Total Knee Replacement Surgery
Your doctor may have told you that you are a candidate for total knee replacement surgery. This surgery removes the damaged and painful areas of the thigh- and shinbones. These areas are then replaced with specially designed metal and plastic parts.
Standard surgical incision for knee replacement
The standard surgical incision is between 8 to 12 inches. The incision is made through the quadriceps tendons and muscles to position the replacement parts. Patients generally have two to three months recovery time. Much of the postoperative pain a patient feels is a result of the cutting of the tissues. While tissues are healing, scar tissue forms, which may cause pain and stiffness.
Minimally invasive total knee replacement procedure
This new technique at Midwest Orthopaedics at Rush has revolutionized total knee replacement surgery . The short incision total knee replacement is a surgical modification using a smaller incision that requires less muscle dissection, which generally results in more rapid and less painful recovery with better early range of motion and improved function.
Potential benefits of this minimally invasive technique include increased range of motion sooner after surgery, less blood loss during surgery, faster recovery and a shorter hospital stay. In fact, many patients leave the hospital the same day.
For additional information about the Midwest Orthopaedics at Rush experts in minimally invasive total knee replacement, call 877 MD BONES .
The Benefits Of A Minimally Invasive Approach To Knee Surgery
Knee pain is pretty much a fact of modern life, with millions of people seeking treatment every year for some type of knee discomfort. Sometimes, its just tendonitis or some other condition that can be treated with ice or another non-invasive approach. If that wont satisfactorily resolve your issues, you may need to undergo knee surgery.
Arthroscopic Surgery Vs Knee Replacement
Once conservative knee pain treatment options no longer provide benefit, people with chronic, severe knee pain must often make a decision between two procedures: arthroscopic surgery or knee replacement. The choice is an important one, and patients should be aware of the differences between arthroscopic surgery and knee replacement before making a decision.
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Advantages Of Knee Arthroscopy
The primary advantage afforded by arthroscopy is the ability to gain multiple views inside the joint. In the past, gaining access to some of these areas required an arthrotomy – a surgery in which an open incision was made – and dislocation of the patella or knee cap. “That procedure required additional trauma to the knee and carried the risk of additional injury to the joint,” explains Dr. Cordasco.
In contrast, arthroscopic examination of the knee joint usually does little damage to surrounding soft tissues. While most orthopedic surgeons continue to rely on radiographs and MRI to provide important preliminary information, many agree that arthroscopy is the best diagnostic tool available.
“Arthroscopy offers pieces of information that the other tests don’t,” says Dr. Cordasco, “including that which is derived by probing the affected tissue. MRI is a wonderful tool to evaluate the structure of the soft tissues, but does not provide the tactile information acquired by probing the soft tissues and evaluating them with direct visual observation.”
Here at Hospital for Special Surgery, general anesthesia is rarely indicated for arthroscopic surgery of the knee which is generally performed with or occasionally local anesthesia .
Therapeutic applications of arthroscopy can also eliminate the need for large incisions.
Orthopedic Surgeons In North Dakota
If you have knee problems and want to explore whether knee replacement surgery is right for you, contact us at The Bone & Joint Center. Our expert team has substantial experience treating all types of orthopedic conditions, including knee pain, and we can diagnose your condition and advise you on the best type of treatment and the results you can expect.
So dont delay, contact us today to make an appointment by calling 424-2663 or request an appointment online now. We look forward to serving you!
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What Happens During Total Knee Replacement
Your provider can help explain the details of your particular surgery. An orthopedic surgeon will perform the surgery aided by a team of specialized healthcare professionals. The whole procedure may take a couple of hours. In general, you can expect the following:
Most likely, you will be given spinal or general anesthesia so that youâll sleep through the surgery and wonât feel any pain or discomfort during the procedure. Or you may receive local anesthesia and a medicine to keep you relaxed but awake.
A healthcare professional will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.
You may receive antibiotics, during and after the procedure, to help prevent infection.
Your surgeon will make an incision over the middle of your knee, cutting through your skin and underlying tissue.
He or she will remove the damaged portions of your thigh and shin bone, removing a little of the bone beneath as well.
Next, metal implants are placed into the joint space, usually cementing them into the remaining bone.
In most cases, your surgeon will also remove part of the underside of the kneecap.
A plastic spacer is inserted into the space between the metal implants, for ease of movement.
The layers of your skin and muscle will be surgically closed.
Knee Arthroscopy And Recovery
Arthroscopic surgery takes place only after the immediate post-injury swelling and inflammation has diminished, and the patient has recovered almost complete range of motion.
Arthroscopic photo showing meniscus tear.
When the ACL is sustains a complete tear, the surgeon must replace it with a graft. Grafts can be obtained from the patients own knee , or from donated tissue . Generally, autografts are used in the adolescent and young population of athletes, and allografts are used in the older patient population. The autograft sources include the bone-patellar tendon-bone graft, the hamstring tendon graft or the quadriceps tendon graft. When an autograft is used, it is retrieved through a small open incision.
The general success rate following ACL reconstruction is 85 to 90%. In recent years the revision ACL surgery rate has increased, often as a result of recurrent injury to the knee sometime after the original surgery .
Recovery time from an ACL reconstruction varies, with a period from about 6 to 9 months representing an average time required before the athlete returns to collision sports. During that period the patient participates in a rehabilitation program designed to restore range of motion, strengthen muscles, and regain balance and sports-specific skills.
Arthroscopy photo showing meniscus tear.
Illustration showing tear and area of resection.
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Common Shoulder Surgeries And Procedures
Most shoulder injuries are typically treated with conservative treatments first, including anti-inflammatory medication, activity modification, physical therapy and cortisone shots. However, if the shoulder does not respond to those treatments or in traumatic injuries, we will use surgical shoulder treatment.
Knee Cartilage Repair Regeneration And Replacement
There are two primary types of cartilage in the knee: articular cartilage and meniscus . SeeSoft Tissue of the Knee Joint
These surgeries can be performed on almost any joint, but they are most commonly performed on knees. They are generally appropriate for people who have specific cartilage injuries rather than widespread cartilage damage, like that found in moderate to severe knee arthritis.
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How Much Pain Will I Have After My Knee Surgery
This varies between patients, however, the advances in pain management have allowed our total knee patients sufficient pain relief to undergo this procedure on an outpatient basis. On average, the pain being reported is generally no more than four out of a 10-point scale. You will have one of us by your side when you wake up and throughout the day until you leave our facility. We can address any pain that you may have promptly and efficiently.
Types Of Knee Surgeries
Knee replacement surgery, also known as knee arthroplasty, involves the surgical replacement of all or part of the knee joint with artificial parts, depending on the extent of the damage in your knee. Knee surgery can now be performed in a minimally invasive manner, which helps to reduce post-operative pain and recovery time, and this can even be offered on an outpatient basis.
There are a number of different types of knee replacement surgeries and procedures available. Knee surgery is usually only recommended if other treatments have not worked.
The main types of knee replacement surgery are the following:
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Mako/ Partial Knee Resurfacing
Mako Robotic-Arm Assisted Technology provides you with a personalized surgical plan based on your unique anatomy. First, a CT scan of the diseased knee joint is taken. This CT scan is uploaded into the Mako System software, where a 3D model of your knee is created. This 3D model is used to pre-plan and assist your surgeon in performing your partial knee replacement.
Setting The Stage For A Successful Outcome: Surgery At Hss
Partial knee replacement is widely recognized as a technically demanding surgery. As demonstrated in the scientific literature, data shows that choosing an orthopedic surgeon and institution with extensive experience with this procedure can help ensure a good result. In fact, at high-volume institutions like HSS, in well-selected patients, surgeons achieve the same longevity for partial knee replacement as that reported for .
Its important to understand that partial knee replacement is a challenging procedure to perform, says , Attending Orthopedic Surgeon at HSS. At HSS, we collect data on partial knee replacement patients on an ongoing basis. This allows us to continuously refine screening and surgical techniques to achieve predictable results and the best outcome possible.
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Knee Surgeon In Ft Lauderdale
Many conditions, including osteoarthritis , rheumatoid arthritis, knee injury, or a bone spur in the knee, can all cause inflammation, pain, and damage to the knee joint. Experienced orthopedic surgeons will first attempt the least-invasive treatments, such as corticosteroid injections, pain medicines, and physical therapy but if you continue to experience chronic or severe knee pain, then a total knee replacement may be the best solution.
If your knee constantly hurts, contact our team of medical professionals at Total Orthopaedic Care for a consultation. Our orthopedic surgeons treat knee pain and perform partial or total knee replacements on a regular basis, so they are experts at helping their patients achieve relief from their knee pain.
Call us today at 735-3535 or request an appointment online. We even offer same-day appointments for acute or new knee injuries. We look forward to seeing you here and helping you enjoy a pain-free lifestyle once again.
Recovery After Arthroscopic Surgery On Your Knee
As a general rule, the procedure itself typically takes an hour or two. Most people who have arthroscopic knee surgery do so on an outpatient basis, going home after a little time in recovery. You can expect some swelling, but thats typically easy to manage with ice and elevation. You may work with a physical therapist, or may get some exercises to help you recover strength and mobility in your knee. The length of your recovery time will depend, in part, on the severity of your injury and the extent of the surgical procedure, but most people are able to return to an active lifestyle in three months or less.
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The Unhappy Total Knee Replacement Patient: Figuring Out What Is Wrong
Do I Have The Wrong Size Knee?
Unfortunately, there are a significant number of people who have undergone total knee replacement and are not happy with the result. Some studies estimate 20% or more fall into this category. Defining success or a satisfactory result can mean two very different things to an individual who had the total knee versus the surgeon who implanted it. At the end of the day, its most important that the person who had the TKR is happy.
Defining success for the TKR begins even prior to surgery, during a frank discussion between patient and surgeon, with regard to what that patients goals are and if the surgeon thinks those goals are achievable and appropriate. Some goals simply are not reasonable, such as long distance running or team soccer, particularly if the new joint is to enjoy longevity.
When a patient is not happy with the result after surgery, it is very important that we understand why. Many times, the specific complaints give clues as to the underlying problem. Ultimately, if the situation is to be rectified and the problem corrected, then the specific etiology must be clearly delineated. TKRs work wonderfully, but only when a host of important variables comes together. I call these the surgeons goals which is what I try to achieve during an operation and, when accomplished, helps assure a stable, pain-free knee with which the patient is happy.
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How Do I Manage Pain During My Recovery
You should consider a number of options for pain relief following knee surgery. These options should be discussed with a pain management specialist, who can explain the pros and cons of each option or combination of options, including effectiveness, potential side effects, potential for addiction, and impact on the recovery process. Physician anesthesiologists who specialize in pain management can work with you before and after surgery on a plan tailored to your condition, personal history, and preferences.
Some of the options to consider and discuss are:
- Analgesics such as acetaminophen . These act solely to relieve pain.
- Anti-inflammatory medicines like aspirin, ibuprofen, and naproxen sodium. These act to relieve pain and reduce inflammation.
- Peripheral nerve blocks. These involve the injection of an anesthetic into specific nerves to block pain signals between the brain and the knee.
- Opioids. These drugs, which block pain signals to the brain, are sometimes necessary to relieve severe or persistent pain, but patients should take them only as needed and use as low a dose as possible. Monitoring by a pain management specialist is important because opioids can be addictive.
- Multimodal therapy. This is commonly used for pain management after knee replacement surgery and typically involves opioids and one or more additional pain relief methods. Multimodal therapy can improve pain control while limiting opioid use.
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Minimally Invasive Knee Replacement
In minimally invasive knee replacement, the surgical procedure is similar, but there is less cutting of the tissue surrounding the knee. The artificial implants used are the same as those used for traditional knee replacement. However, specially designed surgical instruments are used to prepare the femur and tibia and to place the implants properly.
Minimally invasive knee replacement is performed through a shorter incisiontypically 4 to 6 inches versus 8 to 10 inches for traditional knee replacement. A smaller incision allows for less tissue disturbance.
In addition to a shorter incision, the technique used to open the knee is less invasive. In general, techniques used in minimally invasive knee replacement are “quadriceps sparing,” meaning they avoid trauma to the quadriceps tendon and muscles in the front of the thigh. Other minimally invasive techniques called “midvastus” and “subvastus” make small incisions in the muscle but are also less invasive than traditional knee replacement. Because the techniques used to expose the joint involve less disruption to the muscle, it may lead to less postoperative pain and reduced recovery time.
When Can I Take A Shower After Outpatient Knee Replacement
You can take a shower the day after your surgery. Please wait until the visiting nurse and physical therapist arrives. The nurse will check your dressing and your overall health that morning, and the therapist will educate you on how to safely get in and out of the shower.
Your outer padded dressing and tape can be removed. Underneath you will find a clear tape that is glued to your skin. Do not remove this. You may shower with this and get it wet. Please do not scrub the surgical area. Pat dry with a clean towel when you are finished. We also ask that you do not let your surgical site get soaked with water. Do not take a bath or get into a pool or hot tub.
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What Is Arthroscopy And What Types Of Procedures Can Be Done Arthroscopically
With an arthroscopic procedure, your surgeon makes a small incision and inserts a miniature camera . Using that camera, the surgeon can perform certain procedures, such as trimming a torn meniscus. Arthroscopy can be used to diagnose and treat a number of knee conditions, including a torn ACL or PCL , torn meniscus, loose cartilage or a dislocated patella .
How Do I Get Ready For Total Knee Replacement
Ask your provider how you should plan to get ready for your surgery.
Tell your provider about any medicines you are taking, including:
All prescription medicines
Over-the-counter medicines such as aspirin or ibuprofen
Herbs, vitamins, and other supplements
Ask if there are any medicines you should stop taking ahead of time, like blood thinners.
If you smoke, try to quit before your surgery.
If you are overweight, your provider may advise you to try to lose weight before your surgery.
Donât eat or drink after midnight the night before your procedure.
You may want to make some changes to your house, to make your recovery smoother. This includes things like adding a handrail in your shower.
In some cases, your provider might want additional tests before you have your surgery. These might include:
X-rays, to get information about your hip
MRI, to get more detailed information about your hip
Electrocardiogram , to make sure your heart rhythm is normal
Follow any other instructions from your healthcare provider.
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