Healthy Knee Healthy Knee Introduction Common Causes of Knee Pain Knee Replacement Surgery Risks of Knee Replacement Surgery Benefits of Knee Replacement Surgery Surgical Alternatives to Total Knee Replacement Computer Assisted Knee Surgery The Right Knee Replacement for You: How Does Your Surgeon Select It?

Arthroscopy is a minimally invasive procedure that involves washing out loose debris and trimming frayed or torn cartilage in the knee. This usually performed in patients with mild to moderate arthritis, small amounts of deformity, and mechanical symptoms (locking or catching) indicating torn or loose cartilage fragments. The results are mixed as far as pain relief is concerned and depends on numerous other factors. A potential pitfall is that removal of cartilage can lead to further degeneration of the knee.

In an Osteotomy, the surgeon actually cuts the bone and removes a wedge to realign the leg and relieve knee pain. This procedure usually results in 85-90% pain relief and is very durable but involves a lengthy post-operative recovery period of up to 3-4 months and could include immobilization of the leg. This procedure is usually reserved for younger, more active patients (40s and 50s) with only a single compartment of the knee affected by arthritis, non-smokers, and people without significant health problems such as diabetes, rheumatoid arthritis or heart disease.

Pre Osteotomy	Post Osteotomy

Uni-compartmental Knee Replacement involves resurfacing only one part of the knee joint with plastic and metal parts. This usually results in greater than 90% pain relief. One potential problem is that the parts may wear or loosen early on, leading to more surgery. Some studies have shown better longevity of this procedure in older, thinner, sedentary people.

Pre Uni-compartmental  knee replacement	Post Uni-compartmental  knee replacement

Arthrodesis or fusion of the knee involves cutting the ends of the bones of the knee and fixing them rigidly together with either internal plates and screws or a rod placed in the canal of the bones then letting the two bones heal together. This gives the patient a stiff, painless knee. The operative leg is left shorter so walking on flat surfaces is not usually a problem. Activities such as stair climbing may be more difficult, but not impossible. This procedure is reserved for the very young patient (< 35 yrs) with severe arthritis in more than one compartment of the knee, frequently related to trauma. Fusion of the knee can lead to arthritis of the back and/or hip on the same side and is performed relatively infrequently. 

Computer-assisted surgery helps the surgeon align the bones and joint for accuracy not possible with the naked eye. This improved revolutionary technique promises improved alignment, ligament balance and potentially longevity for total knee replacement and improved knee joint stability. The Styker surgical Navigation system is the most advanced system of its kind in the area. Dr. LaButti first worked with the system during fellowship with Orthopedic Surgeon and designer Dr. Ken Krackow on the first generation in 1999. Dr. LaButti performed the first computer assisted knee surgery in Tulsa in May of 2004.

The two main variables attributed to a successful knee replacement are proper alignment and balance of the knee ligaments. This system greatly minimizes, or in some instances, completely eliminates those variables.

The Stryker knee surgery navigation system uses an infrared camera and markers along with unique instruments tracking and software to continually monitor the position and mechanical alignment of the implant components relative to the patient’s knee anatomy. Smart wireless instruments send data pertaining to the knee kinematics (movement) to a computer. The computer analyzes and displays kinematic data on a computer monitor in the form of charts and graphs that supply the surgeon with the optimum angles, lines and measurements needed to align the prosthetic knee with the patient.

Can you achieve similar results with out the machine? The answer is yes. One of the benefits of doing a fellowship in total joint replacement is learning how to balance and align the knee and the importance of it. Having the computer may take 15 minutes off surgery time, but well trained physicians have been doing this for years with excellent results.

The Right Knee Replacement for You: How Does Your Surgeon Select It?
Surgeons have a wide variety of knee replacement implants produced by various manufacturers. Materials and clinical engineering of these implants very, and typically surgeons only use one or two product lines based upon the results they see afterward and ease of using the components. When selecting the implant for your knee replacement surgery your surgeon will consider:

• Your age, activity level, weight and degree of arthritis;

• The implant’s track record of long-term stability and adhesion- called fixation;

• The implant’s material;

• The implant’s ability to reestablish your normal function;

• The surgeon’s comfort level with the surgical instruments associated with the preferred implant; and

• The surgeon’s confidence in the implant’s clinical success rate and product quality.

Don’t be afraid to talk to surgeon about the implant he will be using for your surgery.