The first of only three orthopedic surgeons in Louisiana to perform an arthroscopic assisted innovative partial knee replacement procedure, Dr. Nathan Cohen answers your questions about the minimally invasive procedure® for patients with arthritis or other knee problems.
Patients with osteoarthritis of the knee now have a treatment option other than traditional joint replacement surgery.
What would indicate a patient with knee problems needs a partial joint replacement?
Most patients with knee problems want relief from the pain and stiffness. When a total joint replacement is too much but all of the conservative treatments-including anti-inflammatory medications, cortisone injections, and strengthening exercises-are not enough, we now have something in between.
The HemiCAP® Implant has a metal and plastic component that are personally fitted into the damaged part of joint cartilage. It works much like the way a dentist would use a filling to fill a cavity in your tooth. The HemiCAP system comes in multiple sizes to ensure an anatomic fit.
The HemiCAP is generating interest because it entails a smaller incision, faster recovery, and only removes the damaged areas of cartilage. Plus a portion of the procedure is performed arthroscopically.
How does the knee joint get damaged?
Joints are the locations in your body where bones meet. Movement of these bones at the joint permits our bodies to move. Cartilage is a smooth, slippery surface in the joints which caps or covers our bones where they meet and allows them to slide against one another with minimal friction.
The Patello-Femoral joint has 2 bones which work together: the patella-or kneecap-and the femur-or lower thigh bone. Normally the kneecap moves through grove in center of the thigh bone as you bend and extend your leg. When the patella does not track normally in this groove or there is damage to the cartilage, arthritis can occur. In similar fashion the main femoral-tibial joint can develop arthritis.
A variety of events can damage cartilage, including trauma, infection, inflammation, and malalignment. A traumatic injury can cause an isolated defect just like a golfer creates a divot in the grass. Dashboard injuries from car accidents are a common way the patello-femoral joint can be damaged. Malalignment can cause damage to the joint surface similar to the way the tires on a car lose their tread if the wheels are not properly aligned.
Who is a good candidate for partial knee replacement?
There is a significant patient population with joint disease and damage who has failed early treatment therapies, such as physical therapy, pain medication, arthroscopy and other surgical procedures, yet continues to experience chronic pain and reduced activity levels.
This underserved patient population tends to be comprised of relatively young and physically active patients who are seeking therapies that can help them to maintain their active lifestyles.
What is the benefit of the partial knee replacement?
- Smaller Incision
A traditional knee replacement surgery involves an incision about 8 inches over the front of the knee. In the minimally invasive HemiCap, the incision is about 3 inches, with a portion of the procedure performed arthroscopically.
- Less Blood Loss
Because of the extent of dissection and bone removal necessary for a total knee replacement, the need for a blood transfusion is not uncommon. With the HemiCap, there is minimal blood loss.
- Shorter Recovery
Both the time in the hospital and the time to functional recovery are considerably less with the HemiCAP® Implant. Patients are typically discharged on the day of the procedure.