Transcript Minimally Invasive Knee Replacement

Minimally Invasive (MI)
Knee Replacement: Is it
right for you?
Anatomy of the Knee
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Made up of three
bones:
 Femur (thigh bone)
 Tibia (lower leg bone)
 Patella (kneecap)
A Healthy Knee Joint
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Knee formed by ends of the
femur, tibia and patella
Cartilage provides padding
between the bones and helps
assure an effortless, smooth
gliding movement of the joint
Joint capsule provides fluid for
smooth movement
Causes of Knee Pain
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Osteoarthritis (wear and
tear)
 Rheumatoid arthritis
 Post-traumatic arthritis
caused by:
 Fractures
 Ligament injuries
 Meniscus cartilage tears
What is Osteoarthritis?
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Degenerative condition that is not part of the
normal aging process
 May result from overuse or injury
 Most common type of arthritis
The Arthritic Knee
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Deterioration of cartilage
Bone on bone
Spurs, pitting, grinding
Deformity
Pain, impaired activity
Knee Joint
•Healthy knee joint
•Arthritic knee joint
How Can My Life Change
with Treatment?
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A return to mobility
 Regaining a sense
of your old lifestyle
 Reduce or
eliminate pain
Non-Surgical Treatment Options for Knee
Pain: Over-the-Counter Medications
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Nonsteroidal Anti-Inflammatory Drugs (NSAIDS)
 Can reduce pain, swelling and redness
 Relief can take several months
 Examples:
 ibuprofen (Advil®, Motrin®)
 naproxen (Aleve®)
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Aspirin
 Reduce joint pain and inflammation
 Form of NSAIDs
Common side effects of NSAIDs, aspirin, and acetaminophen are abdominal cramps or
pain, abdominal discomfort, bloating and gas, constipation, diarrhea, dizziness, fluid
retention and swelling, headache, heartburn, indigestion, itching, loss of appetite, nausea,
nervousness, rash, ringing in ears, stomach pain, and vomiting.
Non-Surgical Treatment Options for Knee
Pain: Over-the-Counter Medications
Acetaminophen
 Reduces pain and lowers fever
 Does not decrease or reduce inflammation of arthritis
 Examples:
 Tylenol®
 Datril® Extra Strength
 Tempra®
Common side effects of NSAIDs, aspirin, and acetaminophen are abdominal cramps
or pain, abdominal discomfort, bloating and gas, constipation, diarrhea, dizziness,
fluid retention and swelling, headache, heartburn, indigestion, itching, loss of
appetite, nausea, nervousness, rash, ringing in ears, stomach pain, and vomiting.
Non-Surgical Treatment Options for Knee
Pain: Prescription Medications
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NSAIDS
 Most popular type for osteoarthritis treatment
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Analgesics
 Provide pain relief, but do not reduce inflammation
Non-Surgical Treatment Options for Knee
Pain: Prescription Medications
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Biological Response Modifiers
 Treat rheumatoid arthritis
 May postpone injury to the joints
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Glucocorticoids or Corticosteroids
 Treat rheumatoid arthritis
 Fight inflammation
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DMARDS
 Treat rheumatoid arthritis
 Slow joint destruction
Every drug has possible side effects. Be sure to talk with your doctor about possible side effects
before taking a new medication. If you notice a side effect, contact your doctor immediately to
discuss whether or not you should continue to take that medication.
Non-Surgical Treatment Options for Knee
Pain: Injection Therapy
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Cortisone Injections
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Helps reduce swelling and discomfort from arthritis
Temporary pain relief
Risk of infection
Following the injection, there may occasionally be increased pain or an
inflammatory reaction to the injected medication
Hyaluronic Acid (HA) Injections
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Restores lubrication and fluid in the joint
Creates a shock absorber between the bones
Risk of infection
Following the injection, there may occasionally be increased pain or an
inflammatory reaction to the injected medication.
Non-Surgical Treatment Options for
Knee Pain
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Lifestyle Changes
 Diet and exercise to control weight
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Orthotics
 Assistive devices (walker, cane, etc)
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Walking
Bathrooms
Climbing
Dressing
Surgical Options for Knee Arthritis
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Arthroscopy
 Debridement
 Meniscectomy
 Chondroplasty
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Osteotomy
 Bone cut and re-aligned onto remaining good cartilage
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Arthroplasty (Joint Replacement)
 Uni-compartmental knee replacement (partial knee
replacement)
 Tri-compartmental knee replacement (total knee
replacement)
Arthroscopic Debridement
“clean out” or “scrape bone”
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Somewhat unpredictable
results
50 to 66 percent get relief for
some period of time
Pain relief may be temporary
Best for patients with
mechanical symptoms
(catching, locking and giving
out)
Knee Osteotomy
Re-align weight-bearing axis through “good” cartilage
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Most popular before
success of contemporary
knee replacement
 Useful for patients too
young, heavy or active for
knee implants
 Early results acceptable,
questionable durability
End-Stage Osteoarthritis  Knee
Replacement
“Gold Standard of Care”
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Uni-compartmental Knee
Replacement
 “Uni,” “partial replacement” or
UKR
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Tri-compartmental Knee
Replacement
 “Total replacement” or TKR
 “Minimally invasive” or MITKR
Total Knee Replacement
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Total knee is affected
by arthritis
 Reduce knee pain
 Improve the motion
 Continued
advancements in
technology,
materials, and
designs
Total Knee Replacement
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Resurface joint with 3 components
 Implant materials include:
 Cobalt chrome
 Titanium alloy
 Ultra high molecular weight polyethylene (medical
grade plastic)
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Preserve bone, ligaments, tendons
Background on Minimally Invasive
Knee Replacement
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Continued evolution to refine techniques to
improve safety and cosmetics
 Smaller incisions
 Sparing key tendons and muscles
 Uses traditional implants
Difference Between Traditional and
Minimally Invasive Knee Replacement
Traditional
Minimally Invasive
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Proven clinical success
for decades
Full visualization of
tissues
Larger incision
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Clinical studies in
evaluation
Potentially less tissue
dissection
Smaller scar
Minimally Invasive Knee
Replacement
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Same implants as traditional knee
replacements
 Components
 Femoral
 Tibial
 Patellar
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Reduced tissue trauma
Ideal Candidate for Minimally
Invasive Knee Replacement
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Suffering from arthritis and failure to respond to:
 Medication/injection
 Weight management
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Considerations
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Medical History
Weight
Severity of Arthritis
Condition of skin
Age
Activity level
Potential Benefits of Minimally
Invasive Knee Replacement
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Less trauma to the knee
Less bleeding
Less pain
Cosmetically appealing (smaller scar)
Shorter hospital stay
Quicker recovery than traditional total knee
replacement
Potential Complications and Risks
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Factors that effect risks:
 Skill of the surgeon
 Age, weight and health of the patient
 Patient compliance
Surgical Procedure
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Incision is made.
 Damaged bone surfaces from the femur, tibia
and patella, as well as worn-out cartilage are
removed.
 Precision instruments and guides help
surgeons make cuts at the correct angle.
Surgical Procedure
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An implant is attached to each
of the three bones (femur,
tibia, and patella)
 Implants are designed to
mimic a healthy knee.
 Incision is closed.
The Future of Minimally Invasive
Knee Replacement
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Evolving
 Clinical studies under way
 May be enhanced with computer assisted
surgery