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St. Vincent Medical Center



For physician referral, call (866) 478-8462. For general information, call (213) 484-7111.

To reach a patient, call (213) 484-7111. If you know their room number, call (213) 484-[7 + room number]. Patients can receive calls daily from 7:00 AM to 11:00 PM.


For physician referral, call (866) 478-8462. For general information, call (213) 484-7111.

To reach a patient, call (213) 484-7111. If you know their room number, call (213) 484-[7 + room number]. Patients can receive calls daily from 7:00 AM to 11:00 PM.

 

 St. Vincent Medical Center

Knee Joint Replacement

The knee joint can develop arthritis over time, leading to a complete wear of the articular cartilage. When this point has been reached in the development of the disease, a partial or a total knee replacement is usually necessary to relieve pain and restore function by replacing the worn cartilage with an artificial bearing on both the lower extremity of the femur (the thigh bone) and the top of the tibia (the main lower leg bone).

Non-Operative Treatments

Knee pain can have a number of origins. Our surgeons are committed to a conservative approach to treatment and usually explore non-invasive treatment options as a first step. Non-operative treatment options include:

  • Modification of patient activity
  • Physical therapy
  • Oral medications
  • Local injection

Arthroscopy

Arthroscopy is a procedure which utilizes a tiny camera to look inside the knee joint. This allows the surgeon to evaluate and treat knee disorders. Arthroscopy requires only small incisions around the knee for the insertion of small instruments that are about the size of a pen or pencil. With arthroscopy, degenerated and worn menisci can be trimmed and smoothed, which reduces one source of inflammation. Additionally, the lining of the knee (the synovium), can be trimmed, and this also decreases inflammation. Patients who have knee arthroscopy go home the same day. Recovery from surgery occurs over a couple of weeks. Unfortunately, the benefit of arthroscopy decreases as the degree of arthritis increases. In advanced arthritis, arthroscopy is of little value.

Surgeons performing Knee Arthroscopy at the Joint Replacement Institute:

  • Dr. Goring
  • Dr. Long
  • Dr. McPherson
  • Dr. Mynatt
  • Dr. Samson
  • Dr. Schmalzried
  • Dr. Wassef

Total Knee Replacement

Front view of knee
Front View

Total Knee Replacement employs specially designed components, or prostheses, made of metals and plastics, to replace the cartilage in your knee. The metal that is most commonly used is an alloy of cobalt, chromium and molybdenum. The plastic is ultra-high molecular weight polyethylene. These materials have been used in joint replacement for about 30 years and their behavior in the body is well-known.

In modern total knee replacement surgery, only the worn-out cartilage surfaces of the joint are replaced. The entire knee is not actually replaced. The operation is basically a “re-surfacing” (or “re-tread”) procedure. Only a small amount of bone is removed, the collateral ligaments are left intact, and the muscles and tendons are left intact. Alignment abnormalities can usually be corrected during the operation by adjusting the direction of the cuts of the bones, removing bone spurs (osteophytes), and lengthening tight ligaments. Front and side views of a knee following total knee replacement are shown below. Note that the smooth surfaces of the joint are restored. The joint space is now comprised of polyethylene. The operation only replaces the worn surfaces of the joint. The ligaments, tendons and muscles are retained.


Side view of knee
Side View

Following Total Knee Replacement, more than 90% of patients have no pain, or only slight pain, and their walking is no longer limited by their knee. Most patients can live a full and independent life.

Surgeons performing Total Knee Replacement at the Joint Replacement Institute:

  • Dr. Goring
  • Dr. Long
  • Dr. McPherson
  • Dr. Mynatt
  • Dr. Saluta
  • Dr. Schmalzried
  • Dr. Wassef

Uni-Compartmental Replacement

Uni-compartmental replacement of knee
Uni-Compartmental Replacement

Surgery may be considered even when only a portion of the knee surface has worn out. Uni-compartmental Knee Replacement is the partial replacement of the knee surfaces. Using minimally invasive surgery (MIS) techniques, a partial knee replacement can be inserted through a smaller incision, with minimal disruption of the muscles and tendons around the knee. The smaller incision and less invasive surgical approach allow for patients to recover more quickly. Uni-compartmental Knee Replacement may allow better knee function for return to athletic activity. Severe arthritis and deformity cannot be corrected. Inflammatory arthritis (like rheumatoid) cannot be treated by partial replacement. After Uni-compartmental Knee Replacement surgery, arthritis can still develop in the other parts of the knee.

Surgeons performing Uni-Compartmental Knee Replacement at the Joint Replacement Institute:

  • Dr. Long
  • Dr. Mynatt
  • Dr. Saluta
  • Dr. Schmalzried
  • Dr. Wassef

Knee Revision Surgery

Although it is anticipated that a total knee replacement will last for many years, some fail sooner than expected. The main causes of failure are loosening, wear, osteolysis and component breakage. Fortunately, these occurrences are rare. Unfortunately, they can occur and generally necessitate additional surgery. A prosthetic knee component can loosen from the bone due to relative motion between the component and the bone. The intended use of a total knee replacement results in wear of the polyethylene tibial and patellar components. Just as small pieces of rubber wear off an automobile tire when it rolls, the intended motion of the knee replacement generates very small particles of polyethylene. These particles are released into the tissue around the joint. If enough particles are generated, they can cause inflammation. This type of inflammation can result in resorption of the bone around the total knee replacement. This type of bone resorption is called osteolysis and can necessitate additional surgery.

In the event that a total knee fails, it is possible to implant another knee replacement. Such revision total knee replacement surgery may be a lesser or greater operation than the original total knee surgery. Similarly, recovery from revision total knee surgery may be easier or more difficult than it was from the original total knee surgery. In general, the results of revision total knee surgery are not quite as good or predictable as for primary total knee replacements. The results of revision total knee replacement depend on what the problem was that necessitated surgery. Following revision total knee replacement, most patients have good relief of pain and are able to walk as far as they desire.

Surgeons performing Knee Revision Surgery at the Joint Replacement Institute:

  • Dr. Long
  • Dr. McPherson
  • Dr. Mynatt
  • Dr. Schmalzried
  • Dr. Wassef

Fracture Repair

A fractured bone will typically repair itself if the broken extremities of the bone are close enough and maintained immobilized. However, a surgical intervention will often facilitate a fast and complete recovery, depending on the location of the fracture and the degree of displacement between the two (or more) broken parts of the bone.

Bone fracture repair is a surgery usually involving metal screws, pins, rods, or plates to hold the bone in place. It is also known as Open Reduction and Internal Fixation (ORIF) surgery.

Joint Replacement Institute surgeons performing Fracture Repair around the Knee joint:

  • Dr. Goring
  • Dr. Saluta
  • Dr. Wassef

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