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MINIMALLY INVASIVE ( QUAD SPARING ) TOTAL KNEE REPLACEEMNT SURGERY ( MIS – QS TKR )

What is total knee replacement or TKR?

Total knee replacement, also known as total knee arthroplasty or TKA, essentially involves resurfacing and replacing the damaged portions of the knee:

  • The compartments, or condyles, at the end of the thigh bone.
  • The top of the shin bone.
  • The underside of the knee cap in some cases .
  • BEFORE SURGERYAFTER SURGERY

    CONVENTIONAL KNEE REPLACEMENT WITH CUT QUADRICEPS MUSCLE

    MIS QS KNEE REPLACEMENT SURGERY WITH OUT CUTTING THE QUADRICEPS MUSCLES

    COMPLETED MIS QS TKR

    WHY MINIMALLY INVASIVE SURGERY ?

    In traditional surgery, the surgeon makes a 8 – 10 INCH incision down the front of the knee and the tendon and quadriceps muscle – which control the bending of the knee – are cut.

    In MIS Quad-Sparing TKA ( MIS – QS TKA ) a 4 – 5 INCH incision is made on the side of the knee, and the tendon and "quad" muscles are separated, rather than cut.

    Compared to standard surgery, potential benefits of MIS Quad-Sparing TKA include:

  • Smaller incision – 4 – 5 INCH AS COMPARED TO 8 – 10 INCH FOR CONVENTIONAL KNEE REPLACEEMNT
  • MUSCLES ARE NOT CUT , THEREFORE LESS BLEEDING . MOST OF THE PATIENTS UNDERGOING MIS QS TKR DO NOT REQUIRE BLOOD TRANSFUSION EXCEPT UNDER CERTAIN CONDITIONS
  • LESS PAIN AFTER SURGERY . AVOIDS COMPLICATIONS ARISING OUT OF USE WITH STRONG PAIN KILLERS
  • KNEE MOVEMENTS 3 HRS AFTER MIS – QS TKR

    STAIR CLIMBING 3 DAYS AFTER MIS QS TKR

    SINCE THE MAIN MUSCLE OF THE KNEE – ( QUADRICEPS ) ARE NOT CUT PATIENTS CAN STERT WALKING WITHIN 24 HRS AFTER SURGERY WIYHOUT MUCH DIFFICULTY . IN FACT MOST OF THE PATIENTS ARE ABLE TO WALK WITH ONLY A WALKING STICK WITHIN 2 – 3 DAYS AFTER SURGERY .

    ALL PATIENTS ARE ABLE TO USE COMMODE FOR PASSING STOOLS AND URINE THE NEXT DAY OF SURGRERY , SO NO NEED TO USE BED PAN .

  • SINCE MUSCLE STRENGTH REMAINS GOOD AFTER SURGERY , PATINETS CAN START STAIR CLIMBING AFETR 2 – 3 DAYS OF SURGERY.
  • BECAUSE THE RECOVERY IS VERY FAST AFTER MIS QS TKR PATIENTS CAN BE DISCHARGED EARLY FROM THE HOSPITAL THUS REDUCING THE COST OF THE SURGERY AND AT THE SAME TIME REDUCING THE CHANCES OF HOSPITAL BORNE INFECTIONS .
  • PATIENTS CAN RESUME THEIR ACTIVITIES OF DAILY LIVING SOONER AFTER MIS QS TKR .
  • SINCE PATIENTS CAN USE THEIR MUSCLES IMMEDIATELY AFTER SURGERY THE CHANCES OF DEEP VEIN THROMBOSIS ( DVT ) ARE ALSO LESS AFETR MIS QS TKR.

    MIS QS TKR USING HIGH FLEX IMPLANTS

    PTS CONTINUE TO DERIVE BENEFITS OUT OF MIS QS TKR AND ULTIMATELY HAVE EXCELLENT RESULTS WHICH ARE BETTER THAN THOSE SEEN WITH CONVENTIONAL KNEE SURGERY.

    Total Knee Replacement (TKR) with HIGH Flex Knee

    The knee is the hinge joint consisting of three bones. The upper part of the hinge is at the end of the upper leg bone (femur), and the lower part of the hinge is at the top of the lower leg bone (tibia). When the knee is bent, the end of the femur rolls and slides on top of the tibia. A third bone, the kneecap (patella), glides over the front and end of the femur.

    In a healthy knee joint, the surfaces of these bones are very smooth and covered with a tough protective tissue called cartilage. Osteoarthritis causes damage to the bone surfaces and cartilage where the three bones meet and rub together. These damaged surfaces can eventually become painful.

    There are several ways to treat the pain caused by osteoarthritis. One way is a total knee replacement surgery. The decision to have total knee replacement surgery should be made very carefully after consulting your doctor and learning as much as you can about the knee joint, osteoarthritis, and the surgery.

    In total knee replacement surgery, the bone surfaces and cartilage that have been damaged by osteoarthritis are removed and replaced with artificial surfaces made of metal and a plastic material. We call these artificial surfaces "implants," or "prostheses."

    Getting to the Joint
    The patient is first taken into the operating room and given anesthesia. After the anesthesia has taken effect, the skin around the knee is thoroughly scrubbed with an antiseptic liquid. The knee is flexed about 90 degrees and the lower portion of the leg, including the foot, is placed in a special device to securely hold it in place during the surgery. Usually a tourniquet is then applied to the upper portion of the leg to help slow the flow of blood during the surgery.

    An incision is then made that typically extends from just above the knee to just below the knee. The incision is gradually made deeper through muscle and other tissue until the bone surfaces are exposed. We specialize in doing this by MINIMALLY INVASIVE TECHNIQUES i.e without cutting the main muscle that control the function of the knee joint namely QUADRICEPS .LINK MIS TKR TECH VDO

    Removing the Damaged Bone Surfaces
    The damaged bone surfaces and cartilage are then removed by the surgeon. Precision instruments and guides are used to help make sure the cuts are made at the correct angles so the bones will align properly after the new surfaces (implants) are attached.

    Small amounts of the bone surface are removed from the front, end and back of the femur. This shapes the bone so the implants will fit properly. The amount of bone that is removed depends on the amount of bone that has been damaged by the osteoarthritis.
    A small portion of the top surface of the tibia is also removed, making the end of the bone flat.

    Attaching the Implants
    An implant is attached to each of the three bones. These implants are designed so that the knee joint will move in a way that is very similar to the way the joint moved when it was healthy. The implants are attached using a special kind of cement for bones.

    The implant that fits over the end of the femur is made of metal. Its surface is rounded and very smooth, covering the front and back of the bone as well as the end.

    The implant that fits over the top of the tibia usually consists of two parts. A metal baseplate fits over the part of the bone that was cut flat. A durable plastic insert is then attached to the baseplate to serve as an articulating surface between the baseplate and the metal implant that covers the end of the femur.

    The implant that covers the back of the patella is also made of a durable plastic.

    Artificial knee implants come in many designs. The surgeon will choose the implant design that best meets the patient's needs.

    Closing the Wound
    If necessary, the surgeon may adjust the ligaments that surround the knee to achieve the best possible knee function.

    When all of the implants are in place and the ligaments are properly adjusted, the surgeon sews the layers of tissue back into their proper position. A plastic tube may be inserted into the wound to allow liquids to drain from the site during the first few hours after surgery. The edges of the skin are then sewn together, and the knee is wrapped in a sterile bandage. The patient is then taken to the recovery room.

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