Surgical options for patients with osteoarthritis of the knee
Osteoarthritis (OA) of the knee is a progressive disease that ultimately damages the entire joint. Knee OA should initially be treated conservatively, but surgery should be considered if symptoms persist. Surgical treatments for knee OA include arthroscopy, osteotomy and knee arthroplasty; determining which of these procedures is most appropriate will depend on several factors, including the location and severity of OA damage, patient characteristics and risk factors. Arthroscopic lavage and debridement do not alter disease progression, and should not be used as a routine treatment for the osteoarthritic knee.
Bone marrow stimulation techniques such as microfracture are primarily used to treat focal chondral defects; the evidence for the use of these techniques for knee OA remains unclear. The goal of osteotomy for unicompartmental knee OA is to transfer the weight load from the damaged compartment to undamaged areas, delaying the need for joint replacement. This procedure should be considered in young and active patients who are not suitable candidates for knee arthroplasty. For patients with severe OA, total knee arthroplasty can be a safe, rewarding and cost-effective treatment. In selected patients with isolated medial or patellofemoral OA, unicompartmental knee arthroplasty and patellofemoral replacement, respectively, can be successful.A degenerative joint disease, osteoarthritis is one of the oldest and most common forms of arthritis. The disease causes the cartilage normally found in joints to break down. This breakdown removes the buffer between bones and the resulting bone-against-bone friction causes pain and eventual loss of movement. Symptoms include joint pain or aching (often after exercise or extended periods of pressure on weight-bearing joints) and limited or eventual loss of motion. Osteoarthritis affects lakhs of patients in In dia and some of them are not very old.Their level of activity is high and a major procedure like TOTAL KNEE REPLACEMENT is neither needed nor desirable .
MIS High Flex Partial Knee Replacement
MIS High Flex Partial Knee system is a partial knee implant for people who need joint replacement, but only have damage to one side â€“ or compartment â€“ of their knee.
Partial knee replacement has been around for 30 years. What's new with the MIS High Flex Partial Knee is the extent to which this partial knee is capable of bending, which is referred to as flexion. While this implant will not guarantee you high flexion, it will safely accommodate high flexion if you are able to achieve it. This is significant because many other partial â€“ and total â€“ knee implants being used today do not allow for deep knee bending. In addition, MIS High Flex Partial Knee was designed for placement using today's minimally invasive techniques, which if you are a candidate, are helping many people get back to life and work faster than patients who undergo traditional knee replacement surgery.
MINIMALLY INVASIVE UNICONDYLAR KNEE REPLACEMENT
The MIS instruments enable the implantation of Unicompartmental implants through a 3-4inch incision. The MIS technique avoids patella eversion and reduces disruption of soft tissue and quadriceps. Some of the benefits of minimally invasive surgery are:
Reduced length of hospital stay
Less blood loss
Frequently Asked Questions MIS Procedure for the Uni Knee Replacement
Q. What is Partial Knee Replacement, and How is it Different from Total Knee Replacement?
A. In total knee replacement surgery, the damaged surfaces of all three bones are resurfaced with metal and plastic implants. Using special, precision instruments, our surgeon will typically remove the damaged surfaces. The replacement surfaces will then be fixed into place. The surface of the upper bone is replaced with a rounded metal component that comes very close to matching the curve of your natural bone. The surface of the lower bone is replaced with a flat metal component and a slab of ultra-high-molecular weight polyethylene plastic to serve as the cartilage, or the entire component may be plastic. The undersurface of the kneecap also may be replaced with a round disc made of the same polyethylene plastic.
Partial knee replacement is an option for patients who do not require total knee replacement because some of the joint surfaces are still healthy. In partial knee replacement surgery, the surgeon removes only the diseased portion of the knee before placing the implant, leaving the healthy portion untouched. This means that the surfaces are replaced on only one side of the joint, that is, only one of the rounded projections is replaced beneath it.
Q. What is the difference between the MIS procedure and the standard procedure?
A. The MIS procedure involves removing only the diseased portion of the knee, through an incision that is one-third to one-fourth the size of a traditional knee replacement incision. Rehabilitation time after the MIS procedure is estimated at five weeks. Traditional, total knee replacement surgery involves removing or resurfacing more parts of the knee, including both condyles and often the underside of the kneecap. Rehabilitation time for a total knee is estimated at 12 weeks. Most total knee replacements are performed on patients 65 years of age and older; whereas, the majority of patients receiving the MIS procedure for the Uni Knee are 55 and older.
If partial knee replacement is not an option for you, you may want to ask your doctor about minimally invasive procedures for total knee replacement, such as the MIS Mini-Incision or MIS Quad-Sparing TKA.
Q. What are the benefits of the MIS procedure compared to traditional knee replacement surgery?
A. Clinical results suggest that patients who undergo the MIS procedure may experience a shorter hospital stay (24 hours or fewer), faster rehabilitation and a smaller incision scar. Patients may also experience an increased range of motion after recovery.
A successful Uni Knee replacement may delay, and in some cases, prevent a more extensive knee replacement surgery.
FULL RANGE OF KNEE FLEXION AFTER MIS UNI KNEE REPLACEMENT
NORMAL KNEE FUNCTION AFTER MIS UNI KNEE REPLACEMENTT
Q. Is MIS Partial Knee Replacement Better?
A. The MIS partial knee replacement procedure may not help your new knee joint function better or last longer than traditional surgery, but it might help make your surgery, recovery, and rehabilitation faster and easier for you.
Q. How do I know if I am a candidate for the MIS procedure and Uni Knee Replacement?
A. A number of factors can determine whether a patient is qualified to undergo the MIS procedure for the Uni Knee replacement and how successful the procedure will be. An ideal candidate is someone who has osteoarthritis of the knee that is isolated to only one condyle (or compartment) of the knee. Candidates also may include people who are not responding to other forms of treatment such as medication, arthroscopy or cartilage transfers. The Uni Knee replacement is not performed on individuals with rheumatoid arthritis.
Q. How Do I Decide?
A. The decision to have the MIS procedure for an Uni Knee replacement is up to you and your orthopaedic surgeon. Your doctor will consider a number of factors, including: medical history, weight, health status, and anatomical structure, including bone structure and extent and pattern of arthritis.
Q. Is the procedure covered by insurance?
A. Yes. Although insurance plans vary, the MIS partial knee procedure is usually covered by insurance in the same manner that traditional unicompartmental knee replacement surgery is covered. Check with your insurance plan in advance to be sure.