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What does it mean to get a "minimally invasive" knee replacement?

Updated: Apr 20, 2021

You may have heard that a "minimally invasive" surgery is the best option for your knee replacement, so what does that mean for you as a patient who needs knee pain management, or who is looking for a knee pain clinic, or an orthopedic surgeon?

Minimally invasive usually means less muscles will be cut, your recovery is quicker, and there tends to be minimal to no complications post-surgery.

A prime example of a minimally invasive procedure is my quadricep sparing knee replacement surgery, a technique I've been using since 2000. While technically more difficult, it is providing patients with greater satisfaction and quicker recoveries. The procedure spares the quadricep muscle because I move the muscle to the side to access the knee joint, as opposed to cutting through the muscle. After the knee prosthesis is inserted, I then balance the outside and inside knee ligaments to make sure that they are under the same tension; this step provides the patient a more stable and aligned knee. Quadricep sparing surgery techniques and balancing ligaments are somewhat of a lost art, but over the years, I have observed that this added attention to detail provides my patients the best results.

I also use the Mako SmartRobotics system. This advanced technology assists me before and during surgery by providing a 3-D image of your knee via a CT scan. That image is then uploaded to the surgical robot. During your surgery, the Mako technology ensures that the surgeon only removes the diseased portion of your knee as shown in your CT scan image; if we go outside those parameters, the surgical tool literally will stop. This spares any unnecessary tissue damage or removal.

The most exciting part of these various techniques that result in minimally invasive procedures is the fast recovery for patients. I am currently part of a study by X10 Therapies. This study measures strength and recovery of patients who have had a knee replacement. The data is not yet finalized but so far the results are remarkable for patients who have had the quadricep sparing procedure versus patients who have had traditional surgeries. One of the tests they do as part of the study is called a "Tug Test." This test measures how fast the patients can walk 100 feet before and after surgery. At six weeks post-operation, patients who had the quadricep sparing technique increased their walking speed by 12 seconds compared with patients who had a traditional surgery where their quadricep muscle had been cut. X10 Therapies also found that there was a 146% increase in quadricep strength four weeks post-surgery in patients who had the quadricep sparing technique. After a traditional total knee replacement (arthroplasty), the literature shows patients only obtain 85% of their quadricep strength.

Another measure of how well a patient does following a knee replacement is extension and flexion of the knee. Traditionally, four weeks following surgery, a patient's knee would go from 10 degrees to 90 degrees. My patients were able to show full extension of their legs at 6 weeks and bend their knees 0 degrees to 130 degrees. This quicker recovery and greater degree in movement is a direct result of the increase in quadricep strength because the muscles aren't scarred and the body is healing more quickly. I also believe that the therapy, balanced ligaments and the robotic navigation are making an impact on these positive results.

If you have any questions about what it means to have a minimally invasive knee arthroplasty, please call our office for an appointment at 248-626-0135 where we can go over your questions during a more personalized consultation.

Robert Ference, M.D.

Joint Plus Excel Orthopaedic Clinic, Farmington Hills, Michigan

Keyword Topics: knee pain management, knee pain clinic, hip pain clinic, hip pain relief products, orthopedic surgeon






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