What is Minimally Invasive Total Knee Replacement Surgery?
Total knee replacement is a common orthopedic procedure that is used to replace the damaged or worn surfaces of the knee. Replacing these surfaces with an implant or "prosthesis" will relieve pain and increase mobility, allowing you to return to your normal, everyday activities.
One of the most important orthopedic surgical advances of the twentieth century, knee replacement surgery was first performed in 1968. Improvements in surgical materials and techniques since then have greatly increased its effectiveness. Approximately 300,000 knee replacements are performed each year in the United States alone, making it one of the most common surgeries worldwide. Over the past decade, however, minimally invasive techniques have been developed and today, there are minimally invasive procedures for both partial and total knee replacements.
Knee Replacement Surgery Preparation
Before your departure your records will be reviewed thoroughly by our orthopedic surgeon. This includes X-rays and a complete medical and surgical history as well as your specific issues. In addition, you may be asked to consult with a physical therapist to discuss recovery, hip rehabilitation and important precautions you must take postoperatively. The physical therapist may even give you exercises you can begin prior to your surgery in order to aid with recovery.
After traveling to Cyprus, a new set of X-rays will be taken as well as an in person physical examination. The surgeon and anesthetist will also go through you medical and surgical issues with you. During this visit, your surgeon will also review your hip replacement procedure and answer any questions.
Getting your house ready before your surgery
It is also important to get your house ready for after you come home from the hospital. At first it will be harder for you to move around, so arrange your furniture and household items ahead of time to make it easier for you during your rehabilitation.
Preparation for the hospital
Here are a few things to keep in mind as you pack and prepare for the hospital and recuperation:
Clothing
Getting dressed in the morning helps you feel better, so be sure to bring some comfortable clothing to the hospital:
THE PROCEDURE
During any knee replacement, the damaged cartilage and bone from the surface of the knee is removed, along with some soft tissues. The goal of knee replacement surgery is to provide the patient with a pain-free knee that allows for the return to daily activities and lasts for a long time.
The traditional approach to knee replacement uses a long vertical incision in the center of the knee to view and access the joint. Minimally invasive total knee replacement is a variation of this approach. Minimally invasive knee replacement differs from traditional knee replacement in that it uses an incision that is approximately half as long and fewer muscles are cut and detached. This less-invasive technique endorses the reduction of postoperative pain and speeding recovery.
Traditional Knee Replacement:
To perform a traditional knee replacement, the surgeon makes an 8- to 10-inch vertical incision over the front of the knee to expose the joint. The surgeon will then:
Minimally Invasive Knee Replacement:
In minimally invasive knee replacement, the surgical procedure is similar, but there is less cutting of the tissue surrounding the knee. The artificial implants used are the same as those used for traditional knee replacement.
Your orthopedic surgeon will remove the damaged cartilage and bone and then position the new metal and plastic joint surfaces to restore the alignment and function of your knee. However, specially designed surgical instruments are used to measure and prepare the femur and tibia and to place the implants properly, endorsing an optimal fit.
Minimally invasive knee replacement is performed through a shorter incision—2-to 3- inches versus 8 to 10 inches for traditional knee replacement. In addition to a shorter incision, the technique used to open the knee is less invasive. In general, techniques used in minimally invasive knee replacement are "quadriceps sparing," meaning they avoid trauma to the quadriceps tendon and muscles in the front of the thigh.
Other minimally invasive technique called "subvastus" makes small incisions in the muscle but is also less invasive than traditional knee replacement. Because the technique used to expose the joint involves less disruption to the muscle, it may lead to less postoperative pain and reduce recovery time.
The procedure itself takes approximately 1-2 hours.
After your total knee replacement surgery, you will be taken to the recovery room for a period of observation. The staff will monitor your blood pressure, heart rate, respiration and body temperature. Special attention will be given to your circulation and sensation in your feet and legs. When you awaken and your condition is stabilized you will be transferred to your room.
Your leg may be positioned in a Continuous Passive Motion (CPM) machine after surgery. While you are in bed, this machine will continuously bend and straighten your leg. The CPM machine keeps your joint from becoming stiff and speeds recovery.
How Long Will the Knee Implant Last?
The longevity of the implant depends on many factors such as the patient’s weight, the patient’s activity level, and the presence or absence of disease in other joints of the lower extremities.
Implants can last ten to fifteen years and even longer. New techniques allow for an implant to be removed and replaced, but our goal is to be able to implant a prosthesis that will last the patient a lifetime without revision.
The Knee Replacement Surgery Advantages
Knee Replacement Surgery Results
Results are impressive and gratifying to both the patient and the surgeon. Most patients are pain-free and able to bend their knees from 90° to 100°, resuming daily activities without restriction. The remarkable results of total knee replacement are due to patient determination, the surgeon’s skill, and the bioengineers’ well-designed implants and instruments. However, a total knee replacement procedure will not make you a super-athlete or allow you to do more than you could before you developed knee problems. Activities that you can reasonably expect to be able to do after surgery are:
Hospital discharge and home instructions
The hospital stay after minimally invasive surgery is similar in length to the stay after traditional knee replacement surgery, typically ranging from 1 to 4 days. The procedure is also sometimes performed on an outpatient basis.
Progress varies from patient to patient so discharge instructions may vary.
Before leaving the hospital, our surgeon and staff will help you adjust to recovery in every way possible. You will receive specific instructions and precautions from your surgeon and physical therapist and they will show you safe techniques of simple activities like getting in and out of bed, bathing, going to the bathroom, managing steps at home and getting in and out of a car.
TOTAL KNEE REPLACEMENT RECOVERY
Physical rehabilitation is a critical component of recovery. Your surgeon and physical therapist will provide you with specific exercises to help increase your range of motion and restore your strength.
The estimated rehabilitation/recovery time after MIS partial knee replacement is approximately five weeks for many patients, but it varies.
LIFE AFTER SURGERY
In general, patients must use support in two hands for about six weeks after surgery while their muscles are rehabilitating. You will be given written instructions for the exercises you will be continuing upon your return home.
Physical Therapy
Following surgery, you will receive physical therapy. Trained professionals will determine the personalized exercise programs for your physical therapy.
Your physical therapist will start you off between parallel bars in preparation for the use of crutches or a walker. These bars allow you to practice walking by supporting part of your body weight with your arms rather than on your surgical leg. A short robe and low-heeled walking shoes are recommended when learning to walk with crutches or a walker.
As you become more comfortable with walking, your physical therapist may allow you to practice walking on the hospital unit with assistance. Before you go home, your therapist will teach you to climb stairs and to transfer from a bed, chair, and car.
Your physical therapist will design an exercise program to increase the motion and strength of your knee. Range of motion exercises will let your knee move easily from the fully straight position to a 90° bent position.
Your participation is vital. The goal is for you to become as independent in your personal care and daily activities as possible before you return home.