Less-Invasive Total Knee Replacement

A LESS-INVASIVE APPROACH

SMALLER INCISION  |  REDUCED HOSPITAL STAYS  |  LESS BLOOD LOSS AND TISSUE INJURY

Most total knee replacements have traditionally been performed through an incision, typically eight-to-12 inches, in the middle of the knee, which also entails cutting surrounding muscles, tendons and soft tissue. The recovery for this procedure often also entails a minimum of a few days in the hospital, after which patients gradually recover full mobility over the course of a few months. As an alternative to the traditional approach to total knee replacement, which is detailed more below, Dr. Clark specializes in a less-invasive procedure as part of his commitment to help patients achieve optimal orthopedic outcomes.

The less-invasive approach to total knee replacement procedures involves a much smaller three-to six-inch incision that does not disturb surrounding muscle and tendons to the degree that the larger incision specific to the traditional procedure does. For instance, a traditional knee replacement requires that the kneecap be moved 180 degrees so the surgeon can more easily reach the tibia and femur, whereas a provider performing a less-invasive procedure is required to move the kneecap far less. Another major difference between the two types of surgery is that the minimally invasive approach may not require dislocation of the tibia or femur, and generally the procedure results in less blood loss as compared to the conventional method.

The less-invasive approach to total knee replacement procedures involves a much smaller three-to six-inch incision that does not disturb surrounding muscle and tendons to the degree that the larger incision specific to the traditional procedure does.

With the less-intensive approach, providers will sometimes also not use a tourniquet, which is a surgical device that applies pressure to an area (the thigh, in the case of total knee replacements) to slow blood flow for the purposes of reducing blood loss and providing an area that is easier to operate within during the procedure. Tourniquets can increase patient pain and swelling while slowing the recovery process by limiting motion, and are also not appropriate for some patients, including those who are obese or who have specific cardiac concerns (such as pulmonary embolisms, deep vein thrombosis, or other conditions). Dr. Clark does not use tourniquets when performing the less-invasive approach to total knee replacements, as his procedures are focused on encouraging patient mobility and active recovery while minimizing pain and discomfort, inflammation and the structural impact of orthopedic surgery.

One of the primary benefits of the less-invasive total knee replacement procedure is a reduced hospital stay for many patients. This is primarily due to the reduced level of disruption to surrounding bones, muscle, tissues and tendons associated with the procedure, as patients who have undergone the minimally invasive approach generally are able to leave the hospital and begin walking, including without support assistance, sooner than those who receive knee replacements via the traditional approach. A patient may also begin a more extensive physical therapy program at an earlier date after a less-invasive total knee replacement. While the total knee replacement procedure and rehabilitation varies with each patient, many patients who undergo the minimally invasive approach experience a less physically intensive surgery that allows for a shorter and less challenging recovery period.As an experienced area leader in performing less-invasive total knee replacement surgery, Dr. Clark believes in offering his patients surgical solutions focused on addressing the underlying orthopedic concern while promoting earlier post-operative mobility and functionality.

While the total knee replacement procedure and rehabilitation varies with each patient, many patients who undergo the minimally invasive approach experience a less physically intensive surgery that allows for a shorter and less challenging recovery period.

A TRADITIONAL KNEE REPLACEMENT PROCEDURE

LARGER INCISION  |  LONGER REHABILITATION  |  INCREASED TISSUE AND SKIN DAMAGE

As referenced above, the traditional approach to total knee replacement involves a much more invasive procedure. Patients undergoing this surgery receive an eight-to-12-inch incision in the middle area of the knee, after which their surgeons create access points to the joint area during the operation by severing the quad tendon that connect the quadriceps muscles to the kneecap, the quadriceps muscle in the thigh, and other surrounding soft tissue. The tibia is also dislocated from the femur in order to properly apply prosthetics to each, while the kneecap is moved 180 degrees to allow the surgeon greater access. Ultimately, these invasive steps will generally also cause the patient to lose more blood and experience more impact to their skin in the surgical area than would be the case with minimally invasive total knee replacement surgery. During the procedure, tissue that was cut is repaired, the artificial components are inserted and set, and the incision is stitched up.

Tourniquets are often used during traditional total knee replacement surgery in order to stem patient blood flow/loss and create a drier surgical area. As referenced above, these devices can slow the post-surgical rehabilitation process and lead to increased pain and swelling. Tourniquets are also inappropriate for patients with certain pre-existing weight and/or heart conditions.

Post-surgery recovery time in the hospital is generally one-to-five-days, after which the patient returns home to begin a rehabilitation program, with the goal being unassisted walking within one-to-two months after the procedure. This therapy process typically entails gradual increases in mobility and functionality concerning normal daily activities, such as driving, and generally requires more intensive rehabilitation and a longer recovery period than has been found with less-invasive total knee replacement surgery.

A SPECIALIZED LEVEL OF CARE

MORE THAN 15 YEARS PERFORMING LESS-INVASIVE SURGERIES

The type of total knee replacement surgery you receive depends on your specific condition and the expertise of your provider. As with many orthopedic procedures, the patient’s age, weight, bone health, and attitude toward surgery and recovery are all important factors to be considered in determining what type of knee replacement surgery is best for him or her.

Due to the more limited area of operation within the patient’s knee and the somewhat increased time for the surgery (relative to the traditional surgical option), less-invasive total knee replacements are extremely technical and require substantial knowledge, training and experience. Dr. Clark has a significant level of expertise in performing minimally invasive total knee replacement procedures and helping patients throughout the Cedar Valley, the state of Iowa, and the nation achieve excellent orthopedic outcomes through less-intensive surgery. To learn more about less-invasive total knee replacement procedures or to schedule an appointment, click below.

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