Minimally-Invasive Surgery (MIS) Quadriceps-Sparing Total Knee Replacement: New Quad Sparing Technique May Provide Faster Recovery for Patients with Arthritis of the Knee.
Edited By: Seth S. Leopold, M.D.
Last updated Tuesday, April 15, 2008
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Preparing for surgery
What type of preparation needs to take place before minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis?
Patients undergoing total knee replacement surgery usually will
undergo a pre-operative surgical risk assessment. When necessary,
further evaluation will be performed by an internal medicine physician
who specializes in pre-operative evaluation and risk-factor
modification. Some patients will also be evaluated by an
anesthesiologist in advance of the surgery.
Routine blood tests are performed on all pre-operative patients;
chest X-rays and electrocardiograms are obtained in patients who meet
certain age and health criteria, as well.
Some patients opt to predonate their own blood in advance of surgery
to try to minimize the likelihood that transfusions from the blood bank
will be needed. Each patient’s individual circumstances need to be
considered when deciding whether this is worthwhile.
Surgeons will often spend time with the patient in advance of the
surgery, making certain that all the patient's questions and concerns,
as well as those of the family, are answered.
What about the timing of minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis? How long can it be safely delayed?
The decision to have minimally-invasive or traditional total knee
replacement is a quality of life choice, best made by an educated
patient in consultation with an experienced surgeon. The timing of this
procedure should revolve around the patient’s medical condition and
social support networks. Only rarely does knee replacement get done as
an urgent procedure. Very occasionally, in cases of rheumatoid or other
types of inflammatory arthritis, excessive delays can result in the
loss of bone and tendon tissue. These losses can compromise the quality
of the surgery and its result.How can the costs of minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis be anticipated?
The surgeon's office should provide a reasonable estimate of:
- the surgeon's fee,
- the hospital fee, and
- the degree to which these should be covered by the patient's insurance.
Who should perform minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis and where?
Minimally-invasive quadriceps-sparing total knee replacement
requires an experienced orthopedic surgeon and the resources of a
large medical center. Patients should inquire as to the number of knee
arthroplasty procedures that the surgeon performs each year overall,
and how many minimally-invasive knee replacements the surgeon has
performed.
Some patients have complex medical needs and around surgery often
require immediate access to multiple medical and surgical specialties
and in-house medical, physical therapy, and social support services.
How can surgeons experienced in minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis be found?
There is good evidence that the experience of the surgeon performing
partial knee replacement affects the outcome. It is important that the
surgeon be experienced--and preferably fellowship-trained--knee
replacement surgeon.
Some questions to consider asking your knee surgeon:
- Are you board certified in orthopedic surgery?
- Have you done a fellowship (a year of additional training,
beyond the five years required to become an orthopedic surgeon) in
joint replacement surgery?
- How many knee replacements do you do each year?
- How many minimally-invasive knee replacements have you performed?
In what type of facility is minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis usually done?
A large hospital, usually with academic affiliation and equipped with
state-of-the-art radiologic imaging equipment and medical intensive
care unit is clearly preferable in the care of patients with knee
arthritis. These centers have surgical teams and facilities specially
designed for this type of surgery. They also have nurses and therapists
who are accustomed to assisting patients in their recover from knee
replacement surgery.Surgery for knee arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call the Bone & Joint Surgery Center at 206-598-BONE (2663) or Eastside Specialty Clinic at 425-646-7777 to make an appointment. Our clinical center is located in Seattle Washington, USA
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