A partial fix may mean total freedom. When it comes to knee replacement, sometimes less is more.
George Kleinfeld, knee replacement patient: "Pain, it's primarily the pain issue. It hurts to walk or climb stairs."
George Kleinfeld: "I just decided that's the way to do it."
The way to do it? Not a total knee replacement but a partial fix.
Dr. Craig Della Valle, orthopedic surgeon, Midwest Orthopedics at Rush: "To a lot of people it makes sense. One part of my knee is broken and the other two thirds is working well fix the part that's broken and leave me with the rest that's working normal
It made sense to George. Most of his knee was healthy, but cartilage on the inside was wearing away.
Dr. Della Valle: "You can see that nice, healthy looking cartilage on the outside of the knee, and we replaced the inside of the knee."
Partial knee replacements aren't new. The prostheses and procedure have been around for three decades but with mixed results.
Dr. Della Valle: "I think a lot of people gave up on partial knee because total knees were doing so well. A lot of it was surgical technique and picking the right patients."
But now doctors at Midwest Orthopedics at Rush are giving the procedure another go.
Dr. Della Valle: "Over time successful designs, successful techniques have risen to the surface and now, at least in my practice, it's just about 20% are partial knees."
The basic concept is the same as a total knee replacement. Both operations require a similar-sized incision and similar parts, just fewer for the partial fix. And once inside, doctors do less construction, preserving the anterior and posterior cruciate ligaments as well as the knee cap.
Dr. Della Valle: "We leave those ligaments intact, and we leave the knee cap intact, which at the end of the day may be the most important thing because pain around the knee cap is one of the most common complaints after a knee replacement."
Dr. Della Valle: "Let's see you bend, excellent."
With good range of motion, arthritis limited to one area of his knee and ligaments in working order, George was a perfect candidate. In the end, the choice was his.
Dr. Della Valle: "Patients appreciate the choice, and we're rapidly able to explain to patients the differences between a partial and a total, and then they can be part of the decision making process. They have a faster recovery, they wind up with a knee that feels more normal and natural and the risk of complications form the surgery itself is lower."
George Kleinfeld: "Just being able to do the normal things of life and go to places with the grandkids and with my wife and do what you want to do and not have to think about, 'It hurts.'"
Doctors at Rush followed partial knee replacement patients for the last two decades and found 90% were still in good working order. To learn more check out www.rushortho.com.
Partial knee replacements
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