Move Freely with MAKOplasty in Cincinnati
If you’ve been active your whole life, unexplained knee pain may appear to be a minor setback at first. When the pain doesn’t go away, you may find yourself holding back from your regular events.
Don’t let your knee pain stop you from living your life.
If you feel ready to jump back into things, speak with a specialist about MAKOplasty. Here at The Noyes Knee Institute, we help active adults eliminate knee pain with MAKOplasty in Cincinnati.
Partial Knee Replacement with Robotic-Assisted Technology
Partial knee replacement (also called unicompartmental knee replacement) is an operation that is used in patients who have severe arthritis in only one portion of their knee joint. There have been many advances in this operation, including improved implant design and surgical techniques, that now make it an attractive alternative to total knee replacement in the appropriate patient candidate. Robotic-assisted surgery was introduced in the mid 2000s in order to improve accuracy in planning and performing partial knee replacements.
Dr. Frank Noyes was one of the pioneers of this operation in Cincinnati, using the MAKOplasty Partial Knee Resurfacing Systems with the Robotic Arm Interactive Orthopedic System (Stryker, Kalamazoo, MI). Performed at the Jewish Hospital, this minimally-invasive operation has achieved superior accuracy and precision compared with older partial knee replacement techniques. The MAKO technology creates three-dimensional models of each patient’s knee anatomy from computed tomography (CT) scans that are taken before the operation. The model is then used to plan the amount of bone that will be resected and where the knee replacement components will be placed.
The advantages of partial replacement over total knee replacement include less blood loss, smaller incisions, preservation of bone stock, return to higher levels of function, fewer complications, shortened hospital stays, and an overall faster recovery. Most patients are able to walk without support within approximately 2 to 3 weeks after surgery and the majority return to daily activities within 4 to 6 weeks. Light, low-impact activities such as walking, swimming, golfing, light hiking, and bicycling can often be performed by 3 months.
How MAKOplasty Can Help
If you experience chronic knee pain, you’ve likely damaged the later compartment, medial compartment, or cap of your knee. In the past, this kind of damage might have warranted total knee replacement to restore functionality and mobility.
However, MAKOplasty is a relatively new procedure that can extend your knee function for years, with minimal invasion. Thanks to robotic assistance, this procedure offers precise knee resurfacing. Rather than replacing the entire knee cap, it only replaces the damaged area, saving healthy ligaments and bone.
Many patients assert that the partial knee replacement feels natural, and after healing, they can often return to their favorite activities and recreational sports.
Call Our Office to Learn More
If you believe that MAKOplasty may be your solution, schedule an appointment. Our board-certified orthopedic surgeon, Dr. Frank R. Noyes, will meet with you to discuss your treatment options. The staff at Noyes Knee Institute stays up to date on the latest treatments and procedures, so you can rest assured that you’re in good hands.
With our help, you can receive the personalized care and treatment you need to return to an active lifestyle. Contact us at 513.794.8471, If you’re a new patient, don’t forget to fill out our new patient registration form here.
If your knee is severely damaged by arthritis, it may be difficult to perform simple daily activities such as walking, squatting, or climbing stairs. You may have pain while you are sitting or lying down. Swelling is common and may occur either during the day or in the evening. Sports activities are usually not possible without pain or swelling. Your orthopedist may have shown you x-rays that demonstrate “bone-on-bone” in your knee in which the normal joint space between the femur (thigh bone) and tibia (shin bone) is gone.
If conservative measures such as weight control, medications, physical therapy, and injections are no longer effective in managing your knee symptoms, you may want to consider knee replacement surgery. This operation is a safe and effective procedure that relieves pain, corrects leg deformity, and aids in the resumption of normal activities.
Knee replacement surgery was first performed in 1968. Since then, improvements in surgical materials and techniques have greatly increased its effectiveness. Over 600,000 knee replacements are performed each year in the United States alone.
The decision of whether this operation is indicated is based on evaluations and discussions between you, your surgeon, your family physician, and family. Patients who benefit from total knee replacement frequently have:
- Severe knee pain or stiffness that limits daily activities such as walking, climbing stairs, kneeling, and getting in and out of chairs. Walking more than a few blocks is usually not possible without significant pain. The knee pain may also occur while resting, either during the day or at night.
- Chronic knee inflammation and swelling that does not improve with rest or medications.
- Knee varus or valgus deformity — a condition in which the knee bows in or out.
- No benefit from conservative measures including medications, injections, injections, physical therapy, or weight control.
There are no absolute age or weight restrictions for total knee replacement surgery.
Recommendations for surgery are based on a patient’s pain and disability, not age. Most patients who undergo total knee replacement are 50 to 80 years old, but this operation may be performed in younger patients if indicated.
Realistic Expectations From Surgery
An important factor in deciding whether to have knee replacement surgery is understanding what the procedure can and cannot do. More than 90% of patients experience a dramatic reduction of knee pain and a significant improvement in function following the operation and physical therapy. Light, low-impact activities such as walking, swimming, golfing, driving, light hiking, and biking can often be performed. However, running and higher-impact athletics are not advised. This is because, with normal use and activity, knee replacement implants will wear in their plastic spacers. Too much physical activity or body weight may speed up this normal wear and may cause the knee replacement to loosen and become painful. With appropriate activity modification, knee replacements can last for many years.
How is the Operation Done?
Total knee replacement (also termed knee arthroplasty) may be thought of as knee “resurfacing” because only the surface of the bones are removed and replaced. This is similar to the manner in which a tooth cavity is filled by a dentist. At our Center, the operation is done with the assistance of a robot which helps the surgeon make very precise calculations and bone cuts in order to achieve the best implant fit possible.
There are four basic steps to a knee replacement procedure:
- Prepare the bone. The damaged articular cartilage surfaces and a small amount of bone are removed at the ends of the femur and tibia.
- Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or “press-fit” into the bone.
- Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. No all patients require a resurfacing of the patella.
- Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.
Partial Knee Replacement Surgery
If only a portion of your knee is severely damaged by arthritis, then it is possible to replace just that area. Partial knee replacement surgery, also known as uni-compartmental or patellofemoral joint replacement, is now a viable operation for younger patients aged 20-40 who do not require a total knee replacement. Candidates for this operation are patients who have pain with daily activities and who usually have had several prior operations that failed to alleviate pain and limited function. This operation essentially “buys time” before a total knee replacement, which is important in younger patients.
In some patients, only the kneecap is severely damaged and in these cases, just the patella is replaced. In others, only the medial or inside portion of the knee joint is damaged. In these patients, just the damaged cartilage and bone surfaces in the medial ends of the femur and tibia are replaced.
What is Expected After Surgery?
All patients require physical therapy for approximately 6 months after knee replacement surgery to restore range of knee motion and normal function. Many exercises may be done at home, although a physical therapist will monitor your progress carefully. The postoperative protocol may be downloaded here
Possible Complications of Surgery
The complication rate following knee replacement is low. Serious complications, such as a knee joint infection, occur in fewer than 2% of patients. Major medical complications such as heart attack or stroke occur even less frequently. Chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur, they can prolong or limit full recovery.
Infection. Infection may occur in the wound or deep around the prosthesis. It may happen while in the hospital or after you go home. Minor infections in the wound area are generally treated with antibiotics. Major or deep infections may require more surgery and removal of the prosthesis. Any infection in your body can spread to your joint replacement. Warning signs of infection are persistent fever greater than 100° F (orally), shaking chills, increased redness, tenderness, or swelling of the knee wound, drainage from the knee wound, and increasing knee pain with activity and at rest.
Blood clots. Blood clots in the leg veins are the most common complication of knee replacement surgery. These clots can be life-threatening if they break free and travel to your lungs. Your surgeon will outline a prevention program, which includes periodic elevation of your legs, lower leg exercises to increase circulation, support stockings, and medication to thin your blood. The warning signs of a blood clot in the leg are increasing pain in your calf, tenderness or redness above or below your knee, and increasing swelling in your calf, ankle, and foot. Warning signs of a clot that has traveled to your lung (pulmonary embolism) are sudden shortness of breath, sudden onset of chest pain, and localized chest pain with coughing. If any of these symptoms occur, you should contact your surgeon immediately.
Implant problems. Although implant designs and materials, as well as surgical techniques, continue to advance, implant surfaces may wear down and the components may loosen. Additionally, although an average of 115° of motion is generally anticipated after surgery, scarring of the knee may occur, and motion may be more limited, particularly in patients with limited motion before surgery. Our physical therapy protocol is designed to restore at least 115° of motion and to recognize potential problems with knee motion early after surgery so that they can be corrected.
Continued pain. A small number of patients continue to have pain after a knee replacement. This complication is rare, however, and the vast majority of patients experience excellent pain relief following knee replacement.
Neurovascular injury. While rare, injury to the nerves or blood vessels around the knee can occur during surgery.