Total Knee Replacement

Total Knee Replacement

Total Knee Replacement

Total knee replacement has been utilized for nearly 50 years in addressing end stage arthritis of the knee joint.

 

If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.

Description

A knee replacement (also called knee arthroplasty) might be more accurately termed a knee “resurfacing” because only the surface of the bones are actually replaced.

(Left) Severe osteoarthritis. (Right) The arthritic cartilage and underlying bone has been removed and resurfaced with metal implants on the femur and tibia. A plastic spacer has been placed in between the implants. The patellar component is not shown for clarity.

Is Total Knee Replacement for You?

The decision to have total knee replacement surgery should be a cooperative one between you, your family, your family physician, and your orthopaedic surgeon. Dr. Alosh will present all possible options and the decision to undergo surgery, if needed will occur as a partnership with the patient.

When Surgery Is Recommended

There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:

  • Severe knee pain or stiffness with daily activities
  • Moderate or severe knee pain while resting, either day or night
  • Knee deformity — a bowing in or out of your knee
  • Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries

Deciding to Have Knee Replacement Surgery

Realistic Expectations

An important factor in deciding whether to have total knee replacement surgery is understanding what the procedure can and cannot do.

 

More than 90% of people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement will not allow you to do more than you could before you developed arthritis.

 

With normal use and activity, every knee replacement implant begins to wear in its plastic spacer. Excessive activity or weight may speed up this normal wear and may cause the knee replacement to loosen and become painful. Therefore, Dr. Alosh advises against high-impact activities such as long-distance running. 

 

Low-impact activities following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, tennis, and other low-impact sports.

 

With appropriate activity modification, knee replacements can last for a lifetime.

Pre operative and post operative x-rays of minimally invasive knee replacement performed by Dr. Alosh

Minimally invasive knee replacement

Traditional knee replacements use an incision typically over one foot in length, with associated soft tissue and muscle disruption.  Furthermore, the knee is dislocated, major ligaments are cut, and the knee cap is flipped over in order to obtain access with traditional techniques. This adds up to a great amount of soft tissue and muscle disruption that increases pain and delays recovery.

 

Dr. Alosh, MD is board-certified and fellowship-trained in minimally invasive joint reconstruction.  He specializes in minimally invasive knee replacement and has obtained advanced training in the most contemporary techniques.  This incision is smaller, the major ligaments are preserved, and the knee cap is gently shifted to the side rather than flipped into an unnatural position.  Regardless of where you are considering knee replacement, we strongly advise that you obtain a consultation with a board certified, fellowship-trained MD with advanced training in adult reconstruction.  No one’s knee deserves mediocre surgery.

Minimally invasive knee replacement

Average knee replacement

Surgeon
  • Dr. Alosh is a board-certified MD
  • All education at top 10 US hospitals
  • Fellowship-trained and specialized in minimally invasive joint reconstruction
  • Questionable board certification
  • Variable training background
  • “Dabble” in joint replacement
Experience Dr. Alosh has performed over a 1000 replacements using the latest techniques and advances Broad range of quality: Some surgeons dabble and only perform a couple replacements a year. Some high-volume surgeons still use old techniques.
Knee dislocation Dr. Alosh does not dislocate the knee to perform the operation Traditional surgeons aggressively dislocate (separate) the knee to obtain access
Knee cap Dr. Alosh gently shifts the knee cap to the side Traditional surgeons flip over and dislocate knee cap increasing trauma
Blood loss Minimal, less than 50ml 200-300ml
Recovery Most patients discharge the next day, some the same day In hospital for 3 days