Main Navigation

Joint Replacement

Facts About "Mini-Total Knee" Surgery –

Minimal-Incision Total Knee Replacement Surgery

Background

Total knee joint replacement surgery has been successfully performed for over 30 years. The procedure can be used to straighten mal-aligned joints, restore range of motion, and in many cases eliminate the pain of crippling arthritis. More than 300,000 knee joint replacements are performed in the United States every year. Although knee replacements have a very high rate of success, patients usually have to endure a prolonged period of disability until they are fully recovered. The pain and extensive rehabilitation associated with conventional knee replacement surgery has prompted surgeons and their patients to search for ways to perform these procedures using less invasive techniques.

Conventional Total Knee Replacement

Millions of people in the United States suffer from knee arthritis and its associated pain and disability. Non-operative treatments including medication, braces, physical therapy and injections, can be very helpful in many cases. However, when progressive deterioration of the joint leads to severe pain and deformity, patients will often choose total knee replacement as a solution.

Conventional knee replacement surgery involves the insertion of a metal and plastic artificial joint into the knee, usually through an eight- to 11-inch incision. Patients usually undergo several months of extensive physical therapy in order to regain their knee strength and range of motion.

Mini-Total Knee Surgery

Over the last few decades, surgeons have developed less invasive techniques to treat a wide variety of problems. Laparascopic surgery, microsurgery and arthroscopic surgery have benefited hundreds of thousands of patients. During this time, orthopaedic surgeons performing knee procedures have also helped to develop less invasive techniques. Surgeons soon recognized that the complete disassembly of joint structures during surgery led to more pain and longer recovery periods for the patient. The critical element for a shorter recovery seems to be to avoid harm to the major muscle groups during surgery. Conventional total knee replacement is associated with a long incision in the quadriceps muscle and complete dislocation of the knee-cap.

Once it was recognized that avoidance of the large muscles around the knee could result in a faster recovery, it became a matter of developing appropriate equipment and techniques. Small-incision total knee replacement is only recently available and in many cases replaces an eight- to 11-inch incision with a four- or five-inch one.

Advantages

Although all of the benefits of mini-total knee surgery have not yet been proven, it is easy to see where a four- or five-inch incision would be preferable to a much larger one.

More rapid return to function. Mini-total knee replacement patients at Abington's Human Motion Institute and elsewhere have been shown to achieve faster gains in rehabilitation. This includes return of muscle strength and functional walking ability.
Smaller, less disruptive incision. Less disruption to muscles, tendons, and other soft tissue structures is a clear advantage of this procedure. Although cosmetics may not be important to every patient, the visible scar from a mini-total knee is significantly smaller.
Reliable, proven knee implants. New procedures often involve the development of entirely new and unproven systems. Since conventional knee replacement components are still utilized, this is not a problem for mini-total knee procedures. The difference is how the materials are implanted, not what device is used. These components have proven track records showing reliable relief of pain for many years in the majority of patients. The only difference is that special instruments and techniques have been developed in conjunction with major manufacturers that allow the knees to be implanted in a much less invasive fashion. The goal of less invasive surgery is to achieve excellent outcomes for patients using procedures that cause less discomfort. Although all of the benefits of mini-knee surgery have not yet been discovered, preliminary studies at Abington's Human Motion Institute and elsewhere are very encouraging.

Referral

For more information about minimal-incision total knee replacement surgery, call 215-481-BONE. For referral to an orthopaedic surgeon who can perform this procedure, please call our Physician Referral Service at 215-481-MEDI.