Sunday, June 28, 2009

Total Knee Replacement: Treating the Knee with Surgery

By Dr. Stefan Tarlow

Minimally Invasive Surgery for Total Knee Replacement (MIS TKR)

Minimally Invasive Surgery for Total Knee Replacement (MIS TKR) provides patients with a better postoperative experience. A patient who is operated on using this technique can expect less pain, a shorter hospital stay, and a speedy recovery.

With MIS TKR, a very small skin incision is made. The exact site of the location is determined based on a number of individual factors about the patient. This incision does not affect the quadriceps tendon - the large muscle located on the anterior of the thigh. Therefore, there is less soft tissue trauma, and the patient experiences greater recovery benefits.

A very innovative combination of MIS TKR and Computer Navigation allows the surgeon to make the most accurate placement of the knee possible. Dr. Tarlow has been practicing this unique innovation since August of 2004.

Patients often want to know if they will be a good candidate for MIS TKR. Experienced MIS TKR surgeons can make that determination in-office with an examination and evaluation. Occasionally, the decision to do MIS TKR will be made during knee surgery.

Click here for more on Knee Arthroscopy.

Women are usually better candidates for MIS TKR. This is because they tend to have flexibility of the knee tissue, also called good soft tissue mobility. Additionally, they may tend toward a mild knee deformity - bowed or knocked knees, which is an advantage. Good preoperative ROM (range of motion) and BMI (body mass index) less than 35 are also helpful.

Men, on the other hand, may not be ideal candidates due to their tendency to have more muscle tissue and more stiffness of the knee tissue. This is known as poor soft tissue mobility. Aside from this, men frequently have had knee surgeries in the past. This may result in large knee deformity and poor preoperative ROM (range of motion). To make matters worse, men often have a BMI of greater than 35.

The use of computer-assisted surgery is good for reducing surgical errors and improving surgical outcomes in knee and hip surgery. Computer assisted orthopedic surgery helps with the identification of surgical anatomy and improves surgical accuracy.

By using computer based tools it becomes easier to reliably repeat procedures in surgery. These tools increase accuracy and improve quality in surgical procedure. Oddly, these tools are not widely accepted in the US. In Germany, computer based tools are used in surgery forty percent of the time. In the US, this is true only three percent of the time. Technology variations, cost, efficacy and surgeon preference may be the cause of this discrepancy.

In order to best benefit society with this technology, it will be necessary for industry, government, and surgeons to work together to develop standards for computer assisted surgery and imaging.

Click here for more on Dr. Stefan Tarlow, a leading Phoenix knee doctor.

About the Author:

No comments: