Dr. Breien Discusses Surgical Advances In Knee Replacement
Surgical advances improve patient outcomes and patient experience.
No one’s knees escape the ravages of age. Over time, wear and tear—if not outright injury—takes a toll on the cartilage that cushions the bones in the knee. As cartilage deteriorates, the knee joint becomes stiff and painful. Losing the ability to move fluidly and painlessly can have a significant impact on quality of life. But today’s medical and surgical advances offer better treatment options for painful knees.
“We have a wide range of nonsurgical treatments for our patients with painful knees,” says knee surgeon Dr. Kristoffer Breien. “If conservative treatments cease to be effective, knee replacement surgery is also an option. More than 600,000 knee replacement surgeries are performed in the United States every year. Surgical advances have made knee replacement surgeries very safe. And outcomes are excellent.”
Dr. Breien reviews some of the surgical advances that have made total knee replacement one of the safest and most effective surgeries available.
Surgical advances in minimally invasive techniques
“Knee replacement surgery has been performed for more than 50 years,” explains Dr. Breien. “Initially it was performed as a maximally invasive surgery with long incisions. Incision size caused excessive tissue trauma. Then, surgeons began handling procedures through microincisions. This approach had its own issues. When incisions were too small, long-term results were compromised because surgeons couldn’t see what they were doing. The pendulum swung back. Today, our minimally invasive standard calls for incisions that are five to seven inches long, depending on the person. These incisions are smaller than they’d been historically, but large enough for accurate performance. Huge incisions are a thing of the past.”
Surgical advances in technology improved accuracy and implant performance
“We used imaging preoperatively to evaluate the knee prior to surgery,” says Dr. Breien. “As imaging technology advanced, we began using imaging during the surgical procedure to increase the accuracy of implant placement and maintain limb alignment. Concurrently, implant materials became more sophisticated and implants more customizable. Better technologies improved both surgical accuracy and patient outcomes.”
Surgical advances in pain management provide a more comfortable patient experience
“Even with tiny incisions, replacing a knee means cutting bone and inserting implants,” notes Dr. Breien. “We dislocate the knee, cut multiple ligaments and bone, and remove unnecessary meniscus. Essentially, you are cutting numerous enervated tissues, and that is going to cause pain.”
The move toward smaller incisions began to reduce pain. Today, anesthesiologists use a nerve block approach for even more pain control. “Selective longer-lasting nerve blocks around the knee can last up to two days following surgery,” explains Dr. Breien. “These blocks interrupt the message sent by angry nerves to the brain. During surgery, we also have longer-acting Novocain to numb all of the tissues that we cut.”
This multimodal pain management approach reduces use of morphine for pain relief. “Morphine is effective,” says Dr. Breien, “but it comes with unpleasant side effects. Today, the first 24 to 48 hours following surgery are fairly pain-free. Patients benefit from local anesthetic in the tissues and nerve blocks. Multimodal pain management make the first one or two days of recovery a much more comfortable experience.”
Summit Orthopedics is committed to staying at the forefront of surgical advances that improve the patient experience and surgical outcomes. “Knee replacement surgery has come a long way in the last 60 years, and advances continue,” says Dr. Breien. “At Summit, our patients can trust that we’ll handle their care with the safest and most effective surgical options available.”
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