A damaged knee can be very painful, limiting your normal activities and significantly reducing your quality of life. When knee pain and dysfunction begin to interfere significantly with daily activities, work, exercise, and social activities, it may be time to consider minimally invasive knee replacement. That’s the time to see the highly skilled and leading orthopedic specialists at OCC – Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado. For every type and severity of injury, they have extensive knowledge and experience that can help you prevent the worsening of the injury and degenerative changes, not to mention reduced mobility and function. Early diagnosis and treatment can prevent long-term complications and improve recovery.

OVERVIEW

The minimally invasive total knee replacement procedure (sometimes referred to as total knee arthroplasty or TKA) involves the use of modified techniques and instruments to place the same clinically proven implants used in standard surgery but through a much smaller incision and without cutting through the quadricep tendons and muscles. The minimally invasive total knee arthroplasty (TKA) is performed through one small, 3- to 4-inch incision instead of a large, 8- to 12-inch incision. Potential benefits of this less invasive technique include increased range of motion sooner after surgery, less blood loss during surgery, faster recovery, and a shorter hospital stay, as 92% of patients leave the hospital the same day. Factors whether one requires TKA include:

Age: People aged 60-80 are the most common recipients, as knee osteoarthritis (the leading cause of knee replacements) typically worsens with age.

Gender: Women are more likely than men to undergo knee replacements. Studies suggest women tend to experience more severe osteoarthritis in their knees, possibly due to differences in joint structure, hormones, and body mechanics.

Body Weight: Individuals with obesity or higher body weights are also more likely to need knee replacements because excess weight adds strain on knee joints, accelerating joint wear and tear.

Activity Level: Those with physically demanding jobs or high-impact athletic backgrounds may experience earlier joint deterioration, increasing their likelihood of needing knee replacements at a younger age.

Health Factors: People with chronic conditions like rheumatoid arthritis, past knee injuries, or a family history of osteoarthritis are also more likely candidates.

ABOUT THE KNEE

The knee consists of bones, cartilage, ligaments, and tendons. The major bones are the femur, tibia (shin bone), and patella (kneecap). The knee has two types of cartilage: articular cartilage, which covers the ends of bones and allows smooth movement, and menisci, which are C-shaped cushions that provide stability and absorb shock. Four main ligaments stabilize the knee: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). The knee serves several important functions in the body, including:

Weight Bearing: The knee supports the body’s weight during activities such as standing, walking, running, and jumping.

Movement: It allows for flexion (bending) and extension (straightening) of the leg, enabling a wide range of movements necessary for various physical activities.

Stability: The knee provides stability to the leg, especially during activities that involve changes in direction or when the body is in motion.

Shock Absorption: The menisci and cartilage in the knee act as shock absorbers, reducing the impact on the bones during activities that involve forceful movements, such as jumping or running.

Facilitation of Mobility: The knee plays a crucial role in activities like climbing stairs, squatting, and pivoting, contributing to overall mobility and functionality.

Propagation of Force: The knee transfers forces generated in the upper body to the lower body and vice versa, contributing to overall biomechanical efficiency during movement.

WHAT IS MINIMALLY INVASIVE KNEE REPLACEMENT?

Minimally invasive knee replacement is a surgical procedure used to replace a damaged or worn-out knee joint with an artificial implant. Knee implants come in various shapes, sizes, and materials, tailored to each patient’s anatomy and lifestyle. Surgeons may choose a specific implant based on age, activity level, and joint structure, and even custom implants that are now available. The use of modified, advanced techniques and instruments allows the surgeon to place the same clinically proven implants used in standard surgery but through a much smaller incision and without cutting through the quadricep tendons and muscles. Specially designed instruments are used to prepare and place the femur and tibia implants properly. In addition to a shorter incision, the technique used to open the knee is less invasive. In general, techniques used in a minimally invasive total knee replacement are “quadriceps sparing,” meaning they avoid trauma to the quadriceps tendon and muscles in the front of the thigh. Other minimally invasive techniques called “midvastus” and “subvastus” make small incisions in the muscle but are also less invasive than a traditional total knee replacement. The smaller incisions used in minimally invasive knee surgery reduce the risk of infection compared to larger incisions in open surgery. This is particularly beneficial for individuals with certain medical conditions or a higher susceptibility to infections.

CAUSES

1.  Osteoarthritis: This is the most common cause. Osteoarthritis wears away the protective cartilage in the knee, leading to pain, swelling, and stiffness. As the condition progresses, bone-on-bone contact causes significant discomfort and limits movement.
2. Rheumatoid Arthritis: An autoimmune condition, rheumatoid arthritis causes the body’s immune system to attack joint tissues, leading to chronic inflammation that can damage cartilage and eventually erode bone, making knee replacement necessary.
3. Post-Traumatic Arthritis: Previous knee injuries, such as fractures, ligament tears, or meniscus damage, can lead to arthritis over time. Even with treatment, an injured knee is more susceptible to joint degeneration.
4. Avascular Necrosis: This condition happens when blood flow to a part of the bone is interrupted, causing bone tissue to die. In the knee, this can lead to severe joint deterioration that may require replacement.
5. Deformities or Structural Abnormalities: Congenital deformities or misalignments can place excessive strain on the knee joint, accelerating wear and tear and potentially leading to the need for knee replacement.
6. Severe or Persistent Pain: When pain in the knee significantly affects mobility, quality of life, or the ability to perform daily activities, total knee replacement becomes a viable option if other treatments haven’t worked.
7. An issue with the knee joint not forming correctly.
8. Inflammation: Inflammation can persist, potentially leading to swelling and stiffness in the knee joint.

SYMPTOMS

Symptoms include:

• Persistent Pain: Severe pain in the knee that persists even at rest, particularly at night, is a key symptom. This pain may limit sleep and continue despite rest, medication, or lifestyle modifications.
• Swelling and Stiffness: Chronic knee swelling and stiffness, especially after minimal activity or in the morning, can suggest significant joint damage. Swelling may be due to inflammation or fluid buildup in the knee joint.
• Limited Range of Motion: Difficulty bending or straightening the knee fully, or stiffness that restricts everyday movements like walking, standing, or climbing stairs, often signals advanced joint damage.
• Difficulty with Weight-Bearing: Increased pain when standing, walking, or moving, particularly if the knee feels like it might “give out,” can indicate severe joint instability or damage.
• Visible Knee Deformity: If the knee appears bowed, misshapen, or has other visible structural changes due to arthritis or past injuries, it can indicate that the joint damage is extensive.

NON-SURGICAL TREATMENTS

It is always wise that the first approach to knee damage and injury involves more conservative methods. These include over-the-counter pain relievers such as acetaminophen or NSAIDs (ibuprofen, naproxen) which also reduce inflammation, corticosteroid injections, assistive devices such as braces, orthotic shoe inserts, or walking aids such as canes or walkers. Lifestyle modifications are to help avoid high-impact activities that stress the knee, like running or jumping. Reducing excess weight decreases stress on the knee joint, potentially relieving pain and slowing joint degeneration. Physical therapy and exercise help build muscle support around the knee joint, improve flexibility, and reduce stiffness.

WHEN IS SURGERY INDICATED?

Chronic knee pain can make even a short walk a marathon of misery. If simple tasks such as climbing a flight of stairs or strolling to the mailbox and back have become a challenge, and one’s level of discomfort is increasing despite non-surgical treatment options, minimally invasive knee surgery may be necessary. Orthopedic surgeons often use the following criteria to assess whether a patient is a candidate and surgery is indicated:

• Chronic Pain and Discomfort: Pain is persistent, severe, and impacts quality of life, even during rest or at night. If pain significantly limits activities such as walking, standing, or sleeping, it may be time to consider surgery.
• Failure of Conservative Treatments: Non-surgical treatments (like physical therapy, weight management, pain medications, corticosteroid injections, and joint supplements) have been tried and are no longer effective in managing symptoms.
• Severe Joint Damage Confirmed by Imaging: X-rays, MRIs, or other imaging studies show significant cartilage loss, bone-on-bone contact, or other advanced joint damage that suggests further conservative treatments won’t slow or reverse the damage.
• Limited Mobility and Function: Reduced range of motion or stiffness that limits the ability to walk, climb stairs, stand, or perform daily activities is a strong indicator. If stiffness and pain continue to worsen, surgery may be suggested as the next step.
• Significant Deformity: Visible deformities in the knee, such as bowing in or out, indicate that joint damage has progressed, possibly affecting alignment, stability, and walking ability.
• Impact on Emotional Well-Being: Chronic pain and loss of independence often take a toll on mental health, contributing to stress, anxiety, or depression. If the knee pain is impacting mood and overall well-being, knee replacement can be beneficial.
• Health and Fitness Considerations: Surgery is typically recommended while the patient is still healthy enough for a positive recovery. Surgeons often consider overall health, and readiness to undergo rehabilitation as factors in timing surgery.

GETTING THE RIGHT DIAGNOSIS.  GETTING THE RIGHT DOCTOR.

Advanced Orthopedics in Denver, Parker, or Aurora, Colorado, offers the area’s most sophisticated and innovative minimally invasive care for knee conditions that are the result of injury deterioration, deformities, and traumatic injuries. What makes our surgeons so exceptional? First and foremost is their extensive experience. Performing a high volume of minimally invasive knee replacements increases their expertise and allows them to provide their patients with the most advanced treatment and care. This procedure requires a highly skilled surgeon due to the limited space and visibility during surgery. Their precision is impeccable. This knee replacement requires precise alignment of the implant to ensure stability, function, and comfort. An experienced surgeon can make accurate adjustments, reducing the risk of complications like loosening or misalignment. Properly placed implants by a highly skilled surgeon tend to last longer, reducing the likelihood of needing revision surgery (a complex procedure that carries higher risks than an initial replacement). This is especially important for younger patients or those with active lifestyles. Accomplished surgeons like those at Advanced Orthopedics ensure informed decision-making, offering clear, realistic expectations about the procedure, recovery, and potential outcomes. Above all, they have higher patient satisfaction, which is also due to their level of personal, individualized care that addresses both body and mind. Knee pain needn’t stop your life from going full steam ahead.