OrthoVirginia offers two surgical options for total knee replacement – the medial parapatellar approach and the subvastus (or SubV Knee) approach to knee replacement. It is best to consult with your surgeon about which surgical approach may be best for you.
Medial Parapatellar Approach
With the medial parapatellar approach, the surgeon makes an incision down the middle of the knee and enters the knee joint itself by opening the patellar tendon and retracting it laterally to obtain access to the knee joint which allows the medial quadriceps to remain protected. This technique is versatile and can be used even with there is significant underlying deformity or in revision surgery.
Subvastus Approach
With the subvastus approach (SubV Knee), the surgeon makes an incision in the middle of the knee or towards the inside of the knee and enters the knee by retracting all of the quadriceps muscles including the medial muscle laterally. Not every patient is a candidate for the SubV Knee. Eligibility depends on several factors, including your overall health, age, prior knee surgeries, and the specific condition of your knee.
Robotic Knee Replacement
Robotic knee replacement, also known as robotic-assisted total knee arthroplasty, uses a computer-guided robotic system to help surgeons replace damaged knee joints. Both approaches to knee replacements may be performed with or without a robotic system, depending on the surgeon’s preference. and the approach that is recommended for each individual patient.
The robot does not operate independently; the surgeon remains in full control while the robotic system provides real-time guidance for bone preparation and implant placement. Before surgery, high-resolution imaging such as CT scans or X-rays is used to create a 3D model of the patient’s knee, allowing personalized surgical planning.
Anatomy
The knee is the largest joint in the body and one of the most complex. It is made up of the femur, tibia and patella (kneecap). Articular cartilage covers the ends of the bones and allows them to glide smoothly over one another. Osteoarthritis and rheumatoid arthritis cause the surface layer of cartilage to wear away. Without this cushioning effect, the bones of the knee joint rub together. The knee can’t move easily and becomes stiff, swollen and painful.
When is surgery recommended?
If you have knee pain that limits your everyday activities, secondary to arthritis, and all non-surgical methods of treatment have failed – including weight loss, anti-inflammatory medications, cortisone injections, lubricating injections and physical therapy – then you should consider surgery.
Most patients with advanced knee arthritis are considered good candidates for total knee replacement surgery. However, each patient should be carefully screened to determine the most appropriate type of procedure.
What is the recovery time?
Most patients are up and walking following surgery and regain range of motion, strength and flexibility after several weeks of physical therapy. Most total knee replacements can be performed in an outpatient setting where you go home the same day. If you are in the hospital, it is usually a one-night stay.
FAQs
How do I know it is time for a knee replacement?
If non-surgical treatment methods have not provided relief, then you should talk with an orthopedic joint replacement surgeon.
Am I too young or too old for a knee replacement?
Modern techniques have allowed orthopedic surgeons to base surgical decisions on a patient’s pain and disability, and not necessarily on their age.
How long is my recovery?
Recovery varies by patient and activity. Some patients can have outpatient surgery and go home the same day, while other patients may need one or two nights in the hospital. Most patients will need several weeks of physical therapy after their knee replacement.
How much work will I miss?
It depends on your profession. If your work is mostly sitting and local, you may return as early as two to four weeks after your surgery. If your job is more rigorous and involves travel, your time off from work may be longer.