Advanced Knee Care

Knee Surgeon and Specialist Stefan D. Tarlow, M.D.

How To Achieve The Perfect Total Knee Replacement

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The perfect total knee is known as “the forgotten knee”.  Patients with a forgotten artificial knee state that the artificial knee always feel normal in daily activities.  This occurs approximately 66 % of the time, according to French surgeons.

Gender, age, body mass index, and preoperative pain were not predictive of outcome.

Inability to fully straighten the replaced knee, preoperative anterior or popliteal knee pain, patellar maltracking, and the diagnosis of psychological depression are associated with an abnormally feeling total knee replacement.

Better or improved knee flexion (bend) is predictive of a naturally feeling knee.

Both the patient and the surgeon have some influence on surgical outcome.  The ability to straighten the knee is often dependent on strict adherence to a post operative rehabilitation protocol (patient controlled factor).  Better pre-operative knee flexion is associated with more post operative knee bend (surgeon selection of patient for surgical treatment).

Opioids and Total Knee Replacement – Preoperative Use Detrimental

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Most patients with advanced arthritis of the knee do not use strong pain pills in the year prior to knee replacement surgery.  America has an opioid epidemic with many accidental deaths and social problems linked to use of this class of drug.  Most of this use can be traced to the abuse of doctor prescribed hydrocodone and oxycodone.

A report published in the Journal of Bone and Joint Surgery calls to our attention an orthopedic concern in people using opioids in the 2 year period prior to Total Knee Replacement surgery. Specifically, the chronic opioid group obtain less pain relief from the joint replacement surgery.  This group of patients had lower satisfaction scores and a greater number of patients in the opioid group had additional knee surgeries for pain and stiffness.

In summary, patients that are on opioids for an extended period of time prior to their joint replacement are at a greater likelihood of having a surgical failure.

Minimally Invasive Total Knee Replacement

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minimally invasive TKR

One of the most common orthopedic procedures is total knee replacement. This minimally invasive procedure is also known as arthroplasty. It is used to replace worn or damaged surfaces of the knees. Basically, an implant is placed as a replacement for the knee surfaces to increase mobility, relieve pain and help the patient return to his/her normal everyday activities.

Minimally Invasive vs. Traditional Approach

The main goal of total knee replacement procedure is to relieve the pain, restore the health and function of the, and to eventually help the patient return to daily activities. In this procedure, the damaged bone and cartilage are removed from the surface of the knee and replaced with artificial ones.

The traditional approach involves full surgery. It takes longer and leaves a long vertical incision in the center of the operated. Now minimally invasive knee replacement is gaining more popularity over the traditional approach. This is because, as the term suggests, the technique is less-invasive and faster. I also uses a shorter incision; hence, speeding recovery and reducing postoperative complications.

While both traditional and minimally invasive total knee replacement have more or less the same results; minimally invasive promises a faster recovery and lesser risk for complications. The only problem is that unlike traditional approach, minimally invasive procedure is not for everyone. You need to discuss with your surgeon first if you are a good candidate for the said procedure.

Minimally Invasive Knee Replacement

In minimally invasive TKR, the artificial implants used are the same as the ones used in traditional approach. However, the surgical instruments used for the removal of the damaged cartilage and bones and for the placement of the implants are different and more specialized. This is because in minimally invasive procedure, the incision is shorter, about 4 to 6 inches only, compared to the 10-inch incision in traditional surgery. This means less tissue disturbance and faster recovery. Additionally, the technique used in opening the knee is also less invasive, avoiding trauma and reducing risk for infection and other complications.

Among the benefits of minimally invasive knee replacement procedure are quicker and less painful recovery, rapid return to normal daily activities and lesser damage to soft tissues. It also means less stay at the hospital.

As already mentioned, not all people are a good candidate to undergo minimally invasive total knee replacement. If you wish to know if you are a candidate or not, and if you wish to know more about minimally invasive knee replacement; contact an orthopedic surgeon. Make an appointment with Dr. Tarlow today.

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