Everyday I come across patients who are suffering from joint pain in their knee due to osteoarthritis. I am frequently asked about the latest treatment techniques that may offer faster recovery. One procedure that can relieve pain is a minimally invasive technique for partial knee resurfacing. Below are some frequently asked questions about this new procedure.
What is osteoarthritis?
Osteoarthritis (OA), or degenerative joint disease, is characterized by the breakdown and eventual loss of joint cartilage. Cartilage is a substance that serves as the “cushion” for our joints. As the cartilage wears away, eventually the bone is exposed. Severe OA is characterized by “bone-on-bone” changes. Symptoms of OA of the knee include:
- Pain with activities such as standing, walking, stair climbing, or getting up from a chair
- Start up pain or stiffness when activities are initiated from a sitting position
- Joint stiffness after getting out of bed
- Swelling in one or more areas of the knee
- A grating sensation or crunching feeling in the knee during use
How do you treat osteoarthritis?
Symptoms are always treated non-surgically first, but when those solutions fail, total knee arthroplasty is an effective procedure to deal with the pain and disability associated with arthritis in the knee. Approximately 600,000 total knee replacements are performed annually in the United States. A subset of these patients (perhaps 10-30%) may be candidates for a partial knee replacement or unicompartmental replacement. In this procedure, only the affected portion of the knee is replaced leaving the rest of the intact and functioning knee joint in place.
What is the advantage of a partial knee replacement?
The advantages of this procedure, compared to a total knee replacement, are a quicker functional recovery, smaller incisions, less hospitalization and perhaps a more “natural” feel to the operated knee.
Are there any downsides?
Historically, the unicompartmental knee replacement has been a very technically challenging procedure. Small alignment errors may contribute to failure of the procedure.
What advancements have been made in this procedure?
MAKOplasty is the next evolution in unicompartmental knee replacement. In MAKOplasty, a 3-dimensional CT scan of the patient’s leg is obtained. This data is placed into the RIO – Robotic Arm Interactive Orthopedic System pre-operatively. The surgeon then uses 3-dimensional computer modeling to plan the surgery and uses the robotic arm during surgery to complete the plan with great accuracy. The MAKOplasty system also allows for intra-operative adjustments.
What have the results been?
The MAKOplasty procedure is an exciting advancement in partial knee replacement. Studies have shown that it increases the accuracy of the procedure 2-3 times compared to standard techniques. The improved precision of the surgery should lead to better patient outcomes in the short and long term.
Where is it performed?
In Tucson, the procedure is only available at Oro Valley Hospital and is performed by specially trained orthopaedic surgeons.
If you have knee pain well localized to one are of the knee, you may be a candidate. Call the Tucson Orthopaedic Institute in Oro Valley to schedule a consultation with Dr. Bowers.
By Kevin W. Bowers, MD