ORTHOPEDIC HIP & KNEE CARE

What is arthritis of the knee?

Arthritis of the knee is a disease which wears away the cartilage between the femur (thigh bone) and the tibia (shin bone) causing the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded and uneven. The result is pain, stiffness and instability. In some cases, motion of the leg may be greatly restricted.

Osteoarthritis

Osteoarthritis, which is the most common form of arthritis in the United States, is degenerative and, although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.

It is usually confined to the large weight-bearing joints of the lower extremities, including the hips and knees, but may affect the spine and upper extremity joints, too. Patients with osteoarthritis often develop large bone spurs, or osteophytes, around the joint, further limiting motion.

Rheumatoid arthritis

Unlike osteoarthritis, which is a “wear and tear” phenomenon, rheumatoid arthritis is a chronic inflammatory disease that results in joint pain, stiffness and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.

Since the first knee replacement surgery in 1968, there has been enormous progress in improving the surgical techniques and medical devices used to replace damaged bone and cartilage in the knee.

Some of the basic surgical steps that almost all knee replacements have in common are:

Bone preparation. During this step, the damaged cartilage surfaces at the ends of the femur (the thigh bone) and the tibia (the larger of the two lower leg bones) are removed along with a small amount of underlying bone.

Install the metal implants. During this step, carefully selected metal components are fitted to the prepared bones of both the femur and tibia.

Insert a spacer. During this step, a medical-grade, plastic spacer is attached to the lower, metal tibial component, creating a smooth surface for upper, metal femoral component to slide against as the knee moves.

Post-Operative Care

After your surgery, you will be transported to a recovery room for close observation of your vital signs, circulation, and sensation in your legs and feet. After you awaken and your medical team is comfortable with your progress, you may be transferred to your room or, in the case of outpatient surgery, discharged to go home. Here are some things you may notice as you recover from your surgery:

• A large dressing may be applied to your incision. This bandage helps to maintain cleanliness and absorb any fluid that seeps from the incision.
• A drain may be placed near your incision in order to record the amount of drainage from the wound.
• You may be wearing elastic stockings, or a compression stocking sleeve to help minimize your risk of blood clots.
• A PCA (patient-controlled analgesia) device that delivers a small amount of pain medication may be connected to your IV. The unit is designed to deliver a small, controlled flow of pain medication; it This device is button-activated activates when you firmly press the button on the machineand delivers a controlled amount of pain medication. Follow the instructions of your care team on how to use the PCA device.
• A catheter may be inserted in your bladder as the side effects of anesthesia can make it difficult to urinate.

Post-Surgical Pain Management

It is natural and normal to feel some pain after your knee surgery. Your doctor and care team will work to reduce your pain, which may help speed the healing process and make it easier for you recover more quickly.

Short-term pain relief after surgery is usually accomplished using prescription medications. Pain relief medicines that might be used include opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics for pain at the surgical site. You may be prescribed a combination of medicines for the most effective pain relief, as well as to reduce the need for opioids.

It is important to note that opioids are a narcotic and can be addictive. If you are prescribed opioids, be sure to use them exactly as your doctor instructs. The aim is to stop taking opioids as your pain level of pain begins to improve. If your pain doesn’t improve within the timeframe discussed with your care team, be sure and tell this to your doctor.

Recovering From Knee Replacement Surgery

Successful recovery from your surgery greatly depends on you, the patient. How quickly and how completely you recover depends on a number of factors including how thoroughly you follow your surgeon’s instructions as you begin rehabilitation (usually the day after the surgery). Equally important to your recovery time is how well you stick to your therapy and rehab plan at home in the weeks immediately after surgery.

Total Knee Replacement with the CORI Surgical System

This procedure is often recommended for advanced knee pain and damage. With this type of knee implant, the entire knee joint is replaced. Total knee replacement is one of the most common procedures performed in all of medicine.

Since no two knee joints are the same, aligning a new knee implant requires matching its position with the patient’s existing range of motion. The CORI Surgical System uses a robotics-assisted, handheld device – placing an additional layer of planning and accuracy directly into the surgeon’s hands.

Traditional surgical techniques continue to rely on rods and older methodology.

CORI Surgical System

When advanced surgical training combines with robotics-assisted technology and modern implant design, patients can feel confident knowing they are receiving the ultimate knee replacement experience.

The CORI Surgical System uses handheld robotics-assisted technology to plan and perform each unique procedure. This approach is more efficient and accurate than traditional knee surgery.

At the beginning of surgery, the CORI system creates a customized 3D digital model of the patient’s knee. This three-dimensional view helps finalize and verify the selection of the knee implant and create a plan for the surgery without the need for a CT scan or MRI.

During the procedure, the CORI system works in conjunction with the surgeon’s expertise to achieve accurate positioning of the knee implant based on the patient’s unique anatomy. The system sends precise information about the knee to the robotics-assisted handpiece more than 300 times per second, allowing the surgeon to remove damaged surfaces, balance the joint, and position the implant with accuracy.

The result is a naturally shaped knee, made from materials designed to last longer, positioned with added precision to support a quicker, smoother recovery.

What is arthritis of the hip?

Arthritis of the hip is a disease which wears away the cartilage between the femoral head, or hip ball, and the acetabulum, or hip socket, causing the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded and uneven. The result is pain, stiffness and instability, and in some cases, motion of the leg may be greatly restricted.

Osteoarthritis

Osteoarthritis, which is the most common form of arthritis in the United States, is degenerative and, although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.

It is usually confined to the large weight-bearing joints of the lower extremities, including the hips and knees, but may affect the spine and upper extremity joints, too. Patients with osteoarthritis often develop large bone spurs, or osteophytes, around the joint, further limiting motion.

Rheumatoid arthritis

Unlike osteoarthritis, which is a “wear and tear” phenomenon, rheumatoid arthritis is a chronic inflammatory disease that results in joint pain, stiffness and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.

How is Hip Surgery Performed?

During hip replacement surgery, the surgeon surgically removes the damaged bone and cartilage of the joint and replaces it with smooth, artificial implants – thereby eliminating painful bone-on-bone contact.

Almost all hip replacement implants consist of a four-part system:

• A hip stem, usually made from a biocompatible metal such as titanium, which is implanted down the shaft of the thigh bone (femur);
• A femoral head which sits on top of the hip stem and replaces the “ball” portion of the hip’s “ball and socket” design; and
• A two-part hemispherical or “cup-like” component made up of a metal shell and a plastic liner that replaces the “socket” in which the femoral head sits.
• Once implanted, the new femoral head rotates inside the plastic liner to recreate the ball and socket movement of the original joint.