Knee Replacement

Looking for Best Knee Replacement Doctors in Gilbert AZ? Visit OSPI to find the best knee Replacement doctors in Chandler AZ.

How to Choose an Orthopedic Surgeon for Knee Replacement Surgery?

The decision to undergo a knee replacement surgery is a giant leap towards a life of independence and that is why it’s important to feel confident in your choice.

Finding the right surgeon can ensure you have a successful surgery and recovery. To choose an orthopedic surgeon for your knee replacement surgery, here is what you can do.

Do your Homework

Review the surgeon’s education and credentials, including education, training and experience. Find out if the surgeon is Board-certified.

It’s alright to ask the surgeons how many procedures they have performed so far or how many they perform annually. The higher the number, the more experience they have.

Orthopedic surgeons not only gain expertise by performing surgeries but also through continued education on new technologies, current surgical approaches and new devices.

You can ask your surgeon which implant or device s/he recommends. Don’t be afraid to ask your surgeon about his/her choice for your knee replacement and discuss any concerns or queries you may have.

Also discuss your medical history with your surgeon during consultation. This will enable your surgeon to do what suits your needs best and handle any potential complications. For example, if you have a pre-existing condition like diabetes, find out about the surgeon’s experience in handling such cases.

Meet and Ask

Once you have shortlisted potential surgeons, schedule a consultation with them. During the consultation –

  • discuss your condition, symptoms, history, problems, concerns and fears, if any
  • solicit their opinion
  • find out about the implant and/or technology they use
  • whether the surgery can be made minimally invasive
  • the pros and cons of the procedure
  • approximate recovery time
  • any restrictions that may be placed on you after the surgery
  • location, duration and cost of your surgery
  • insurance coverage of the costs
  • decide if they are the right surgeon for you

It is a good idea to prepare a set of questions, in advance, so that you do not skip any important ones.

To learn more about knee replacement surgeries, call the top surgeon in Gilbert, AZ, call OSPI Arizona at 480-899-4333. OSPI’s Board Certified orthopedic surgeons have extensive experience and expertise in joint replacement surgery, sports medicine and general orthopedics.

Who is considered for a Knee Replacement Surgery?

One of the most common reasons for considering a knee replacement surgery is severe osteoarthritis of the knees. Patients with knee joint damage due to trauma, people with stiff knees, rheumatoid arthritis and traumatic arthritis may also be recommended for knee replacement. However, knee replacement becomes an option only if conservative treatments have failed to provide pain relief.

Need for Knee Surgery

The recommendation for a knee replacement surgery is made only after the knee surgeon has made a physical examination of knee joints, assessed X-ray reports and other scans and talked to the patient about severity of pain, extent of damage and the mobility and stability of the joints.

Risks Involved

While modern technology and advancements in medicine have made total knee replacement surgery quite safe, there are a few risks associated with it. One risk is the formation of blood clots in the legs, which can cause pulmonary embolism. Stiffness of the joint or nerve damage are the other associated risks. Discuss these risks and any questions you may have in your mind, before you say yes to knee replacement surgery.

Knee Implant

After a knee replacement surgery, which involves implanting a prosthesis to replace the damaged part of the joint, and rehabilitation and physical therapy, you can expect significant pain relief and restoration of function and motion. You can go back to a normal life, walking and going about your day, with much ease.

If you are looking for the best knee replacement doctors, call the top knee doctor in Gilbert AZ, at OSPI Arizona at 480-899-4333.

Ever too old for Knee Replacement?

If you are wondering whether you are too old for knee replacement surgery, you should know that more than 500,000 people undergo total knee replacement in the United States alone. Generally, people with chronic joint pain and debilitating arthritis are considered candidates for total knee replacement.

Total knee replacement can help these people regain lost confidence and independence. A knee replacement can go a long way in restoring your ability to lead a normal life.

Read on to know more about knee replacement surgery and get answers to the most commonly asked questions.

Arthritis and Knee Pain

The knee joint has a layer of smooth cartilage on the ends of thigh bone, shinbone and the kneecap. This cartilage cushions the gliding surface facilitating smooth knee motion. Arthritis involves wear and tear of this cartilage. This leads to bones rubbing against each other, causing pain, inflammation, swelling and stiffness.

Total Knee Replacement

Total knee replacement involves cartilage replacement with an artificial surface, using metal and plastic implants. This creates a new smooth cushion and a functioning joint that does not hurt.

Success Rates

More than 90% patients achieve good to excellent results with pain and symptom relief and improved activity and mobility.

Candidates for Total Knee Replacement

Based on your history, physical examination, X-rays and conservative treatment results, your orthopedic surgeon will discuss with you if you are a candidate for total knee replacement surgery.

In general, you may not be a good candidate if you –

 

  • have poorly-controlled diabetes
  • are an active smoker
  • are morbidly obese
  • have experienced infections in the affected arthritic joint in the past

Can a person be too old for knee replacement?

Age is not a big issue if you have good overall health and wish to continue living an active life. There are cases of patients in their 90’s who get knee replacements and do well. Your orthopedic may ask you to consult your personal physician about your readiness for surgery.

To learn more or to consult an the best knee replacement doctors in Gilbert, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333.

Rehab Exercises after Total Knee Replacement

Once you return home after a total knee replacement (TKR), you will need to perform certain exercises to prevent complications, improve motion of the knee, and build strength. Most people have weak leg muscles before surgery because they were not used much due to knee problems. Now that surgery has corrected this knee problem, you will need to have a regular exercise regimen.

Exercise Program

A regular exercise program is used to strengthen weak leg muscles. Your success with rehabilitation relies on your willingness to follow the exercise program developed by your physical therapist. You should perform these exercises 2-3 times each day after surgery. Each exercise must be done 10 times, starting out, and you gradually increase the repetitions by 5 times each week until you reach 20 repetitions. Your schedule will be:

  • Week 1 – 10 repetitions
  • Week 2 – 15 repetitions
  • Week 3 – 20 repetitionsheel-slides

Ankle Pumps and Circles

  • Bend both ankles up, pulling toes toward you.
  • Bend both ankles down, pointing toes away from you.
  • Rotate each foot clockwise and then counterclockwise while keeping toes pointed to the ceiling.

Heel Slides (Knee and Hip Flexion)

  • Bend the hip and knee by sliding the heel up toward buttocks while keeping the heel on the bed.
  • Slide heel back down again while keeping kneecap pointed at the ceiling.
  • Repeat with opposite leg.

Thigh Squeezes (Quadriceps Sets)

  • Tighten muscles at the front of the thigh by pushing the back of your knee down on the bed.
  • Hold for 5 seconds, then relax.
  • Repeat with opposite leg.

Leg Slides (Abduction/Adduction)

  • Slide leg out to the side while keeping kneecap pointed toward ceiling.
  • Slide leg back to the starting position.
  • Repeat with opposite leg.

Lying Kicks (Short Arc Quadriceps)

  • Lie on back with a rolled blanket under your knee.
  • Straighten knee and hold for 5 seconds.
  • Lower leg down slowly and relax.
  • Keep back of knee in contact with blanket.
  • Repeat with opposite leg.

Straight Leg Raises

  • b7a636bc5a5da7a0eafbb497fb8cac4eBend leg with foot flat on the bed.
  • Raise opposite leg up 12 inches with knee straight.
  • Hold for 5 seconds.
  • Slowly lower leg and relax.
  • Repeat with other leg.

Knee Bending (Sitting Knee Flexion)

  • Sit on a chair.
  • Bend knee back as much as you can and hold for 10 seconds.
  • Return to starting position and relax.
  • Repeat with other leg.

Sitting Kicks (Long Arc Quads)

  • Sit on a chair.
  • Lift foot and straighten knee as much as possible.
  • Keep knee level as if you are holding a tray on your lap.
  • Hold for 5 seconds.
  • Lower leg down slowly and relax.
  • Repeat with other leg.

Prolonged Knee Stretch

  • Sit on a chair.
  • Bend knee back as much as possible.
  • Scoot your body forward to increase the stretch.
  • Hold for 30-60 seconds.

Knee Straightening Stretch

  • Sit on a chair with your heel up on a footstool or chair in front of you.
  • Hold this for 30-60 seconds.
  • Repeat with other leg.

Knee Dangling/Swinging

  • Sit on a high chair or bed so that feet don’t touch floor.IMG_5017
  • Bend knees and swing surgical leg back and forth.
  • Do this for 2-3 minutes.

Heel Digs (Hamstring Sets)

  • Bend surgical knee.
  • Tighten muscle at back of thigh by digging heel into the bed.
  • Hold for 5 seconds.
  • Repeat with other leg.

Buttock Squeezes (Gluteal Sets)

  • Tighten buttock muscles by squeezing.
  • Hold for 5 seconds and relax.

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Rehab After a Total Knee Replacement

Total Knee Replacement Rehabilitation

Having a total knee replacement surgery is usually the best option for patients with severe knee arthritis. At present, more than 4.5 million people in the U.S. are living with at least one total knee replacement, and around 1.5 million people with a replaced knee are 50-70 years of age. During the last couple of decades, total knee replacement increased by 84% in the U.S. population, with the current rate 22 per 10,000 persons. The most important part the knee replacement process is rehabilitation.

The greatest demand for total knee replacement is not coming from the elderly demographics. Rather, it is younger people who have weight issues. There is a strong relationship between knee osteoarthritis and having a high body mass index. More people ages 18 to 64 years are having severe knee pain and loss of mobility related to being overweight.

General Considerations

  • Patients are weight-bearing as tolerated with a walker, crutches, or cane until they can walk without assistance.
  • Early emphasis is on developing full extension equal to the opposite leg soon as possible.
  • No active or passive flexion motion greater than 90 degrees until stitches are removed.
  • Early exercise will focus on recruitment of proper quadriceps set.
  • Keep incision site clean and dry.b7a636bc5a5da7a0eafbb497fb8cac4e
  • Avoid submerging in a pool, tub, or sauna until wounds are healed.
  • Avoid jumping, twisting, pivoting, or rigorous activities.

Week 1

  • You will return to see the Arizona orthopedic surgeon to change the dressing and review health status.
  • Icing, leg elevation, and swelling control are implemented. Swelling control can be achieved using a compression wrap and circumferential massage.
  • Soft tissue treatments and gentle mobilization are implemented by physical therapist.
  • Exercises include gluteal sets, gait training, and balance/proprioception maneuvers. Straight leg raise exercises with quad sets are began, and passive/active range of motion exercises are started.
  • Goals of therapy are to increase range of motion < 90 degrees, and to decrease swelling and pain.

Weeks 2-4

  • You will return to the Gilbert orthopedic surgeon’s office to have staples/stitches removed and for a check-up.canstockphoto7424057
  • The therapist will continue with soft tissue treatments and gentle mobilization, avoiding flexion or patella contracture.
  • Exercises are continued, including progress flexion range of motion, functional exercises, gait training, and balance/proprioception maneuvers.
  • Aerobic exercise is began as tolerated (cycling, swimming).
  • Goals include decreasing swelling and edema and range of motion < 10 degrees extension to 100 degrees.

Weeks 4-6

  • You will follow-up with the orthopedic surgeon.
  • Gentle mobilization and soft tissue treatments continue.
  • Exercises continue, such as functional exercises (weight machines and walking outside), balance/proprioception maneuvers, and swimming after incisions are closed.
  • Goals include walking without a limp and range of motion < 5 degrees extension to 110 degrees.

Weeks 6-8

  • Continue soft tissue treatments, joint mobilizations, and patellar glides to increase range of motion.
  • Add lateral training exercises, and incorporate single leg exercises as tolerated.
  • Goals include patient walking without limp, and range of motion 0-115 degrees.

Weeks 8-12

  • Continue joint mobilizations, soft tissue treatments, and patellar glides to increase range of motion.
  • Begin activity specific training, such as gardening, sports, and household chores.
  • Low impact activities after week 11.
  • Patients are weaned into a home and gym program with emphasis on their particular sport/activities.
  • Goals include return to functional activities and range of motion within functional limits.

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Resources

Health Research Funding (2016). 23 Amazing Total Knee Replacement Statistics. Retrieved from: http://healthresearchfunding.org/23-amazing-total-knee-replacement-statistics/

Intermediate and Long-Term Quality of Life after Knee Replacement

Osteoarthritis (OA) is one of the main causes of functional disability and chronic pain in older people. OA is related to environmental factors, aging, lifestyle changes, and genetic predisposition. When the knee is affected canstockphoto10845760by arthritis, many people undergo knee replacement procedures.

The goal of total knee replacement is to improve overall quality of life and return patients to a higher level of functioning than before surgery. Most people will heal well without problems if they follow their rehabilitation program. Some activities are permitted and others are not:

  • Permitted: Swimming, golf, dancing, water aerobics, cross-country skiing, cycling, hiking, light labor (involves standing and walking), and sedentary occupations.
  • Not permitted: Jogging, running, impact exercises, contact sports, sports that require pivoting and twisting, and heavy labor.

Post-Operative Exercise

golf swingPost-operative exercise may be detrimental to the success in recovery after a total knee arthroplasty (TKA). You will begin to receive physical therapy in the hospital, and will continue at home, outpatient, or in a skilled nursing facility. A home exercise program is provided before hospital discharge.

Weeks 1-2: Anticipate discharge from the hospital after 3-5 days. Continue using walker with instructions from the therapist. At this time, you will start walking 300 feet, begin to straighten the knee, dress independently, and perform simple homemaking tasks. Home exercises will be advanced with your therapist.

Weeks 2-4: During this time, you will gradually increase independence. The home exercise program involves progressive ambulation using the cane, resuming driving if you had a left knee replacement, independent showering, and walking around ¼ mile.

Weeks 4-6: During this time, your physical therapist will have you bending the knee to 90 degrees, using a cane as needed, walking up stairs, and straightening the knee completely.

Weeks 6-12: You will continue home exercises. During this time, you will progress to walking one mile, climb stairs, and resume usual activities, such as swimming and bowling.

Clinical Studies

Many clinical studies regarding total knee replacement have studied quality of life after surgery. Considered a highly successful operation, technical outcomes from total knee replacement are excellent. In a recent study evaluating intermediate and long-term quality of life following surgery, researchers conducted a large review of studies. They found that both intermediate and long-term post-operative quality of life were superior to the pre-Hiking2operative level in analyses.

In the review of clinical reports, researchers found that most patients were satisfied with the knee replacement surgery and reported substantial improvement in daily functional activities. In addition, the benefits were related to health-related quality of life as well as disease-specific quality of life. Four validated measurement tools were used to assess quality of life: the Western Ontario and McMaster’s Universities Osteoarthritis Index, the Knee Society Score, the Center for Epidemiological Studies Depression Scale, and the visual analogue scale for pain.

Another study evaluated self-reported outcomes in the first year after total knee replacement and attempted to determine which factors influenced patient quality of life. The results showed that after 6 weeks, all patients reported significant improvement for all measured parameters in relation to quality of life.

To examine health-related quality of life after total knee arthroplasty, researchers in a Singapore hospital interviewed patients. Data were collected from almost 5,000 patients. The patients who had total knee replacement all had improved pain scores. In addition, two years after surgery, the majority of patients showed improved physical functioning scores.

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Resources

Ko Y, Narayanasamy S, Wee HL, et al. (2011). Health-related quality of life after total knee replacement or unicompartmental knee arthroplasty in an urban asian population. Value Health, 14(2), 322-328.

Papakostidou I, Dailiana ZH, Papalychroniou T, et al. (2012). Factors affecting the quality of life after total knee arthroplasties: a prospective study. BMC Musculoskel Dis, 13, 116.

Shan L, Shan B, Suzuki A, et al. (2015). Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am, 97(2), 156-168.

How Does a Knee Get Replaced?

How do they Replace a Knee?

Knee replacement surgery is performed due to chronic knee pain and loss of mobility. According to the Center for Disease Control and Prevention (CDC), in 2010 alone, almost 700,000 total knee replacements were performed on adults age 45 years and older. Total knee replacement (TKR) has nearly doubled in prevalence over the last couple of decades, especially for women (a 99% increase).

Steps in a Total Knee ReplacementKnee pain 3

Step 1: Administering anesthesia – Knee replacement surgery is usually performed with you under general anesthesia. The doctor will discuss this with you before the surgery. You will be given medications through an intravenous (IV) catheter, and an intubation tube will be placed in your airway.

Step 2: Prepping the knee – After all excessive hair over the knee is clipped or shaved, the skin over the knee is cleaned with an antiseptic solution.

Step 3: Making incision – The orthopedic surgeon will make a 4- to 6-inch incision in the knee area.

Step 4: Removing damaged surfaces – The damaged knee joint and surface will be removed. This involves specialized instruments used to remove cartilage and bone pieces from the joint.

Step 5: Insert prostheses – The artificial components are made of plastic and metal. Most artificial knee components are cemented into the joint. The prosthesis attaches to the bone using a special cement. The components include a tibial component (resurface top of tibia or shin bone), a femoral component (resurfaces end of femur or thighbone), and a patella component (resurfaces the patella or kneecap).

Step 6: Checking motion and implants – After the implants are in place, the surgeon checks range of motion and prostheses stability.

Step 7: Closing incision – The incision is closed using surgical staples or sutures. Depending on the situation, a tiny catheter with drain may be placed in the incision to remove fluid. A sterile, dry bandage dressing is applied over the knee.

How Long does a Total Knee Replacement Last?

A common reply to this question is that a total joint replacement typically lasts 15-20 years. Most current data suggest that both knee and hip replacements have an annual failure rate of around 0.5%. This means that if you have a total knee replacement today, you have a 95% chance of it lasting 10 years, and an 85% chance that it will last 20 years.

canstockphoto10845760

Types of Implants

The orthopedic implant industry has continued to develop innovative technologies to improve the outcomes of total knee replacement. However, many studies show that there is no clear advantage of any of these designs in relation to improving clinical outcomes. Some designs are:

  • Gender specific – This refers to a modified implant design that accounts for the anatomic difference between women’s and men’s knees. Most companies have some modifications in these designs to allows for sizing options so the prosthesis will fit accurately in relation to the patient’s anatomy.
  • Rotating platform – This refers to a plastic component that independently rotates on a metal tray. The plastic bearing will lock into the tray, and was designed to reduce wear on the bearing. In addition, this device can reduce the rate of loosening of metal components and better replicate the normal knee function and movement.
  • Computer technology – There are studies that have evaluated the emerging technologies in knee replacement surgery along with the success of the procedure using computer technology. Computer, robot, and custom cutting guides are used for accuracy in implant placement, as well as a more efficient surgery.

Resources

Center for Disease Control and Prevention (2015). Hospitalization for Total Knee Replacement Among Inpatients Aged 45 and Over: United States, 2000–2010. Retrieved from: http://www.cdc.gov/nchs/data/databries/db210.htm

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

 

References:

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

 

Minimally Invasive Total Knee Replacement vs. Traditional Total Knee Replacement

Total knee replacement has been a successful procedure for the treatment of end-stage, severe knee arthritis. According to clinical studies, long-term results for functional improvement and pain relief are excellent using total knee replacement. However, the traditional approach to knee replacement requires a large incision and a long recovery period. Many patients suffer from permanent quadriceps weakness after knee replacement.

Benefits

The mini-incision technique, also called minimally invasive total knee replacement, is an alternative to total knee arthroplasty canstockphoto11809008(TKA). The minimally invasive procedure is a true quadriceps-sparing surgery. The proposed benefits of the mini-incision procedure include:

  • Gain of early knee flexion (bending)
  • Decreased pain and need for analgesics
  • Improved quadriceps function
  • Decreased blood loss
  • Shortened length of hospital stay
  • Cosmetically better smaller incision
  • Early recovery
  • Rapid rehabilitation

To evaluate the short-term clinical and functional outcome of minimally invasive surgery TKA compared to traditional total knee replacement, researchers evaluated 80 knees. They found that patients in the minimally invasive TKA group had significant decrease in post-operative pain, hospital stay, and blood loss. The study showed that the mini-incision technique offered many benefits.

In another study comparing the two procedures, researchers compared 50 total knee arthroplasties performed with the traditional method with 50 that were performed using the mini-incision technique. The found that overall, the minimally invasive canstockphoto10845760surgery took significantly longer to perform. The traditional approach was found to be easier for the surgeon, and a substantial learning curve may be required for the surgeon to perform minimally invasive knee replacement.

Incision Size

With traditional knee replacement, an incision of 6-8 inches is required. The patient’s size and the extent of joint damage will also determine the length of an incision. The doctor must have a large incision to fully visualize the joint, the implants, and the disease tissue.

With the minimally invasive technique, the incision is only 4 inches long, which is half the length of a traditional TKA incision. Surgeons perform surgery using special instruments that are designed to move around muscle and soft tissue rather than cut through it. A smaller incision is more aesthetically pleasing to the patient.

Recovery

Recovery after total knee replacement from traditional techniques takes around 6-8 weeks, depending on age, health status, and previous knee injury. Each person’s recovery time will vary, but most patients drive after 3 weeks, garden after 4-6 weeks, canstockphoto1903417and golf after 8 weeks. The surgeon will determine what activities you can participate in and which ones you must avoid.

After a minimally invasive knee replacement, recovery takes half as long than traditional surgery. While every patient is different, most people are driving after 2 weeks, gardening after 4 weeks, and golfing after 6 weeks. Regardless of which procedure you have, certain high-impact activities are not permitted, as they place extreme pressure on the new knee joint.

Considerations

The minimally invasive approach is may not be an option for an overweight or obese person, as well as for very muscular people, those who require a complex replacement, and people with severe knee deformity or instability. The mini-incision procedure requires specialized instruments and is more technically challenging to the surgeon. According to some studies, the risks of complications is higher with the minimally invasive TKA, which can be detrimental for the final outcome of surgery.

While the minimally invasive total knee replacement is a good alternative in the hands of an experienced orthopedic surgeon, you should work with your surgeon to decide which procedure is best for you. Choose an Arizona total knee replacement surgeon who is experienced if you wish to have the mini-incision procedure, and work with your doctor to lose weight before surgery.

Study Background:

Minimally invasive surgery has gained popularity over the past several years. Early results have shown better functional outcome with early recovery and rapid rehabilitation.

Aim:

Evaluation of the short-term clinical and functional outcome of minimally invasive surgery total knee arthroplasty (MIS-TKA) compared with the traditional total knee arthroplasty (TKA).

Materials and Methods:

During 2009, all cases scheduled for primary TKA through the modified mini-mid-vastus approach (MIS group) were studied. This group included 40 knees and was compared to a cohort control group of similar number of patients (40 knees) that underwent the procedure through the standard conventional technique (standard group).

Results:

Patients in the MIS group showed significant decrease in postoperative pain, blood loss in first 24 hours, and in hospital stay. Furthermore, they achieved motion considerably faster than the standard group with earlier return of quadriceps function and greater early flexion.

Conclusion:

This study proved that MIS-TPA has the ability to couple the benefits of less invasive surgical approach.

 

Resources

Dabboussi N, Sakr M, Girard J, & Fakih R. (2012). Minimally Invasive Total Knee Arthroplasty: A Comparative Study to the Standard Approach. N Am J Med Sci, 4(2), 81-85.

King J, Stamper DL, Schaad DC, & Leopold SS (2007). Minimally invasive total knee arthroplasty compared with traditional total knee arthroplasty. Assessment of the learning curve and the postoperative recuperative period. J Bone Joint Surg Am, 89(7), 1497-1503.

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