By: Sara Dale | Category: Health & Fitness | Issue: November 2007
Dr. LaButti has solutions to your knee problems.
A painful knee can severely affect one’s ability to lead a full, active life. But, in today’s age of orthopedics, those suffering from 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 our population ages. “At some point, knee arthritis begins to interfere with quality of life to such a point that something has to change,” says Ronald LaButti, D.O., who practices at Central States Orthopedic Specialists, Inc. Dr. LaButti specializes in hip and knee replacement, as well as 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,” he continues.
“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; however, we now understand that 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, and weakness.
According to Dr. LaButti, disabling pain from moderately severe to severe arthritis can be an indication of the need for knee replacement surgery. Typically, such pain limits a patient’s ability to perform daily living activities such as getting in and out of vehicles and climbing stairs. “The ideal candidate for knee replacement has a normal mental capacity, is over age 65, not overly active and not overweight,” Dr. LaButti mentions. “The converse of this is the ‘high-risk’ patient for knee replacement or someone who has had a previous, unsuccessful knee surgery.”
“Patients who undergo knee replacement surgery have 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 that knee replacements are not normal knees. A percentage of patients occasionally experience minor pain with activity and stiffness or swelling.”
When determining what course is best, it is always a good idea for prospective patients to explore all surgical alternatives to knee replacement surgery. Some alternatives include:
A minimally-invasive procedure, arthroscopy 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 of amounts of deformity, as well as mechanical symptoms, such as locking or catching, which indicate 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.
This surgical procedure involves the cutting of a bone to change the alignment or alter the weight-bearing stresses. It is typically reserved for younger, active, healthy patients with single compartment arthritis of the knee.
Unicompartmental knee replacement
This is performed in only one part of the knee and is for people with single compartment arthritis of the knee.
Also referred to as ‘fusion of the knee,’ arthrodesis involves cutting the ends of the knee’s bones and fixing them rigidly together with either internal plates and screws or a rod placed in the canal of the bones. The two bones then heal together. Activities such as stair climbing may be more difficult but not impossible. This procedure is reserved for young patients, age 35 and younger. Candidates for arthrodesis typically have severe arthritis frequently related to trauma in more than one compartment of the knee. Fusion of the knee is performed fairly infrequently and can lead to arthritis of the back, hip, or both on the same side.
Stryker Surgical Navigation System
This is an exciting option available to those considering knee replacement. An advanced technique known as computer-assisted surgery, the Stryker Surgical Navigation System is a revolutionary procedure. It promises improved alignment, ligament balance, potential longevity for total knee replacement, as well as improved knee joint stability. In 1999, Dr. LaButti began working with the first-generation Stryker Surgical Navigation System during his fellowship with Dr. Ken Krackow, orthopedic surgeon and originator. 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 this system, 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.