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Choose Dr. Morton as your Knee Replacement Surgeon

Content

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Am I a Candidate for Total Knee Surgery?
Diagnosis
Anterior total hip replacements
Total Knee Replacement
Robotic Technology
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Recovery
Imflammmation

Realistic Expectations

Frequently Asked Questions
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What should I expect with my total knee?

There is no reason to sacrifice your lifestyle when it comes to your knee pain. We use our knees every day when we sit, stand, or play with our children. Sometimes, our knees wear out due to injury, illness, or the normal aging process. When your knees become worn, your everyday movements can be painful and difficult.

With robotic knee replacement, I believe we are able to have our patients have their implants placed more accurately, with less soft-tissue injury and faster recovery.

You do not have to live with your aching knees. A knee replacement can help you maintain your quality of life. If your life is limited because of knee pain, you may be a candidate for knee replacement surgery.

Old man

Am I a Candidate for Knee Replacement Surgery?

When you have failed non-operative treatment for arthritis, you should consider a knee replacement. Non-operative treatment includes injections, anti-inflammatory medications, or exercise.
The goal of a knee replacement surgery is to alleviate your pain and improve function. The best time to think about surgery is when you are having difficulty with the following scenarios:

  • Your daily living activities: household chores and grocery shopping
  • Leisure activities: golf, gardening, long walks, bike riding
  • Loss of ability to work due to pain
  • Avoidance of seeing friends or family

Any patient who is a candidate for a total knee replacement is a candidate for a robotic knee replacement.

Am I a candidate for Knee Replacement surgery?

Diagnosis

I will make the diagnosis of arthritis through history and physical exam. An x-ray will be performed in the clinic. The x-rays in someone with arthritis typically show cartilage loss and bone spur growth. The common term we use to describe arthritis is“bone-on-bone.” This term refers to the damage and loss of cartilage between your thigh and shin bones. Bone-on-bone arthritis occurs when you have severe arthritis.

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Knee Replacement

When you have failed non-operative treatment for arthritis, you should consider a knee replacement. Non-operative treatment includes injections, anti-inflammatory medications, or exercise.
The goal of a knee replacement surgery is to alleviate your pain and improve function. The best time to think about surgery is when you are having difficulty with the following scenarios:

  • Your daily living activities: household chores and grocery shopping
  • Leisure activities: golf, gardening, long walks, bike riding
  • Loss of ability to work due to pain
  • Avoidance of seeing friends or family. A total knee replacement is a surgery that removes the damaged parts of your knee, which is replaced with an artificial joint. Your new knee is composed of metal and plastic. During the surgery, the metal is solidly fixed to the end of your thigh bone and your shin bone. Your knee replacement is made of a highly-engineered plastic, called polyethylene, that is inserted between the two pieces of metal. The kneecap is also replaced with a small plastic button. I may also consider you a candidate for a partial knee replacement, and will discuss this during your visit.
Total knee Replacement

Minimally Invasive Knee Surgery

Minimally invasive surgery performed by Dr. Morton typically involves smaller incisions compared to traditional knee replacements. Below is a picture of a patient who recently underwent a right minimally invasive robotic total knee replacement at 5 months after surgery compared to a scar from surgery performed several years ago by a different provider in Hawaii. Over time, the surgery scars gradually fade in color. The surgical incision is roughly half the length compared to the competitor’s incision. With smaller incisions, there is a less pain and a faster recovery.

Total Knee Scar Comparison Standing

Minimally Invasive Knee Replacements incisions such as that seen on the right usually are 4- 6 inches long

Total Knee Scar Comparison Sitting scaled

Traditional Knee Replacements incisions such as that seen on the left usually are 10-12 inches long.

Role of Robotic-Assistance in Hip and Knee Joint Replacement Surgery

Benefits of Robotic Surgery
  • More data collected intraoperatively
  • Increased accuracy
  • Real-time info on size, alignment, and balance
  • Improved real-time surgical decisions
  • Optimized ligament balance
  • Personalized implant position
  • Consistent leg alignment
  • Improved safety with bone cuts

Robot-assisted surgery is a new, exciting tool in orthopedics. In industry, robotic arms have made an incredible difference in efficiency, accuracy, and consistency in manufacturing.

Robots have made advancements in urology, spinal surgery, general surgery, gynecology, gastrointestinal surgery, and many other fields. It makes sense that robots would make their way into joint replacement surgery.

Robotic-assisted surgery is now involved in hip and knee replacements.

While conventional surgery methods for joint replacements have a tremendous success history, this new technology offers many exciting advantages in 2020.

Orthopedic surgeons have a variety of systems to choose from based on their preferences. I will go into the details of these different systems below.

The problem with conventional joint replacements

Hip and Knee replacement surgeries are incredibly successful operations. In fact, the Lancet named total hip replacements “the operation of the century.”

However, hip replacements are known to have problems with dislocations and limb length discrepancies. In patients with hip dysplasia or other deformities in their hips often have distorted anatomy. While anterior hip replacements have improved some of these problems, there is still room for improvement.

Knee replacements are considered an incredibly successful surgery. However, 20% of patients are still dissatisfied with their surgery. In studies of total knees performed on patients in Hawaii by excellent orthopedic surgeons using mechanical jigs, only 86% of these implants are placed in the appropriate position.

Keep reading to learn how robotics improves our surgical techniques.

Preoperative Planning

Prior to surgery, some robotic systems require the use of advanced imaging such as a long-leg standing film or a CT scan. This imaging allows for:

  • Accurate sizing of implants prior to surgery
    • Less guess-work on sizes before
    • Shorter operating period
  • Preoperative measurement of patient’s deformity prior to surgery
Preoperative Planning Rosa Knee Replacement

Rosa Knee Replacement uses x-rays with special calibration markers that allow for accurate determination of preoperative alignment and sizing.   After these x-rays are obtained, a preoperative plan is personalized to each patient before surgery is even performed.

Preop Plan for Rosa Total Knee Arthroplasty

Performing a Robotic Surgery

Insertion of Pins and Calibration of the Robot

Navigation pins allow for the proper utilization of the robot.

Insertion of Pins and Calibration of the Robot
Exposure of the Joint