of the knee joint.
  • Chronic knee swelling and inflammation that does not improve with treatment and rest.
  • Failure to improve on any treatment options, including medications, injections, and physical therapy.

Who is a candidate for surgery?

Recommendations for surgery are not based on age or weight, but rather, on patient’s disability and pain. Most patients are between ages 50 and 80, but the orthopedic surgeon in Chandler will evaluate each person uniquely.

How do I prepare for surgery?

Before the knee replacement procedure, you will undergo a thorough physical examination and several tests used to rule out medical issues that can affect the surgery. You must discuss all medications with your physician, and some blood-thinning agents must be held for several days. You should not eat or drink after midnight, and arrive two hours before your scheduled appointment. Arrange to have someone drive you home upon discharge from the hospital.

What happens during the surgery?

An incision is made over the knee. There are four steps to a knee replacement procedure:

  • Preparing the bone – The damaged cartilage surfaces at the end of the thighbone (femur) and leg bone (tibia) are removed.
  • Positioning the implants – A metal or plastic prosthesis is placed in the areas where the cartilage was removed to recreate a joint surface.
  • Resurfacing the patella – The underside of the patella is resurfaced with a plastic button.
  • Inserting a spacer – A plastic spacer is inserted between the implants to create a smooth gliding surface.

What can I expect after the procedure?

After the knee replacement surgery, you will remain in the hospital for 2-4 days, depending on the extent of the surgery. On the day of your surgery, a physical therapist will teach you exercises to restore leg and knee movement. The therapist works with you 1-2 times each day during your hospital stay. An anticoagulant medication is administered to prevent blood clots, and you must wear elastic stockings to reduce swelling.

What outcome can I expect following a total knee arthroplasty?

After knee replacement surgery, more than 90% of patients report a drastic reduction in knee pain, as well as significant improvement in mobility. However, knee replacement does not allow you to do any more than you could before the development of arthritis. Because excessive weight may cause the replacement to become painful and loosen, weight loss is encouraged. In addition, certain activities should be avoided, such as jogging, jumping, and high-impact sports.

How do I prepare for going home?

Several modifications must be done to make your home easier to navigate following surgery. Be sure to make the following changes:

  • A toilet seat riser with arms
  • Safety bars in the bath or shower
  • Secure handrails on the stairway
  • A stable chair with a firm cushion, back, two arms, and footstool
  • A sleeping area on the same floor as your living area

The top orthopedic surgeons in the East Valley including Gilbert, Chandler and Mesa are at OSPI. Minimally invasive and outpatient procedures are offered for knee replacement, with most insurance plans being accepted.

Call OSPI today for treatment with the top orthopedic surgeons Gilbert and Chandler trusts!

The Latest Advancements in Knee Replacement for Active Boomers

The majority of patients coming in for knee replacement surgery are in their 50s, according to Steven Haas who is heading the Knee Surgery and Attending Orthopedic Surgeon Department at the Hospital for Special Surgery based in New York City. If these statistics are compared with those of 20 years ago, there has been a rapid shift in demand for knee replacement surgery, especially for people in their 50s.

Why the sudden interest and growth of demand for the surgical procedure? The points responsible for this are new and innovative technologies that are being used now, especially in implant design and far more improved surgical techniques that are being used by orthopedic surgeons to meet with the growing demand for knee replacements. In addition, the growing number of baby boomers reaching older age has increased the numbers in need of the procedure.

The Latest in Knee Replacement Surgery

Only recently, the orthopedic community announced the arrival of the newest advancement for the surgery, i.e. a knee replacement implant that can last the patient as much as 30 years instead of the standard 10-15. Moreover, the implant has also been cleared by the FDA which means that those looking for ways to make their implants last longer, can opt for this.

VERILAST technology is used for making the implant that will make it possible for patients to possibly outgrow the implant, rather than the other way round. In addition to this, the implants are thought to be much more functional than the earlier versions, as is proved by a series of tests that researchers underwent before giving that verdict.

Adoption of Better Surgical Procedures and Techniques

Orthopedic surgeons have also changed their way of performing surgical procedures, by introducing techniques such as minimally invasive surgery, which helps in decreasing trauma to the patient, as much as possible, which in turn leads to a faster recovery.

Another development is the usage of small surgical instruments for performing the procedure, where the goal is to cut as little as possible, which will minimize the collateral damage and trauma that came with previous surgical procedures that were extremely invasive in nature.

Better Recovery Rate Due To Minimal Invasive Surgical Procedures

The entire point of such a surgery is not to make the cut big enough to fit the instruments, but rather, to use smaller instruments during the procedure that would best fit the cut made. This is the reason why, smaller incisions are used to get access to the knee area after providing local anesthetic to the patient.

One point in favor of the minimal invasive procedure is that, no need is felt to cut the quadriceps tendon or flip the kneecap upside down in order to gain access to the area, which was required in the case of previous surgical techniques. This has also improved the recovery rate far more significantly and at a much faster rate, than old surgical techniques, so now patients are up and about after only 6 weeks of having the procedure done as compared to 3 months.

OSPI offers expert knee replacement doctors in Gilbert, Chandler and Mesa AZ who specialize in the latest technologies including computer navigation, minimally invasive and even outpatient procedures. Call OSPI today to receive treatment with the top orthopedic doctors in the entire East Valley!

What Are The Benefits Of A Knee Replacement Surgery?

Our knees carry a lot of weight and stress, which is something we cannot ignore. Over time, it’s normal for the hardworking appendage to feel some decay and fail due to over-usage and exertion, but the problems developing as a result of it, can prove to be quite painful if they reach their chronic stage.

It’s at this stage when a Gilbert orthopedic surgeon might recommend knee replacement surgery. It’s normal for patients to feel nervous or worried about the implications of undergoing surgery, but in many cases, this is the only way to relieve the pain.

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To gain a better understanding of the entire procedure, take a look at the information given below that will alleviate some of the worry regarding knee replacement surgery that you might have if the procedure has been recommended.

Different Levels of Knee Damage Will Require Different Types of Knee Replacement Surgery

Broadly speaking, there are two categories or types of knee replacement surgeries, i.e. total and partial. The surgeon will first evaluate the damage done to your knee and then determine the type of surgery that will be needed to fix it.

Total Replacement Surgery: Also known as Arthroplasty, this type of surgery involves replacement of all the knee compartments.

Partial Replacement Surgery: Otherwise known as Unicondylar Knee Replacement, nothing other than the affected parts is replaced.

Both the types of knee replacement surgeries offer more or less of the same benefits, although success of the surgery still largely depends on the extent of damage to be repaired, the rehabilitation process, and the right precautions taken after the surgery.

Knee Replacement Surgery Benefits Outlined

A Reduction in Knee Pain

Unicompartmental knee replacementYou will feel a stark contrast and improvement in pain after undergoing the surgery. Not only that, the range of motion of the operated knee will be more comfortable and you will gain independence to go about your daily activities with more ease.

A Significant Improvement on Motion

You must know that the artificial knee will in no way be good as the original one, but the range of motion that was limited before the surgery will be improved greatly. Your limited mobility and inability to perform daily duties will be dramatically reduced as well.

The Rectification of Deformity

The best benefit that comes from undergoing a knee replacement surgery is deformity elimination. In addition to being a benefit, this is also a very good reason to opt for the surgery, as after it, you won’t be exposed to the side effects of long term pain medication treatments.

Out of all the benefits of undergoing knee replacement surgery, the one that appeals the most to patients suffering from knee damage is receiving another chance to enjoy life and other activities that were an important part before the pain. This in turn, will improve overall quality of life, although patients who opt for the surgery will have to take more care of their new knee.

The top knee replacement doctors in Arizona at OSPI are experts in both total and partial knee replacement. Most insurance is accepted at the practice, which serves patients in the East Valley including Mesa, Gilbert, Chandler, Queen Creek, Casa Grande, Eloy, Maricopa and surrounding areas.

Call 480-899-4333 today!

Joint Replacement with Top Gilbert Orthopedic Surgeons

Joint replacement is a significant procedure for the hip, knee, shoulder, which is often reserved as a last resort option. Joint replacement can be performed for several joints in your body, with the most common by far being the knee or the hip.

Total hip or shoulder replacement is a surgical procedure where the normal ball and socket joint in that area is replaced with a plastic cup and a metal ball, both of which are meant to simulate the natural joint in your body. These procedures are intended to restore natural function in that joint and provide you the opportunity to continue living independently.

Who qualifies for total joint replacement surgery?

Someone who is suffered from severe tendon damage, joint damage, or severe cartilage damage should exercise all nonsurgical treatments available. Once all nonsurgical treatment options have been tried and the results do not rectify the pain leaving you with severe pain and inability to move your joint properly, total joint replacement surgery might be the last option. This surgery should only be utilized if you have permanent damage to the joint which you cannot be fixed in any other fashion and nonoperative treatments have failed.

What happens after the replacement?

After the surgical replacement of your hip or knee joint you will be monitored overnight. Certain patients at OSPI are able to receive an outpatient hip or knee replacement. For those who don’t qualify, inpatient stay make take 2-3 days.

Given the severity of this surgery you might have to work with a professional and licensed physical therapist for the first few weeks after your surgery.You will also need somebody to be with you during the first few weeks of your recovery. After the first two weeks of your recovery you should be able to dress yourself and feed yourself but it is nonetheless recommended that somebody remain with you. Following the surgery and recovery you will be asked to return to either your Gilbert or Chandler orthopedic surgeon’s office or the hospital to have x-rays and a follow-up examination. Both of these are designed to see how well the surgical process took and how well your body is responding.

Are there complications?

This is a very technical procedure but like all surgeries it does come with potential complications including the risk for bleeding and infection. There is a potential for stiffness, blood clotting, and other issues.

What can be expected during recovery?

Following your surgery you will have to wait in a recovery room for at least two hours prior to being placed in your hospital room. You will be monitored during this time for your responsiveness and you will be administered pain medication if you need it. After the first few days he will need somebody to drive you home and stay with you overnight.

OSPI is the top orthopedic surgery practice in the East Valley of AZ serving Gilbert, Chandler, Mesa, Queen Creek, San Tan, Casa Grande and surrounding areas. Most insurance is accepted, call OSPI today at 480-899-4333!

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