Total Knee Replacement Surgery

Hiking after total knee replacement

Knee replacement (sometimes called knee arthroplasty) is a procedure in which an arthritic, diseased knee joint is resurfaced, and the damaged cartilage and diseased bone are replaced with anatomically similar parts made of metal or plastic. (Knee replacement might more accurately be called a “resurfacing” because only the surfaces of the bones are replaced.) More than 600,000 patients undergo knee replacement each year. Replacement can be partial or total, depending on the extent of the damage to the joint.

Damage typically occurs from arthritis, the most common form of which is osteoarthritis, or the normal “wear and tear” that occurs in people age 50 and older (though it can also occur in younger individuals). Other types of arthritis include post-traumatic arthritis, which is caused by injury, and inflammatory arthritis, which is caused by a variety of conditions, the most common being rheumatoid arthritis. Whenever possible, Dr. Nordt prefers to use minimally invasive techniques for knee replacement. Minimally invasive knee replacement involves the use of a smaller incision as well as advanced techniques for opening the knee.

Patients undergoing minimally invasive replacement typically have an incision that is just 4 to 6 inches long, compared with 8 to 10 inches in traditional knee replacement. Dr. Nordt uses a specially designed prosthesis and computer-guided instruments that allow him to access the knee through this smaller incision. Possibly more important than the length of the incision, however, is the use of newer quadriceps-sparing methods that protect the quadriceps muscle and tendon in the front of the thigh.

On occasion a “mid-vastus” or “sub-vastus” approach may be used; these make small incisions in the muscle but are still far less invasive than the traditional approach. Studies have shown that less invasive procedures have several benefits when compared with traditional methods, including less blood loss, reduced hospital stay, and better motion after surgery. Regardless of whether the replacement is partial or total, minimally invasive techniques can lessen your pain and recovery time and lead to a less noticeable scar.

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