“Noyes Knee Disorders” by Dr. Frank R. Noyes, MD. Master the technical details of procedures such as anterior cruciate ligament reconstruction, meniscus repair, articular cartilage restoration, and many others, and implement appropriate post-operative rehabilitation programs and protocols.
News Around Knee Surgery & Sports Medicine
Arthrofibrosis of the knee is a condition characterized by abnormal scar tissue growth around the knee joint. This condition may…Read More
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Move Freely with Partial Patellofemoral Replacement 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. Here at The Noyes Knee Institute, we help active adults eliminate knee pain.
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 Partial Knee Replacement 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.
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. 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.