Knee Replacement

Knee Resufacing Update

I think this procedure will be a major improvement for a number of our patients. It can be done athroscopically with a small incision for the femoral (thing bone) component which allows most patients to go home the same day. Pain is much less than with a total knee replacement and the physical therapy is much easier. The parts are so small that, if a patient needs a total knee replacement someday, they will not interfere. Not everyone is a candidate, but I think this procedure will spare a lot of people from a premature knee replacement
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Arthrosurface

I very excited about a new technology that we now have access too. Called Arthrosurface, it’s an innovative new approach to knee arthritis. Using an arthroscopicly assisted technique, we can resurface small parts of the knee that are worn our for arthritis. This is a much smaller operation than a knee replacement, and patients can go home the same day and walk on the knee immediately. Physical therapy is much easier and the time investment is much less. Not everyone is a good candidate for this new procedure, but I think it will save many patients from a much larger operation. We don’t know the long term outcomes yet, but I’m very optimistic about this technique’s future.
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Gender Knee Update

I still get quite a few women asking about gender specific knees. Most of them have seen television ads or a web site promoted by an implant manufacturer. I think one of the issues that has gotten lost amid all the hype is the wide variarions that occur normally in human knees. Knees vary not just by gender, but by age, race, height, weight and the type of arthritis that the patient is suffering from. Sometimes a “male” knee is better for a woman or vice versa depending on the size of the patients knee.
The most imporatant thing to focus on is the number of sizes available and picking the right knee for each patient. I try to pick the knee that is most appropriate for a specific problem, and then use the wide variety of differnent sized to get a perfect fit. In my experience, focusing on just the patient’s gender is too much of an oversimplification.
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Deuce Knee Implant

We have a new knee implant available for patients with arthritis of the knee. It's called the Deuce because it replaces the inside of the knee and knee cap only.
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The implant can be put in with a minimally invasive technique and retains all the knee ligaments, which isn't possible with traditional total knee replacements. The thigh bone side of the implant is made of a ceramic, called Oxinium which may not wear out as fast as standard metal implants. I think it may be a good choice for younger patients who want to remain active. We can determine if this is an appropriate choice by examining x-rays and the arthritic knee.

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Gender Specific Knees

I've had some questions recently about Zimmer's gender specific knee, which is targeted at female patients. I am actually pretty upset about what is a blatant attempt to market unproven designs directly to patients. It is true that femaie knees are generally smaller and have a slightly different groove for the knee cap than men do. However, most implants already take this into account and have for years. There is no reason to label a knee "specific to women" other than to steer them to a Zimmer implant. I believe that my patients are smarter than that and will see through what is basically marketing hype. Unfortunately, we often spend a lot of time talking about non-issues like gender specifics rather than important things, like getting through the surgery in the safest and smoothest fashion possible.
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Advertising

I have been very concerned about advertising on both TV and radio being done by many surgeons and orthopaedic companies. Much of the information is misleading or downright wrong. One of the surgeons in our area is advertising a procedure he's only done a few of, and some others are promoting older technology as if it were invented yesterday. Of course, it's important for patients to discuss the type of prosthesis they may be getting, but I think the advertising can interfere with that process.
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