New Knee-Replacement Technique Offers Impressive Results

PLATTSBURGH, N.Y. -- There's a new technique for total knee replacement. It's customized for each patient and is promising a faster return to an active lifestyle with more knee stability, less pain and greater joint longevity.

Plattsburgh, N.Y.-based orthopedic surgeon Dr. C. Philip Volk is now offering patient-matched instrumentation, a procedure that utilizes a patient's magnetic-resonance imaging (MRI) and X-ray results to create customized surgical instruments based on the person's unique anatomy.

"We've been very good at doing total-knee replacements," Volk said. "But we are always looking for ways to do a better job. This new computer-assisted procedure allows us to make more precise cuts."

Smaller Incisions
With patient-matched instrumentation, Volk can create a 3-D model of the knee to create cutting blocks that are used during the surgery to create precise cuts.

"These cutting blocks allow us to align the knee perfectly," he said. "It allows us to calculate the appropriate size. There is no guesswork involved."

If a knee replacement is not perfectly aligned, it can lead to early failure. It also results in poor range of motion.

The state-of-the-art technology Volk employs was developed by Smith & Nephew, a global medical-device manufacturer. The replacement knee is made of Oxinium, a metal that is nearly 5,000 times more abrasive resistant than the cobalt chrome used in other knee-replacements.

Oxinium has shown to reduce wear by up to 85 percent in lab testing, potentially reducing the amount of wear on the new knee. The material also contains no detectable levels of nickel or chromium, reducing the potential for allergic reactions in patients who have metal allergies. The Food and Drug Administration estimates that 10 percent of the American population has metal allergies. The cutting block also allows for much smaller incisions, reducing the anesthesia time and minimizing the risk for infection. "We're finding it to be very effective," said Volk, who has offered the procedure for more than six months. "By cutting out steps, the procedure takes less time." That amounts to about an hour, about half the time as more standard procedures, and patients are walking within a few days and back to full activities in six to eight weeks. "My patients have had excellent range of motion (following the procedure)," he added. Restored MotionDegenerative arthritis is becoming more prevalent as baby boomers age, Volk noted. He is seeing more and more people in their 40s and 50s with increased levels of arthritis. "These are people who have been very active in life," he said. "We want them to get back to their normal function and be as active as before surgery."
Patients with patient-matched instrumentation can typically do most everything they did prior to the procedure, including hiking and skiing. There may be restrictions with certain contact sports, he said. Robert Sterling of Rouses Point had knee problems for about seven years. In fact, the pain became so severe that he eventually had to retire early from the Rouses Point Public Works Department. "With these knees, I couldn't go anymore," said Sterling, 63. "I was having difficulty walking, and there is a lot of heavy work involved in the job, a lot of getting in and out of ditches, a lot of lifting. The pain made daily tasks almost impossible." The cartilage in each of Sterling's knees had worn to a point where bone rubbed against bone constantly, aggravating the nerves in that area and creating intense pain. He had his left knee replaced in September '09 using Volk's new patient-matched instrumentation procedure. His right knee was done in January. "It's fantastic at this stage," he said. "It's made all the difference in the world, like day and night." He has gone through physical therapy for both knees and is now just about fully recovered from both surgeries. "I'm absolutely amazed," Sterling said. "It's a whole new world for me, and I plan on being a lot more active. Now I have the freedom to do so." The procedure may not be for everyone, Volk said. Patient selection is based on age, weight and ability levels.Related articles:Learn to Love Your CardioCholesterol Questions? What to Ask Your DoctorWhat Does Dick Cheney's Case Say About Heart Attack Treatment?
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