Standard Treatment Options

Conservative Treatments

Conservative treatments, such as steroidal and non-steroidal anti-inflammatory drugs, physical therapy, bracing, and cortisone injections may effectively relieve pain and restore mobility for some patients, for some period of time. But more severe conditions may not respond adequately to these approaches. In these cases, the orthopaedic surgeon may recommend knee replacement surgery.

Conventional Knee Replacement

Conventional knee replacement is a surgical procedure — performed in the US since the 1960s — in which a diseased or damaged joint is replaced with an artificial joint called a prosthesis. Made of metal alloys and high-grade plastics (to mimic the function of bone and cartilage, respectively), the prosthesis is designed to move just like a healthy human joint. Over the years, knee replacement techniques and instrumentation have undergone countless improvements. Today, knee replacement is one of the safest and most successful types of major surgery; in well over 90% of cases it is complication-free and results in significant pain relief and restoration of mobility.

Knee replacement is major surgery, and as such, there are certain risks and expectations that must be recognized. For example, for some knee replacement candidates, the 3 to 5 day hospital stay, 3 to 12 week recovery period, and 8 to12 inch scar present significant obstacles to having the procedure.

Minimally Invasive Surgery

Over the past 25 years, minimally invasive surgery has revolutionized many fields of medicine. Its key characteristic is that it uses specialized techniques and instrumentation that enable the physician to perform major surgery without a large incision. In this respect, MIS Knee Joint Replacement is indeed “minimally invasive”, requiring only a small incision and causing minimal trauma to the soft tissues. Minimally invasive surgical techniques may offer benefits that include less pain, less recovery time and less scarring.

MIS Total Knee Replacement (TKR)

Unlike conventional TKR - which requires a large incision (8 to 12 inches) and may significantly disrupt the muscles and tendons - MIS Knee Joint Replacement is performed through a 3 to 4 inch incision. The amount of soft tissue (muscles and tendons, etc.) that is disrupted during surgery may also be reduced. Through that same small incision, the diseased surfaces of the knee joint are exposed and then replaced, one at a time, with the artificial joint components.

MIS Partial Knee Replacement (PKR)

Partial Knee Replacement (PKR) is a minimally invasive procedure for relieving arthritic knee pain and disability. During the operation, the damaged compartment of the knee joint is replaced with metal and plastic implants. With PKR, only the damaged surface of the knee joint is replaced, minimizing trauma to healthy bone and tissue.

What Happens During the Surgery

In surgery, the knee is flexed and the leg suspended. One muscle is separated to expose the femur (thigh bone); later, the tibia (shin bone) is exposed. The damaged surfaces at the end of the thigh bone are trimmed to shape it to fit inside the total knee prosthesis. The shin bone is cut flat across the top and a hole is created in the center to hold the stem of the tibial component. If needed, the knee cap is trimmed and the patellar component attached.

At various points during surgery, the alignment, function, and stability of the knee joint are evaluated and required adjustments are made. The prosthesis components are cemented into place, any contracted ligaments are released, the midvastus muscle is reconstructed, and the incision is closed.