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Friday, June 26, 2009

Treating the Knee with Total Knee Replacement Surgery

By Dr. Stefan Tarlow

Minimally Invasive Surgery for Total Knee Replacement

For a better postoperative experience that includes reduced pain, a minimal hospital stay and quick recovery, patients are enjoying the benefits of minimally invasive surgery for total knee replacement. (MIS TKR).

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.

Since August 2004, Dr. Tarlow has used a combination of MIS TKR techniques and Computer Navigation. Using this innovative combination of procedures allows him to provide the most precise possible knee placement.

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.

Surgical procedures may be more reliably repeated and quality control more accurately monitored thanks to the use of computer based tools. Regardless of this, computer assisted techniques have not yet caught on in the US. This may be because of surgeon preferences, cost, efficacy and/or variations in technology. Whatever the reason, only about 3% of knee surgeries are done using this method in the US. This is a sharp contrast with Germany, where these tools are used 40% of the time.

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. - 17269

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