Dr. Michael Rieber is one of the foremost orthopedists treating sports injuries and knee pain in the New Jersey area, and has offices conveniently located in Newark and Livingston. He believes that conservative treatments, such as physical therapy or a regimen of pain medication, are among the best solutions for knee pain. However, not all knee pain can be dealt with through noninvasive measures, and surgery may be recommended to patients with more serious musculoskeletal conditions. In these cases, minimally invasive surgical (MIS) methods are preferred. Dr. Rieber has many years of experience with arthroscopy and other minimally invasive techniques. Minimally invasive procedures are great for treating athletes and older patients alike, quickly returning them to active lifestyles and allowing them to walk and move without pain again.
Partial Knee Replacement - Minimally Invasive Joint Replacement
Minimally invasive knee replacement surgery involves the removal and replacement of an affected knee joint through a smaller incision than standard total-open knee replacement surgery. Using prosthetics that have been engineered to feel as natural as possible and made with biocompatible materials that ensure comfort and support, the surgeon replaces the diseased or damaged knee joint with a prosthetic joint, made to mimic the function of a natural knee. With current techniques, 90% to 95% of minimally invasive knee replacement surgeries last more than 15 years.
Partial knee replacement allows an orthopedic surgeon to remove the damaged portion of the knee while leaving the rest of healthy knee intact. As less of the knee must be removed, the incision size is subsequently smaller, and less manipulation of the muscles and tendons occurs, which provides patients with benefits such as reduced scarring and faster post-operative recovery time.
When nonsurgical treatments such as physical therapy, cortisone injections, or pain medications, have failed to relieve pain and other limiting conditions associated with osteoarthritis or extensive damage to the joint, knee replacement surgery is recommended. The goal of knee replacement is to remove diseased or damaged portions of the knee and then replace them with precise prosthetic components that allow for relatively normal function and activity over longer periods of time.
Indications for Knee Replacement
When climbing stairs, walking long distances and other routine activities become painful and difficult, knee replacement surgery may be recommended to restore previous function and comfort levels. Knee surgery can also become a necessity when other pain management treatments and noninvasive measures, such as medications, exercise, weight loss, and activity modification do not work.
Arthroscopy is a minimally invasive technique that orthopedic surgeons use when treating sports medicine injuries such as ligament and cartilage tears – two of the most common being ACL tears and meniscal tears. Arthroscopy allows the orthopedic surgeon to perform the procedure through a pair of small incisions in the knee that ultimately provide a quicker recovery with fewer complications when compared to an open, more invasive surgery.
During an arthroscopic procedure, the surgeon first makes an incision just large enough to insert the arthroscope (a fiber-optic camera that sends real-time images to a computer monitor), which gives the surgeon a clear image of the knee joint from inside. The surgeon then makes a second incision to insert the pen-sized operating instruments to perform the minimally invasive procedure.
(on the left) The entire knee joint is replaced. In partial, or unicompartmental knee replacement (on the right), the surgeon only replaces the damaged part of the knee.
Image courtesy of the American Academy of Orthopaedic Surgeons (AAOS).
Types of Knee Replacement
There are many different types and designs of artificial knees. Most consist of three components:
• Femoral component, which is the part that attaches to the thigh bone.
• Tibial component, the part that attaches to the shin bone.
• Patellar component, the knee cap.
Cemented and Uncemented Joint Components
Joint components may also be attached to your own bone in different ways. Most are cemented with a special joint glue into your existing bone; others rely on a process called biologic fixation to hold them in place. This means that the parts are made with a porous surface, and over time your own bone grows into the joint surface to secure them. In some cases, surgeons use a combination of cemented and uncemented parts. This is referred to as a hybrid implant.