New technology for Arthritis Surgery

1)   Uni-Knee

        "Minimally Invasive" (smaller incision as work is done only on one half of the knee).  If there is disease on the opposite half of the knee or under the kneecap, this is the wrong procedure to do.  These devices feel more like a "normal" knee, as the cruciate ligaments are kept intact. 

2)    Uni-Spacer

        This is a device that is new (but was allowed to be used by the FDA as it resembled an old device).  It has not been tested very much, and has had problems with the implant popping out of place.  The verdict is still out on which kind of person this is a reasonable choice for, and until such time that more is known about how reliable this may or may not be, we will not be doing it.

3)    "Alternative Bearings"

        Since becoming popular in the 1970's, Total Hip and Total Knee replacements have been using metal on plastic to replace the worn out cartilage.  Over the past 30 years, we have realized that many of the problems affecting the longevity of these devices comes from a breakdown of the plastic (polyethylene).  There have been attempts to improve this material in the past, but some made the problem even worse.  We think we now have a reasonable understanding of how to make the plastic better, and how to lock it into the metal better, but only time will tell.  For hip replacements, we now have the ability to use CERAMIC on CERAMIC surfaces and METAL on METAL surfaces, both of which eliminate the polyethylene, and the problems associated with the wear of it.  We use both of these surfaces, and can explain their uses on an individual basis. 

4)   What is Minimally Invasive or "Less  Invasive"

        Smaller incision is NOT important, what is more important is the ability to do the procedure well and get good results.  If that can be accomplished with a smaller incision, then that is OK, but under no circumstance should the result be compromised for a smaller incision

        Newer instruments are being developed to us a smaller incision.  Perhaps the only real benefit comes from a little less pulling on the Quad mechanism in total knee replacement, which may allow for a faster recovery.

        For hip replacement, when possible we can use incisions that are about 4 inches long.  Others have started using 2 incisions that are about 2 inches long each, and there are some significant problems with breaking the femur.  Again, for hip replacement, being able to do a great job inside is what matters most.  A smaller incision and smaller amount of dissection might save a half of a day in recovery, but that is not the point.