Tag: KCOA

Dr TJ Rasmussen and knee model

Total vs. Partial Knee Replacement: What You Should Know

Posted on | by Kiran Chandra

This blog post will dive into both total and partial knee replacements, explaining when each might be recommended, and help you understand how our team at KCOI can guide you through this journey.

Understanding Knee Osteoarthritis: The Root of the Problem

The most common reason people consider knee replacement surgery is severe osteoarthritis. This degenerative joint disease occurs when the protective cartilage that cushions the ends of your bones wears away over time. In the knee, this includes the cartilage on the end of your thigh bone (femur), shin bone (tibia), and kneecap (patella).

As this cartilage deteriorates, the bones begin to rub directly against each other, leading to:

  • Pain: Often described as a deep ache, sharp pain, or grinding sensation, especially with movement or after periods of rest.
  • Stiffness: Making it difficult to bend or straighten the knee, particularly in the mornings.
  • Swelling: Due to inflammation within the joint.
  • Limited Range of Motion: Affecting your ability to walk, climb stairs, or perform daily activities.
  • Clicking or Popping Sounds: Known as crepitus, as the joint surfaces grate against each other.

While osteoarthritis is often age-related, previous knee injuries (such as ligament tears from sports or trauma), genetics, obesity, and overuse can also contribute to its development. When these symptoms significantly impact your quality of life and non-surgical treatments like physical therapy, medication, and injections are no longer effective, your orthopedic specialist may discuss surgical intervention.

Non-Surgical Approaches: When Is Surgery the Next Step?

Before recommending surgery, your orthopedic surgeon will always explore a range of non-surgical treatments. Such approaches include:

  • Physical Therapy: Targeted exercises to strengthen the muscles around the knee, improve flexibility, and enhance stability.
  • Medications: Over-the-counter pain relievers (like NSAIDs), prescription anti-inflammatory drugs, or pain medications.
  • Injections: Corticosteroid injections to reduce inflammation and pain, or viscosupplementation injections (hyaluronic acid) to lubricate the joint.
  • Lifestyle Modifications: Weight management to reduce stress on the knee, and activity modifications to avoid high-impact movements that aggravate symptoms.
  • Assistive Devices: Using a cane or walker to reduce load on the affected knee.
  • Compression Sleeves & Braces: Sleeves can reduce swelling and inflammation, while braces recreate stability and offload the knee joint.

You can learn more about comprehensive orthopedic treatments available at KCOI for various knee conditions, including those managed by our skilled sports medicine specialists for less severe injuries.

The decision to move towards knee replacement surgery is made when these conservative methods fail to provide lasting relief, and the pain severely limits your daily activities and quality of life. This is where understanding your surgical options becomes paramount.

Total Knee Replacement (TKR): A Comprehensive Solution

Total Knee Replacement (TKR) relieves severe knee pain and restores function by replacing damaged joint surfaces with metal and plastic implants. At KCOI, we use advanced techniques—including robotic-assisted surgery—to customize each procedure to the patient’s unique anatomy.

How TKR Works:

  • Femoral Component: A metal cap covers the end of the thigh bone.
  • Tibial Component: A flat metal plate with a polyethylene (plastic) insert is placed on top of the shin bone. The plastic insert acts as a new smooth cartilage surface.
  • Patellar Component (Optional): A plastic button may be placed on the underside of the kneecap.

The goal of TKR is to resurface all three compartments of the knee (medial, lateral, and patellofemoral) to eliminate bone-on-bone friction, reduce pain, and improve the knee’s alignment and movement. TKR is often recommended for patients with widespread arthritis affecting multiple areas of the knee joint.

Partial Knee Replacement (PKR): A More Targeted Approach

Partial Knee Replacement (PKR) is a less invasive option for patients with arthritis limited to one knee compartment, typically the inner side. It preserves healthy bone and cartilage by replacing only the damaged area. Dr. Sean Bonanni notes PKRs work well for isolated wear but may not last as long as total knee replacements.

How PKR Works:
  • Only the damaged cartilage and bone from the affected compartment are removed.
  • Small metal components are resurfaced onto the ends of the femur and tibia in that specific area.
  • A plastic insert is placed between these metal components to create a new smooth gliding surface.
Advantages of PKR (when appropriate):
  • Smaller Incision: Generally, a less extensive incision compared to TKR.
  • Less Bone Removal: Preserves more of your natural bone and ligaments.
  • Potentially Faster Recovery: Many patients experience a quicker return to activities.
  • More Natural Feel: Some patients report that a PKR knee feels “more natural” because more of their own knee anatomy is preserved.
  • Reduced Blood Loss: Typically less blood loss during surgery.
  • Shorter Hospital Stay: Often allows for a shorter recovery period in the hospital.
Considerations for PKR:

PKR is not for everyone. Ideal candidates usually have:

  • Arthritis primarily affecting only one compartment of the knee.
  • Intact knee ligaments (especially the ACL).
  • Reasonable knee alignment.
  • No significant inflammation or other widespread knee conditions.

Your orthopedic surgeon will carefully evaluate your specific condition, including X-rays and potentially MRI scans, to determine if you are a suitable candidate.

Choosing the Right Path: Factors Your Orthopedic Surgeon Considers

The decision between a Total Knee Replacement and a Partial Knee Replacement is complex and highly individualized. It involves a thorough discussion with your orthopedic surgeon at KCOI, taking into account several factors:

  • Arthritis Extent: Widespread = TKR; isolated = PKR possible
  • Ligament Stability: Strong ACL needed for PKR
  • Knee Alignment: Major deformities may require TKR
  • Age & Activity: May influence implant choice and recovery
  • Patient Goals: Pain relief and function drive decision
  • Surgeon Expertise: Surgeon selects best fit for your anatomy
  • Bone Quality: Good bone needed for secure implant placement

What to Expect: Recovery and Rehabilitation

Regardless of whether you undergo a total or partial knee replacement, rehabilitation is a critical component of your recovery. Both procedures aim to alleviate pain and restore function, but the journey involves dedication and effort.

  • Hospital Stay: Typically a few days, though some patients may qualify for outpatient joint replacement.
  • Pain Management: Your care team will provide medication and strategies to manage post-surgical pain.
  • Physical Therapy: Begins almost immediately after surgery, focusing on restoring range of motion, strength, and walking ability. This is crucial for optimizing your outcome.
  • Home Recovery: Continuing exercises, managing swelling, and gradually increasing activity levels as advised by your surgeon and physical therapist.

Our commitment at KCOI extends beyond the operating room. We work closely with our partners at KCOA to provide a seamless and comprehensive patient experience. From pre-operative education to post-operative rehabilitation, our goal is to support you every step of the way towards a successful recovery and a pain-free life.

Life After Knee Replacement

Modern knee replacements are highly successful at relieving pain and improving quality of life. Most patients return to daily activities like walking, swimming, or cycling. High-impact sports are usually discouraged, but your surgeon will guide you based on your recovery and procedure type.

Read about KCOA patient Leo Sebus, and his journey from pain to knee replacement to recovery.  Sebus tells us that he relied on his team’s guidance on pain management and routines, and differentiating between pain, soreness and general discomfort helped him navigate his recovery. 

 

Take the Next Step Towards a Pain-Free Life

Living with chronic knee pain doesn’t have to be your reality. Understanding the options available, from conservative treatments to advanced surgical procedures like Total and Partial Knee Replacement, is the first step towards reclaiming your mobility and improving your quality of life.

At KCOI, our expert surgeons use the latest techniques to treat all knee conditions with personalized care. Don’t let knee pain hold you back.

If you’re experiencing persistent knee pain and want to explore your treatment options, contact KCOI today. Schedule a consultation through the physician clinic at KCOA: Request an Appointment. Your journey to a healthier, more active life starts here.

hip joint model

Hip Osteoarthritis: When to Consider Joint Replacement

Posted on | by Kiran Chandra

Understanding Hip Osteoarthritis: When is Joint Replacement the Answer?

That nagging ache deep in your hip, the morning stiffness that feels like your joint is locked in place, the increasing difficulty with everyday activities you once took for granted – these could be telltale signs of osteoarthritis (OA), a prevalent condition affecting countless individuals. Here at Kansas City Orthopaedic Institute (KCOI), our dedicated team of orthopedic surgeons understands the profound impact hip pain can have on your quality of life.

This post will familiarize you with the symptoms of hip osteoarthritis and the various treatment pathways, while helping you understand when hip joint replacement surgery might be necessary.

couple walking

What is Osteoarthritis of the Hip?

Osteoarthritis of the hip isn’t simply “wear and tear.” It’s a complex degenerative process within the joint. The hip joint, a ball-and-socket joint, relies on a smooth layer of cartilage covering the femoral head (the “ball” at the top of your thigh bone) and the acetabulum (the “socket” in your pelvis). This cartilage acts as a frictionless cushion, allowing for fluid and pain-free movement. In osteoarthritis, this protective cartilage gradually erodes and thins. As the cartilage deteriorates, the underlying bone becomes exposed. This bone-on-bone friction during movement leads to the hallmark symptoms of pain, inflammation and stiffness.

Over time, the joint can also develop bone spurs (osteophytes), which can further restrict movement and exacerbate pain. While age is a significant risk factor, it’s crucial to understand that OA isn’t an inevitable part of aging for everyone. Factors such as a family history of arthritis, previous hip injuries including a labral tear, developmental hip dysplasia, obesity (which puts increased stress on the joints) and repetitive high-impact activities can all increase your susceptibility to developing osteoarthritis in the hip.

Recognizing the Symptoms of Hip OA 

The onset of hip osteoarthritis symptoms is often gradual, which can sometimes make it challenging to recognize the early stages. Paying attention to subtle changes in how your hip feels and functions is key. Beyond the core symptoms previously mentioned, here are some more nuanced ways hip OA can manifest: 

  • Night Pain: As the condition progresses, you may experience persistent hip pain even while resting, often disrupting your sleep. 
  • Referred Pain: The pain from hip OA can sometimes be felt in unexpected areas, such as the lower back, groin, or even down the front of the thigh towards the knee. This “referred pain” can sometimes make diagnosis tricky. 
  • Changes in Gait: You might notice yourself favoring one leg over the other, developing a more pronounced limp, or experiencing a Trendelenburg gait (where your pelvis drops on the side of the lifted leg due to weakness in the hip abductor muscles). 
  • Loss of Flexibility: You may find it increasingly difficult to perform actions that require hip flexion, extension, abduction (moving the leg away from the body), or rotation. Simple tasks like crossing your legs or bending to tie your shoes can become significant challenges. 
  • Swelling and Tenderness: In some cases, particularly during periods of increased activity or inflammation, you might experience mild swelling or tenderness around the hip joint. 
  • Crepitus: The grinding, clicking, or popping sound you hear (crepitus) can become more frequent and pronounced as the cartilage wears away and the bony surfaces roughen. 

 

hip consult with patient

Exploring Treatment Options for Hip Osteoarthritis 

The management of hip osteoarthritis typically begins with a comprehensive evaluation by an experienced orthopedic surgeon. This evaluation will involve a thorough physical examination, a review of your medical history and symptoms, and diagnostic imaging such as X-rays. In some cases, MRI and/or CT scans may be used to provide more detailed information about the soft tissues around the hip, including ruling out other conditions like a labral tear. 

Fortunately, there are various treatment options available for managing hip osteoarthritis. Initially, your orthopedic surgeon at KCOI will likely recommend conservative approaches, such as: 

  • Lifestyle Modifications: This can include weight management, low-impact exercises like swimming or cycling, and avoiding activities that aggravate your pain. 
  • Physical Therapy: Strengthening the muscles around your hip can help to stabilize the joint and reduce pain. 
  • Medications: Over-the-counter pain relievers like ibuprofen or naproxen, as well as prescription medications, can help manage pain and inflammation. 
  • Injections: Corticosteroid injections into the hip joint can provide temporary pain relief. 

When is Joint Replacement Surgery Considered? 

While conservative treatments can be effective in managing early to moderate hip osteoarthritis, there may come a point when these options no longer provide sufficient pain relief and improvement in function. Your orthopedic surgeon may then discuss hip joint replacement surgery as a potential solution. 

Things to consider when determining if you are a candidate for hip replacement surgery: 

  • Severe Pain: You experience significant hip pain that interferes with your daily activities, sleep and overall quality of life. 
  • Limited Mobility: You have significant difficulty walking, climbing stairs, or performing basic movements despite trying other treatments. 
  • Lack of Improvement with Non-Surgical Options: Conservative treatments have been exhausted without providing substantial or lasting relief. 
  • X-ray Evidence of Advanced OA: Imaging studies clearly show significant damage to the hip joint. 
  • Your Personal Goals and Expectations: What are your goals for pain relief and improved function? A successful hip replacement can often allow individuals to return to activities they previously had to give up. 

Hip replacement surgery involves replacing the damaged cartilage and bone in your hip joint with artificial components (prosthesis). This procedure can effectively relieve pain, improve mobility, and allow you to return to a more active lifestyle. The decision to undergo joint replacement surgery is a collaborative one between you and your experienced orthopedic surgeon at KCOI.  

KCOI Physicians Specializing in Hip Replacement

Dr. Scott Abraham, Dr. Cris Barnthouse, Dr. Sean Bonanni, Dr. John Carlisle, Dr. David Clymer, Dr. Scott Cook, Dr. Burrel Gaddy, Dr. Michael McCabe, Dr. Kirk McCullough, Dr. Christopher Peer, Dr. Dan Reinhardt, Dr. Robert Sharpe, Dr. Nick Ting and Dr. Scott Wingerter.  

Living with chronic hip pain from osteoarthritis can significantly limit your enjoyment of life. Understanding the symptoms, exploring the range of treatment options, and knowing when joint replacement surgery might be the most effective solution are crucial steps in taking control of your health. 

Don’t let hip pain control your life. If you’re experiencing symptoms of osteoarthritis and conservative treatments haven’t provided the relief you need, it may be time to explore other options. 

Take the first step towards a more comfortable and active future. Contact us to Request an appointment with one of our expert hip specialists at KCOI today.