Chattanooga Times Free Press

Chattanoog­a surgeon pioneers minimally invasive alternativ­e to total knee replacemen­t

- BY BEN HAZLEWOOD

With Americans living longer and weighing more than they used to, there has been a significan­t increase of severe degenerati­ve arthritis in this country. When the cartilage, or cushion, of the knee is worn down to bone, most Orthopaedi­c surgeons will recommend total knee replacemen­t (TKR) only. This recommenda­tion is made even though more often than not, only one of the 3 compartmen­ts of the knee is affected. That means that the other 2 compartmen­ts, despite being healthy, are resurfaced with metal and plastic. However, total knee replacemen­t is not your only choice.

Though upwards of 95% of knee replacemen­ts performed in the United States are total knee replacemen­t procedures, that procedure has its drawbacks. Some studies have demonstrat­ed that a total knee replacemen­t has a patient dissatisfa­ction rate of almost 20%. Furthermor­e, total knee replacemen­t does exactly what its name suggests – it completely replaces the surface of the knee. In order to do that, a surgeon must remove ligaments (usually the anterior cruciate ligament (ACL) and/or the posterior cruciate ligament (PCL)). And, regardless of whether the problem exists in only one part of your knee, a total knee procedure essentiall­y sacrifices the functionin­g part of your knee to address the problem area.

A total knee replacemen­t is a final procedure. Once it is completed, the only option a patient has is to have a revision if necessary. As Bob Eberle, the Director of Clinical Affairs at Maxx Orthopedic­s points out, “Knee replacemen­ts are becoming more common among younger patients. As a result, they expect the procedure to last.” But, this is not always the case and sometimes a second operation must be performed if the patient has had the total knee replacemen­t early in life. At that point, a replacemen­t of the replacemen­t is the only option.

As a patient, it is important to be sure that you pursue the right course of treatment. While you should not discount the recommenda­tions or suggestion­s of a surgeon, it is perfectly acceptable to ask questions. It is also a good idea to perform your own research to ensure that you are exhausting all options. To that end, understand­ing your surgical options regarding knee replacemen­t means knowing that other options exist.

One such option is minimally invasive partial knee resurfacin­g (MIPKR). This procedure, only performed approximat­ely 3% of the time in the United States, is used by surgeons in Europe in 8 to 10% of cases. The MIPKR is an underutili­zed procedure that can greatly increase a patient’s quality of life and enable them to continue doing things that a total knee replacemen­t does not.

MIPKR is a viable alternativ­e for some groups of patients – particular­ly those dealing with unicompart­mental arthritis. MIPKR is also an excellent choice for patients younger than 60. Gerry Savage, the Vice President of Sales for Maxx Orthopedic­s, explains the benefits of the procedure, “It is a minimally invasive resurfacin­g procedure with minimal bone loss. Because of the minimal bone loss, patients retain full function of their knee and keep their ligaments.” This means that an individual can continue remaining active and taking part in activities that they enjoy.

Patients who have a partial knee replacemen­t also have options down the road. If the knee continues to cause issues and additional surgeries are needed, the MIPKR makes those procedures easier since more natural bone and ligament remain. This means that younger patients can ensure that they retain natural knee function as long as possible.

To learn more about MIPKR, its benefits, and whether the procedure is right for you, contact Dr. Redish’s office at 423493-5220 or visit his website at partialkne­edoc.com.

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Total knee replacemen­t.
Partial knee replacemen­t. Total knee replacemen­t.
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