What’s New in Knee Replacement Surgery? | El Camino Hospital


Knee replacement surgery
has been around for more than 30 years and is an
incredibly successful operation. In the past, when a person
had bad arthritis of the knee, they were pretty much out of
luck other than taking aspirin. They’d be debilitated and
limited in their activities. So, when a person
has pain, stiffness, and their life is becoming
restricted by that, that’s when it’s time to
consider knee replacement. We always do non-surgical
treatment first. When that doesn’t work
anymore, then it’s time to consider knee replacement. About 500,000 a year are done,
and most patients who have gone through this basically say that they wish they
had done it sooner. With a knee replacement surgery, we’re essentially resurfacing
the inside of the knee to replace the worn
out, painful cartilage. In a normal knee, you have
smooth slippery surfaces that allow the knee
to glide properly, but when it becomes arthritic,
it’s quite pitted and rough, and you have now very
painful surfaces trying to glide past each other, and
they simply can’t anymore. The way we do the surgery is to
replace the worn out cartilage with prosthetic materials that
resurface the end of the femur and the tibia and that allows for pain-free smooth
motion again. The knee replacement can be
a complete knee replacement or a partial knee
replacement where only part of the knee is replaced. If there’s only one area
that’s involved and damaged, then a total need replacement
is not always necessary. More often than not we find that total replacement is
the best way to go however. The materials have
improved tremendously in the last 20 years. The metal material is
essentially the same. However, the plastic
material is improved in terms of its durability and strength.>>What we’ve found is
that for knee replacements to last hopefully a lifetime,
they need to be inserted in perfect alignment and
the trend now is to go with navigation pretty much as you’d navigate
in your automobile. Navigation can be done during
surgery, intra-operatively, and there are devices and
our computers to assist us in perfect placement
of the components. This has been shown to
improve the alignment and thereby should improve
the longevity of the implant. Now the newest trend is to
actually do a lot of this work, which we used to do during
the surgery, ahead of time. And so, we can actually base
the alignment’s cutting blocks on a patient’s MRI or CAT scan. By taking an MRI ahead of
time of the knee, the hip, and the ankle, we can get custom
made alignment blocks made for the patient so that the
surgery will go much faster and the cuts will be
absolutely accurate and precise. The time now in the
hospital based on our newest techniques is
only a two-day time frame. A lot of people stay three days, but now with tissue
sparing techniques, we spare the quadriceps
muscle, we don’t violate that during the surgery. People are able to get up
and walk even the day of and the day after surgery. So the hospital stay
is much shorter. The recovery time depends on how active you were
before the surgery. Some people are using a
walker before the surgery. Some people are just impaired
a little bit while they’re playing tennis. If you’re a community ambulator,
you’re able to get back into the community, typically
within a month you’re able to drive, go to the store, and go to the mall
that type of thing. Within a month sports
will depend on how active you wish to be. Golfing usually within two to
three months you’ll be able to start hitting balls again.>>When deciding to have
knee replacement surgery, I think the surgeon and the
hospital are very important. If you want to choose a surgeon
who has a lot of experience with this and who does
the surgery regularly, people tend to be better at things they do all the time
rather than on occasional basis. So, the surgeon’s experience and
volume of surgery is important, but the hospital
is very important in terms of rehabilitation. The nurses and physical
therapists and the doctors are all a
team and at our hospital, at El Camino Hospital, we
have a very dedicated focused on rapid recovery after a
joint replacement surgery. If that whole team
is not in place, then the recovery becomes
much more difficult to predict and there’s much less
support for the patient. One of my most memorable
patients was a retired admiral who had several war wounds
resulting in bad arthritis in both knees and
before he came to see me, he had been almost
wheelchair-bound for about five years. He could barely get up, he
could barely walk and stand. We did both knee
replacements one at a time and following the replacements,
he is now up and playing tennis and doing cross country skiing,
hiking in Yosemite and back to a very vigorous
lifestyle and he one of the happiest people
you might ever meet.

4 thoughts on “What’s New in Knee Replacement Surgery? | El Camino Hospital

  1. im 24 and im now going to have the replacement i was am very nervous and my anxiety is thru the roof. But after I saw this video I am now more relaxed and my anxiety about the surgery has lessened. Thanks for the information. 🙂

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