By: Sara Dale | Category: Consumer News | Issue: October 2006
Dr. Ronald S. LaButti
A painful knee can severely affect one’s ability to lead a full active life. But, in today’s age of orthopedics, those suffering with chronic knee pain have plenty of reasons to smile.
Over the last 25 years, major advancements in artificial knee replacement have greatly improved the outcome of surgery. Artificial knee replacement surgery is becoming more and more common as the population of the world begins to age. “At some point, knee arthritis begins to interfere with quality of life to such a point that something has to change,” says Ronald S. LaButti, D.O., who practices with Central States Orthopedic Specialists, Inc. and specializes in hip replacement, knee replacement, and revision surgery of the hip and knee. “When treatments such as anti-inflammatory, medications, cortisone injections and physical therapy fail to improve the situation, total knee replacement could be an option.”
What are the Most Common Reasons for Knee Pain?
“The most common reason for knee pain is knee osteoarthritis or degenerative joint disease, characterized by progressive loss of articular cartilage and formation of bone and cartilage at the joint margins,” Dr. LaButti says. “This is frequently referred to as ‘wear and tear’ arthritis, although we now understand osteoarthritis is more than simply a condition of joint aging. As the cartilage surface on the ends of the bones is worn away, the normal mechanics of the knee joint are altered. The knee becomes inflamed and irritated, and the damaged cartilage, inflamed tissues, and exposed bone can cause pain.”
Symptoms of osteoarthritis include:
Pain in the involved joint that is typically worse with activity and relieved by rest, Stiffness after periods of immobility
Instability, Limitation of motion, Muscle atrophy, Weakness.
How Do I Know If I’m Ready for Knee Replacement Surgery?
“The indication for knee replacement surgery is disabling pain from a moderately severe to severe arthritis which limits the patient’s ability to perform daily living activities such as getting in and out of a car and climbing stairs,” Dr. LaButti says. The ideal candidate for knee replacement is a patient who is over 65, not overly active, with normal mental capacity, and of a normal weight. The converse of this is the “high risk patient” for knee replacement, or those who are under 65, overweight, very active, or who had a previous knee surgery that was unsuccessful.”
Surgical Alternatives to Knee Replacement Surgery
“The patient who undergoes knee replacement surgery has a 95 percent chance of having good or excellent results,” Dr. LaButti says. “This translates to drastically improved range of motion, and complete or nearly complete relief of pain. Nonetheless, it’s important to keep in mind knee replacements are not normal knees and that a percentage of patients occasionally experience minor pain with activity, stiffness and/or swelling.”
When determining what course is best, it’s always a good idea for prospective patients to explore all surgical alternatives to knee replacement surgery. Some alternatives include:
Arthroscopy is a minimally invasive procedure that involves washing out loose debris and trimming frayed or torn cartilage in the knee. This is usually performed in patients with mild to moderate arthritis, small amounts of deformity, and mechanical symptoms (locking or catching) indicating torn or loose cartilage fragments. The results are mixed as far as pain relief is concerned and depend on numerous other factors. A potential pitfall is that removal of cartilage can lead to further degeneration of the knee.
Osteotomy is a surgical cutting of a bone to change the alignment or alter the weight-bearing stresses. Osteotomy is typically reserved for younger, more active, healthy patients with single compartment arthritis of the knee.
Unicompartmental knee replacement is performed only in one part of the knee and is for people with single compartment arthritis of the knee.
Arthrodesis or fusion of the knee involves cutting the ends of the bones of the knee and fixing them rigidly together with either internal plates and screws or a rod placed in the canal of the bones then letting the two bones heal together. Activities such as stair climbing may be more difficult, but not impossible. This procedure is reserved for the very young patient (younger than 35 years of age), with severe arthritis frequently related to trauma in more than one compartment of the knee. Fusion of the knee can lead to arthritis of the back and/or hip on the same side and is performed fairly infrequently.
Stryker Surgical Navigation System
Another exciting option available to those considering a knee replacement is an advanced technique known as computer-assisted surgery (or commonly referred to as the Stryker Surgical Navigation System). This improved revolutionary procedure promises improved alignment, ligament balance and potential longevity for total knee replacement and improved knee joint stability. Dr. LaButti first worked with the first generation Stryker Surgical Navigation System during his fellowship with orthopedic surgeon and originator Dr. Ken Krackow in 1999. Dr. LaButti performed the first computer assisted knee surgery in Tulsa in May 2004.
“Knee replacement surgery is already successful, but the Stryker Surgical Navigation System helps us get even closer to perfection,” Dr. LaButti says. “It allows the surgeon to map out the knee before any bone is cut and monitor progress throughout the operation. With it, we can give a patient a new knee that has the best possible stability and range of motion, even in different or abnormal anatomic situations.”
To learn more about knee replacement surgery or the Stryker Surgical Navigation System, visit Dr. LaButti’s website at www.hipandkneedoc.com or call Central States Orthopedic Specialists, Inc. at 918-481-2767.