New Quad Sparing Technique May Provide Faster Recovery For Patients With Arthritis Of The Knee
Edited by Seth S. Leopold, M.D., Professor, UW Orthopaedics & Hip & Knee
OverviewKnee replacement is a surgical procedure that decreases pain and improves the quality of life in many patients with severe knee arthritis. Typically patients undergo this surgery after non-operative treatments have failed to provide relief of arthritic symptoms. Surgeons have performed knee replacements for over three decades generally with excellent results most reports have ten-year success rates in excess of 90 percent.
Broadly speaking there are two types ways to insert a total knee replacement: the traditional approach and the newer minimally-invasive approach.
Traditional total knee replacement involves a roughly 8 incision over the knee a hospital stay of 3-5 days and sometimes an additional stay in an inpatient rehabilitation setting before going home. The recovery period typically lasting from one to three months. The large majority of patients report substantial or complete relief of their arthritic symptoms once they have recovered from a total knee replacement.
The main potential benefits of this new technique include:
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Pros And Cons Of Knee Replacement Implant Material
For a healthy lifestyle, it is important that the knees are in good shape and remain free of pain. Pain in the knees is a common condition and results mostly due to medical conditions such as osteoarthritis and cartilage wear and tear. It is the knees that provide strength and support to the human body and this is why mobility is severely affected if anything happens to the knees.
A common solution to get relief from immense knee pain and discomfort is to opt for knee replacement. During this surgery, the damaged or diseased part of the knee is removed and replaced with an implant or prosthesis.
The prosthesis comprises a flat metal plate and stem, which is inserted in the patients tibia, a polyethylene bearing surface as well as a contoured metal implant that is attached at the end of the femur bone. The flatter bearing of the knee replacement implant makes it less problematic than other implants, including the hip implants.
Generally,the cost of Knee Replacement starts from $4000, and it is also offered on day-care basis for select patients. The knee replacement implant material used may differ from patient to patient, on the basis of their condition, actual requirement, and also the choice made by the surgeon. Here is a list of the different knee replacement implant materials and their pros and cons.
Types Of Knee Replacement Implants
According to Dr. Trevor North orthopedic surgeon, Most surgeons use one style of implant for a significant majority of knee replacement cases. Only about 10% of total cases may require a different style of implant. He adds, There are certain nuances and different tools for each implant. You want a surgeon who is very familiar with the style of replacement you are receiving.
The most common type of knee replacements is called a single radius knee. Its commonly accepted that this type of implant offers the greatest level of extension and flexion for majority of patients, regardless of age, gender, activity level and so forth.
Other variations in the type of replacement received are fixed bearing and mobile bearing. This has to do with how the plastic insert locks into the tibia component. Majority of replacements are fixed bearing, meaning that the plastic insert is locked into the metal tibial plate. In a mobile-bearing knee, the plastic insert in the tibial component can rotate inside the tibial tray. An overwhelming majority of the replacements produced by the various manufacturers are classified as single radius, fixed bearing implants.
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Thx4 Copper Sports Compression Knee Brace
THX4 makes one of the top knee braces for athletic activities. Its knee brace has been designed under supervision from professional trainers and physiologists.
This allows the brace to serve you with utmost comfort and reliability. The knee support compresses your knee to ensure that it stays in position, while the embedded copper lining keeps your skin healthy and free from bacteria.
This fastens your recovery and prevents any further conditions from developing. The knee brace comes with anti-slip design that allows you to keep it on for long hours. You can use it for various sports related knee injuries such as ACL, PCL, LCL, etc.
Comfort and Stability
Made from a compound fabric , this knee brace is very comfortable. It is moisture wicking and anti-odor as well.
Durability and Quality
The knee brace is made for professional athletes. This is why it is no surprise that its fabric is of top grade and has been double stitched to prevent it from coming apart. You can wear it daily with full confidence.
The Role Of The Patients Body Frame In Knee Replacement Implants
Orthopaedic surgeons have reported that there are several anatomical differences between the body frames of patients who need knee replacement implants. The patients body structure plays an integral role in deciding the right type of implant. As such, surgeons cannot adopt the “one size fits all” approach when it comes to knee replacement surgeries. Instead, they have to modify the knee implant to suit the patient’s gender, ethnicity, and body frame, thereby ensuring optimal performance.
Meril’s FREEDOM ® Total Knee System is an optimised sizing matrix, designed to cater to the requirements of the global population, with varying requirements. Developed using advanced design engineering technologies and extensive clinical experience, this implant addresses the anatomical, physiological and lifestyle needs of today’s patients. The implant enables patients to achieve optimal high-exion motion and requires minimum bone cutting.
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How Do I Know If I Need Knee Replacement Surgery
You may need surgery if:
- Your knees are stiff and swollen.
- There is pain throughout the day, even at rest.
- Walking, getting up or climbing stairs is difficult and painful.
- Medication and therapy do not offer enough relief.
- Knee cartilage is so damaged and worn away that you are walking âbone on bone,â in which the bones of the joint are scraping together.
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Find The Best Knee Replacement Implant: Top Brands
There are more than a dozen manufacturers of artificial knee implants. However, like anything else, some knee implant manufacturers have a larger market share than others. In the US, the most popular knee replacement parts manufacturers are Zimmer , Stryker, DePuy and Smith & Nephew.
Here are the top brands and styles used by surgeons in the US.
Zimmer is the most popular manufacturer of knee replacements. In fact, according to Zimmer, more than 25% of knee replacements implanted worldwide are a Zimmer product. Thats a whole lotta implants!
Different Styles
Biomet
Biomet, who has recently merged with Zimmer and is now called Zimmer Biomet, offers a nickel-free implant for those with allergies. They also offer an antioxidant polyethylene material insert component to pair with their tibial and femoral parts. In saything this, there is nothing to prove that antioxidant plastic holds any true benefit. Admittedly, it sounds pretty good though!
Different Styles
Among the most popular manufacturers in the US, Stryker offers total, partial, and revision knee replacement systems that are suitable to a wide variety of patients. Stryker implants are used in over 100 countries.
Different Styles
DePuy
Different Styles
Smith & Nephew offers a wide range of replacement variations that fall under their Legion family. This includes replacements made from oxidized zirconium, a nickel-free metal thats suitable for patients with metal allergies.
Different Styles
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Results Of Friction And Wear
Clinically speaking, friction and wear lead to the release of very small particles into the surrounding joint cavity. This initiates an aggressive inflammatory response.
The body mounts a cellular reaction to try to deal with the wear debris. This reaction, unfortunately, often leads to unwanted destruction of bone around the implant. When osteolysis becomes severe, it can cause pain, loosening of the implant and the need for revision surgery to replace the implant components. One way to relieve the problem of osteolysis and increase the longevity of joint replacements is to improve the wear resistance of the bearing materials.
Advanced Orthopedic Care In Colorado Springs
Here at the Colorado Center of Orthopaedic Excellence, our goal is to provide comprehensive orthopedic care under one roof. Our surgeons, podiatrists, physical therapists, occupational therapists, and other medical staff collaborate to treat a wide range of musculoskeletal problems and provide you with world-class orthopedic care. We have been an official partner of various U.S. Olympic teams, including the Paralympics.
Walking and knee movements are very important to quick recovery after surgery. We recommend exercise to our patients as soon as the day after surgery. The Colorado Center of Orthopaedic Excellence offers physical therapy and rehabilitation services right here, so you dont have to look elsewhere for your post-surgery recuperation.
If you have any questions about our orthopedic services or you would like to schedule an appointment with one of our physicians or therapists, please call us today at or request an appointment online. We look forward to getting you back in the game!
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What Are The Different Types Of Joint Implants
There are three main types of joint implant materials, and they each have their advantages and disadvantages:
In the 1960s and 1970s, several materials were tried as bearing surfaces in joint arthroplasty, including Teflon® and metallic alloys such as stainless steel and cobalt-chromium alloy. But through the 1980s and much of the 1990s, the preferred combination was ultra-high-molecular-weight polyethylene bearing against cobalt-chromium.
Polyethylene results in a low coefficient of friction when bearing against a highly polished metallic or ceramic surface. Today, metal-on-polyethylene and ceramic-on-polyethylene combinations are considered as primary choices for bearing surfaces. However, ceramic-on-ceramic are also considered, as are metal-on-metal bearings in hip resurfacing surgeries.
Activities With A High Risk Of Falling
After a total knee replacement, loss of strength, range of motion, and balance lead to an increased risk of falling. A fall can damage the prosthesis or interfere with the healing process.
A 2018 study found that 17.2 percent of a group of 134 people who had undergone a knee replacement fell at least once within 6 months of their operation. Roughly two-thirds of these falls occurred when walking.
Some lifestyle modifications to reduce your risk of falling include:
- using the handrail when going up and down the stairs
- using a rubber mat or shower chair when showering
- sitting down when putting on shorts or pants
- keeping the floor clear of stray toys, slippery rugs, and other objects that pose a tripping hazard
- avoiding slippery terrains like mud, ice, or wet grass
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Common And Serious Complications Of Knee Replacement
While knee implants give many recipients a second chance at walking and living a more normal life, complications do occur.
Most problematic is a loosening of the implant, which can be caused by a defective implant or poor positioning at the time of surgery. Implant loosening is a primary cause for revision surgery.
Although rare, metallosis is possible after knee replacement surgery. Metallosis, also known as metal poisoning, can occur when metal implant pieces rub against each other and release tiny metal particles into the knee joint and bloodstream.
Common complications from knee surgery include:
- Swelling and stiffness
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How We Chose Our Selection Of Knee Pads
As we always do when making our selection, we chose the best knee pads based on 3 essential pieces of criteria besides rigorous testing to ensure we picked the brightest and most effective options around.
Brand âWe always search for the best brands available as these are the ones that deliver consistent quality with every product. In our selection, we looked for a range of great brands that all offer something a little different to one another so there are no two knee pads which feel exactly the same.
Price âDifferent demands and purposes leads to different price ranges. We know not everybody wants the most high-tec protective knee pads around, but at the same time, some may want an option thats more suitable and reliable than your standard low-range pair of knee pads. We wanted to find a range of affordability that allowed everyone with whatever needs to find the knee pads they require.
Quality âQuality is always an important factor and for keeping your body protected, we believe it is even more important. Using reviews and studying the construction and materials used in these knee pads, we could figure out the level of quality. If some knee pads seemed like they were mostly useless, they didnt make the cut. The ones you see above boast the quality we demand of every selection.
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What Company Makes Knee Replacements
Other orthopedic companies have also entered the market with , allowing them to differentiate themselves from other companies on the market. Major players in the knee replacement market include Stryker, DePuy Synthes, Zimmer Biomet, and Smith Nephew. Smaller companies are unable to compete with the big four because of their dominance.
Make sure you choose the best device for your specific needs. Each implant has the same basic function, but it differs in some ways. Certain devices are best used in conjunction with certain surgical techniques. All medical devices used in the United States must be approved by the Food and Drug Administration, and there are very few recalls. If you are unfortunate enough to be involved in a recall, you will need to have additional consultation with your surgeon. A knee implant differs from a hip implant in a variety of ways. To ensure that your body does not reject the material used in an implant and that the device withstands the same forces as a human knee, it must be approved by the manufacturer.
What Type Of Surgery Does Dr Chien
What methods will you receive with Dr Chien-Wen Liew
Dr Chien-Wen Liew has a dedicated practice in only total hip and total knee replacements. He no longer accepts new referrals for sports injury, trauma or other conditions of the hip and knee. This allows a dedicated focus to optimising all efforts towards a successful total hip replacemnt or total knee replacement.
total hip replacement
For over 8 years, all total hip replacements have been performed using the Direct Anterior Approach. This is an approach where no muscles or tendons are cut or detached during surgery. A cementless stem and socket combined with a ceramic on ceramic articulation will be used in most cases.
total knee replacement
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Which Implants Are Best For Knee Replacement
There is no definitive answer as to which implants are best for knee replacement surgery. Different patients will have different needs and preferences, so it is important to discuss all of your options with your surgeon. They will be able to help you choose the best implants for your individual case.
Metals and plastic are likely to be used to make the components of a total or partial knee replacement. The four artificial components that comprise a total knee replacement implant are made up of four. The materials are made up of titanium, cobalt-chromium alloys, or a combination of titanium and cobalt. Cobalt and titanium alloys do not corrode or change inside the body, in addition to being biocompatible. Cobalt, on the other hand, is more elastic and favorable to the natural bone around it. The kneecap is made up of a number of components, including a thermoplastic polyethylene that is found in the kneecap. The most common type of knee replacement is a single- radius knee.
Zimmer, Stryker, DePuy, and Smith & Nephew are among the most well-known knee replacement manufacturers in the United States. Approximately 10% of patients may require a different implant type in 10% of cases. Your orthopedic surgeon must be trustworthy and adhere to their own instructions. Your teams hard work will have the most impact on the outcome of your surgery.
What Are The Risks Of Total Knee Replacement
Most people do very well with their minimally invasive total knee replacement. But as with any surgery, the procedure does carry some fairly rare risks. Possible complications of the surgery include:
-
Loosening of the components of the knee
-
Limited motion of the knee
There is also a very slight risk that the procedure might not relieve your pain. Your own risk of complications may vary according to your age and your other medical conditions. Ask your provider about the risks that most apply to you.
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What Is The Best Knee Replacement
There is no definitive answer to this question as it depends on the individual patients needs and preferences. Some people may opt for a traditional knee replacement, while others may choose a more customized or minimally invasive option. The best knee replacement for each patient will be based on their specific situation and should be discussed with their doctor.
Ian McDermott is a knee surgeon at Phoenix Hospital Group who specializes in knee replacement. As he explains, Conformis is superior to off-the-shelf knee replacement implants. In the United Kingdom, approximately 100,000 knee replacements are performed each year. In other words, one in every five knee replacement patients is unhappy with their knee. Using a robot, you can ensure that a knee replacement prosthesis is placed accurately and straight. Conformis implants are made to fit each patient and feature custom-designed cutting blocks. The accuracy of these cutting blocks, according to studies, is comparable to that of robotic surgery.
Most private medical insurance plans in the United Kingdom cover Cancelus knee replacement treatments. Mr. Ian McDermott, with the assistance of Conformis implants, performs total knee replacement surgery at Phoenix Hospital Group. Mr. McDermott is one of the most experienced surgeons in the UK who performs this type of partial and total knee replacement surgery.