Minimally Invasive Surgery

BENEFITS OF MINIMALLY INVASIVE SURGERY FOR KNEE REPLACEMENTS



Minimally Invasive Surgery is a new solution to the traditional problems of knee surgery – scarring, excessive downtime and post-operative pain. Knee replacement has undergone continuous innovation in order to limit these problems as well as wear-and-tear, loosening and loss of range of motion in the artificial knee.

Minimally invasive surgery is meant to keep the problems associated with joint surgeries to a minimum. Prior to minimally invasive knee replacement techniques, knee surgery meant thick scars and an extended recovery time. Compared to traditional total joint replacement, minimally invasive (MIS) knee joint replacement is a drastic improvement in knee replacement in a number of areas, including shorter hospital stay, shorter recovery time, less blood loss1 and potentially less scarring.

Because of the complexity of joints and joint replacement therapy, some of the material regarding knee replacement procedures might seem confusing; feel free to make note of anything that might confuse you. Dr. Lyman will be happy to discuss any questions you have regarding the procedures and pathologies related to knee injuries and knee replacement therapies, and wants to make you feel comfortable with your knee care solution.


KNEE REPLACEMENT



Knee replacement is a surgical procedure in which the damaged knee joint is replaced with an artificial joint called a prosthesis. The prosthesis is designed to move just like a healthy human joint intended to relieve pain from osteoarthritis, rheumatoid arthritis and psoriatic arthritis. Knee replacement is now one of the safest and most successful types of surgeries as a result of minimally invasive methodologies. In well over 90% of cases the minimally invasive surgery is complication-free and results in significant pain relief and restoration of mobility.


MIS KNEE JOINT REPLACEMENT



Minimally Invasive Surgery:
By definition, a minimally invasive procedure is any procedure that is less invasive than open surgery and used for the same purpose. What truly differentiates minimally invasive surgery from open surgery is the use of specialized techniques and instrumentation that enables Dr. Lyman to perform major surgery without a large incision. The minimal incision technique is a specialized technique that is responsible for the reduced scarring and shorter recovery period. Since the incision is smaller, MIS knee joint replacement is inherently less obtrusive, requiring only a three to four inch incision and potentially causing less trauma to surrounding muscles and tendons near the knee joint.


MIS Total Knee Replacement (TKR):
Minimally invasive surgical procedures are advantageous because of its minimal incision technique. Traditional total knee replacement (TKR) requires an incision of eight to twelve inches to expose the front of the knee (patella) and typically causes severance of the muscles and tendons when detaching them from the patella. MIS Total Joint Replacement, on the other hand, is performed through a three to four inch incision using laparoscopic and endoscopic devices. The amount of soft tissue, muscles and tendons that are disrupted during surgery may also be reduced compared to traditional techniques.


MIS Partial Knee Resurfacing (PKR):
Dr. Lyman is one of Phoenix's top knee resurfacing specialists. Partial Knee Resurfacing (PKR) is a minimally invasive procedure for relieving knee pain and disability caused by arthritis. In this procedure only the damaged surface of the knee joint is resurfaced, potentially minimizing trauma to healthy bone and tissue. Because the PKR implants are so much smaller than total knee implants, the surgical incision can be smaller as well lessoning the extent of the surgery.


Potential Advantages:
Because MIS results in less operative trauma for the tendons and muscles with the minimally invasive techniques, their reconstruction is often more natural, wound closure is easier, and recovery may be faster. Clinical studies have shown that the midvastus surgical approach, as opposed to subvastus approach, used in the MIS technique results in less pain, at both eight days and six weeks after surgery, and quicker restoration of muscle control and strength. In comparison, it may take several months to recover from the large incision and muscle disruption that accompanies the conventional knee joint replacement surgical approach.

This is more common in Afro-Caribbeans. There may also be delayed wound healing for numerous reasons. Compartment syndrome: this is a build up pressure within the lower leg and can cause nerve damage, blood vessel damage and muscle damage. If this occurs, an emergency operation will have to be performed to prevent death of tissue of the lower leg/ foot.


Risks Associated with Minimally Invasive Surgery:
The Minimally Invasive Knee Joint Replacement technique is less invasive than conventional TKR, but it is still a major surgery and it takes a little additional time to complete. Also the surgery requires general anesthesia to be administered, rather than regional anesthesia.

As with any major surgical procedure, patients who undergo total joint replacement are at risk for certain complications, the vast majority of which can be successfully avoided or treated. While it is relatively rare, periprosthetic infection remains one of the most challenging complications of joint arthroplasty. As the most serious complication of the surgery, infection of the joint occurs in less than 1% of patients. Other than infection, possible complications include blood clots, deep vein thrombosis, lung congestion, or pneumonia. After surgery risks may include periprosthetic fractures, loss of motion and instability, the risks that are normally encountered in conventional knee joint replacement.