Knee

KNEE REPLACEMENT

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities, such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down.

If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.

MINIMALLY INVASIVE TOTAL KNEE ARTHROPLASTY

The traditional approach to knee replacement uses a long vertical incision in the center of the knee to view and access the joint. Minimally invasive total knee replacement is a variation of this approach. The surgeon uses a shorter incision and a different, less-invasive technique to expose the joint—with the goal of reducing postoperative pain and speeding recovery.
Unlike traditional total knee replacement, the minimally invasive technique is not suitable for all patients. Your orthopedic surgeon will discuss the different surgical options with you.
KNEE ARTHROPLASTY

See more – Minimally Invasive Knee Surgery

TOTAL KNEE ARTHROPLASTY

A knee replacement (also called knee arthroplasty) might be more accurately termed a knee “resurfacing” because only the surface of the bones are actually replaced. There are four basic steps to a knee replacement procedure.

  • Prepare the bone. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
  • Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or “press-fit” into the bone.
  • Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. Some surgeons do not resurface the patella, depending upon the case.
  • Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.

MINIMAL BLOOD LOSS, TOURNIQUETLESS TOTAL KNEE ARTHROPLASTY

Dr. Sayeed has developed a minimal blood loss surgery protocol for total joint replacement procedures. With the use of advanced surgical devices for coagulation and the use of tranexamic acid, blood loss and the need for transfusions have been significantly reduced.

This is a state of the art technique for patients and is offered at all of Dr. Sayeed’s surgical locations. To see if you qualify for this unique procedure, please contact the South Texas Bone and Joint Institute.

Call, visit or email South Texas Bone and Joint Institute in San Antonio at 210-696-BONE (2663) with any questions!

UNICOMPARTMENTAL KNEE ARTHROPLASTY

During knee replacement surgery, damaged bone and cartilage is resurfaced with metal and plastic components. In unicompartmental knee replacement (also called “partial” knee replacement) only a portion of the knee is resurfaced. This procedure is an alternative to total knee replacement for patients whose disease is limited to just one area of the knee.

Because a partial knee replacement is done through a smaller incision, patients usually spend less time in the hospital and return to normal activities sooner than total knee replacement patients.

PATELLOFEMORAL ARTHROPLASTY

During knee replacement surgery, damaged bone and cartilage is resurfaced with metal and plastic components. Patellofemoral replacement is a type of “partial” knee replacement in which only a portion of the knee is resurfaced. The procedure is an alternative to total knee replacement for patients whose damaged bone and cartilage is limited to the underside of the patella (kneecap) and the channel-like groove in the femur (thighbone) that the patella rests in.

Because patellofemoral replacement is done through a smaller incision, there is less damage to soft tissues in the knee. In many cases, this allows patellofemoral replacement patients to recover faster and return to normal activities more quickly than total knee replacement patients.

REVISION KNEE ARTHROPLASTY

If your knee replacement fails, your doctor may recommend that you have a second surgery—revision total knee replacement. In this procedure, your doctor removes some or all of the parts of the original prosthesis and replaces them with new ones.

There are different types of revision surgery. In some cases, only one implant or component of the prosthesis has to be revised. Other times, all three components—femoral, tibial, and patellar—need to removed or replaced and the bone around the knee needs to be rebuilt with augments (metal pieces that substitute for missing bone) or bone graft.

Robotic-Assisted Total Knee

ROSA

Using the Zimmer Biomet ROSA robot, Dr. Sayeed performed the surgery, also known as robotic-assisted knee arthroplasty, on Oct. 17 at Methodist Main Hospital in the Medical Center.

“The surgery turned out fantastic,” Dr. Sayeed said. “We now hope to offer this surgery to all of my patients in need of a total knee replacement. This patient had severe knee arthritis from years of wear and tear. He had constant pain and wanted to return to being active. The patient failed all conservative treatments, such as physical therapy and steroid injections. The patient was an ideal candidate for knee replacement surgery,” Dr. Sayeed added.

During the robotic-assisted surgery, Dr. Sayeed is provided data by the robot regarding the balance of the ligaments, depth of bone resection, and angle of the bony cuts, he explained. “The robotic arm comes in and positions our cutting block based on the data we’ve collected and analyzed as we are performing the surgery.”

See more – Robotic-Assisted Total Knee Surgery

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ROSA Information

During ROSA robotic total knee replacement, surgeons use standard x-ray scans to build a virtual model of the patient’s knee. With that model as a guide, the surgeon then uses the robotic arm to cut the bone precisely which helps to position implants more reliably. “The difference with the ROSA robot is that my hand has control over the saw and not vice versa. The human is in control of the robot,” he said. “The goal of this surgery is that patients will have less pain, better function, and quicker recovery,” Dr. Sayeed said.

Dr. Sayeed, who completed his residency training at the Mayo Clinic in Rochester, Minnesota, and fellowship in total joint surgery at the Rubin Institute for Advanced Orthopedics, trained with the ROSA Knee System in order to be certified to perform robotic-assisted total knee arthroplasty. Dr. Sayeed has a Master of Engineering degree with a specialization in building miniature devices. With his engineering background, using the ROSA robot is a natural tool for him to perform total knee replacement surgery.

Call, visit or email South Texas Bone and Joint Institute in San Antonio at 210-696-BONE (2663) with any questions!