Total Knee Replacement has proven to be one of medicines most successful surgeries allowing people to return to an active life without pain. It is well proven that quality of life improves and productivity improves with total knee replacement and is one of the reasons workplace productivity continues to improve in this country. Total Knee Replacement is actually a resurfacing of the end of the knee bones (the femur and tibia). The collateral ligaments (MCL and LCL), and in some cases the Posterior Cruciate (PCL), and even Anterior Cruciate (ACL) ligaments are preserved. The knee is not “chopped out” and replaced - it is resurfaced. This creates a smoothly functioning joint free of pain. Many patients state “ I wish I had done this sooner.” (picture of model with cap and ligaments ( arrows to ligaments)
We are currently working on and performing knee replacement that preserves all the ligaments of the knee and truly is a resurfacing of the knee. Its is known as a bicruciate retaining knee or anterior cruciate preserving knee. It is in its infancy and may not provide the long-term results that traditional replacement has seen. However, we are optimistic and remain involved in its development.
Minimally Invasive Knee Replacement
The procedure is performed in a minimally invasive fashion with a small incision in an attempt to preserve the quadricep muscle complex. Click on Video below. It is our feeling that patients recover faster and regain more strength with this difficult approach. In addition to the benefits of the minimally invasive approach, our advanced anesthetic approaches (see section on anesthesia) and pain control approaches along with aggressive physical therapy see section on physical therapy or click here ) help speed recovery and make the process easier.
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The results of total knee replacement are excellent with over 95% of patients experiencing a dramatic relief of pain and demonstrating significant improvements in activity. These excellent results can last over 15 years depending on the patients activity level and size. Though the results are excellent, a certain percentage will fail over time requiring a second surgery.
The most common cause of failure is loosening of the implant. Loosening is most frequently caused by wear of the joint surface. With loosening the patient experiences pain and in some instances bone loss. The treatment is a more complicated operation than the first surgery but often is successful leading to pain relief and improvements in activity. If wear of the surface is noted prior to the development of pain, bone loss, or loosening - the polyethylene pad or surface can be replaced as an outpatient surgery. This surgery is much less complicated than a first time replacement and most patients return to normal and normal activities within a few weeks.
Most surgeries proceed without complication. Serious complications though rare do occur and include infection, loosening of the implant, loosening/stretch of the ligaments, joint stiffness, and blood clots. Other complications reported by joint replacement surgeons but far less common include nerve or vascular injury, excessive bleeding, and fracture of the bone or implant.
We currently utilize knee replacement implants which help recreate the normal function and mechanics of the knee. We utilize Smith and Nephew Journey 2 and Legion Knee replacements with VERILAST technology and often utilize Patient Specific Knee Replacement Technology such as VISSIONAIRE. We use gender specific implants (specific for women) to insure adequate fit of the component. With further information at rediscoveryourgo.com. We currently utilize bearing surfaces which minimize wear and lead to longer life of the implant, including oxinium and highly crosslinked polyethylene. These advances have along with wear simulator data lead us to belive we have a "30 year Knee." Consultation with Your surgeon will result in the appropriate implant for you.
In selected patients with knee pain other surgical treatment options are used by our team including arthroscopy, and partial knee resurfacing ( one or two compartment resurfacing and patella femoral replacement all of which can restore normal mechanics of the knee by preserving the ligaments of the knee.