Knee Replacement Surgery

Partial Knee Arthroplasty

Revision Hip and Knee Replacements

Robotic Knee and Hip Arthoplasty (MAKO)

A total knee replacement is somewhat of a misnomer. A more appropriate procedure would be a total knee resurfacing utilizing minimal bone cuts to remove the degenerative cartilage and replaced with highly engineered metal and plastic. This procedure is reserved for people with long standing knee pain that has become refractory to conservative treatment including activity modifications, anti-inflammatories, possible cortisone injections, and in some cases visco-elastic shots (gel shots/synthetic hyaluronic acid).

How do I know if I need a knee replacement?

This is an excellent procedure for patients whose goal is to maintain an active lifestyle, improve function and mobility, and to eliminate pain. Limitations are patient specific but generally include limited high impact activities like running, jogging, high impact recreational sports including basketball and tennis.

Like a Partial Knee, a Total Knee Arthroplasty is now considered minimally invasive as the incision usually measures less than 5 inches long, is muscle sparing, and utilizes new advances in instrumentation to work through smaller operative windows.

Recovery

How long does it take to recover from a knee replacement?

Full recovery can take up to 3 months.

A partial knee Arthroplasty does not resurface the entire knee; rather it resurfaces 1 of the knee compartments and on occasions resurfaces 2 compartments. It’s primarily indicated for patients with isolated medial compartment arthritis (pain on inside of knee/joint line) with relative preservation of the cartilage in the lateral and patellofemoral compartment.

Advantages to this procedure are that you are preserving approximately 70% of the normal cartilage of the knee. It also spares resection of the ACL and PCL giving the knee a more natural feel. It is a much less invasive procedure with half the recovery time as a total knee arthroplasty.

As with a TKA, this procedure is reserved for patients with isolated arthritis which has become refractory to conservative treatment and is affecting function and quality of life. Younger patients with this pathology might be a candidate for a different procedure called a high tibial osteotomy (HTO) which correctly the deformity unloading the diseased portion of the knee without any form of resurfacing.

Although the majority of hip and knee replacements do well with no complications; there are certain cases where the individual may still experience pain, instability, develop an infection, or develop another complication. While some of the complications can be managed conservatively, some might need further surgical intervention which is called a revision procedure.

These procedures require an extensive work up including x-rays, potentially further imaging studies, lab markers, possibly an aspiration from the knee/hip, and an extensive physical exam. Any decision to move forward with a revision procedure is thoroughly discussed with the patient to highlight all risks vs benefits and an informed decision is made.

Robotic MAKO assisted arthroplasty involves utilizing a Robotic Arm to help the surgeon remove the patient’s diseased bone. The surgery is not performed by the robot.

How does a robotic knee replacement work:
The patient gets a pre-operative CT which is used to generate a 3D virtual model of your unique hip or knee. The model is loaded into the MAKO software where your surgeon can pre-operatively template size, alignment, and rotation of your components. This
software and pre-operative templating is the utilized intra-operatively to assist your surgeon in performing the knee or hip arthroplasty. The MAKO system helps the surgeon stay within the planned boundaries that were defined when the personal pre-operative plan was created. It also allows the surgeon to make intra-operative adjustments as needed.