Vital Signs: Thinking about knee replacement? Options abound for individualized treatment - The Daily Progress: Lifestyles

Thursday, October 23, 2014

Vital Signs: Thinking about knee replacement? Options abound for individualized treatment

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Posted: Sunday, July 20, 2014 6:00 am

As our population ages and becomes more active, the demand for knee replacement surgery is rising. In response, the options for treatment are becoming greater in number and complexity. The challenge is sifting through the advertisements, articles and recommendations from others to uncover which of these options is best suited to you.

Just because there are newer, high-tech options out there doesn’t necessarily mean they are the best option for your arthritic knee. Sometimes the tried-and-true surgical approaches are the most reliable over the long term, especially if your surgeon is highly skilled in a particular procedure. Here are some additional points to consider as you’re researching your options for surgery:


Do you truly need surgery?


For some, effective symptom relief may be achieved through non-operative treatments. These may include physical therapy, braces to reduce pressure on the joint, oral medications like anti-inflammatories, or steroid injections directly into the joint. In most cases, you should exhaust these options first. If unsuccessful, then surgery may be the best alternative.


How experienced is your surgeon?


No matter how advanced the surgical tool, the experience of your surgeon matters. Ask your surgeon how long he or she has been in practice and how many similar procedures he or she performs annually (more than 50 is a good sign).


What type of surgical approach is recommended?


There are approximately seven approaches to total knee replacement surgery currently utilized. Some patients will be candidates for a minimally invasive or small-incision approach. For others, these techniques may increase the risk for complications.

It is up to your surgeon to decide which surgical approach allows the greatest visibility and access based on your condition and severity of disease. Ask your surgeon to explain the pros and cons of the recommended approach. There is little difference in outcomes from knee replacement surgery, regardless of the approach utilized.


Which implant is best suited to your needs?


Studies have shown that the type of implant used in knee replacement surgery is not a major factor in the success of the procedure. Most implant devices are similar in functionality; however, there have been recent advances in materials and design that are worth considering. Ask your surgeon about the advantages and disadvantages of each type of implant based on your clinical condition, weight, gender, age and activity level.


What are the risks?


Prior to surgery, be sure you have a clear understanding of every aspect of your treatment. Ask your physician about the methods used for pain management during and after surgery, risk for infection, the recovery process, any potential complications and how your surgeon aims to prevent them.


What are the steps to recovery?


Physical therapy is important in order to regain mobility and range of motion after a knee replacement surgery. Typically, this work begins the same day of the procedure. The more committed you are to a rehabilitation plan, the faster your recovery and the better your results will be over the long term. Ask your physician about the recovery process and which therapy options are available, whether you prefer to go to a rehabilitation facility or receive in-home care.


Why choose UVa Orthopaedics?


The University of Virginia Health System’s Joint Replacement Center is the only area hip and knee replacement program certified as a Center of Distinction by the Joint Commission, the national hospital accreditation group. UVa orthopaedic surgeons perform more than 700 knee replacement surgeries each year. This high volume of surgeries means greater skill in the operating room and more expertise when it comes to evaluating which treatment approach is the best fit for each individual patient.

The surgeons offer the most advanced techniques available, such as minimally invasive and computer-aided surgery, and center is the area leader for revision (or redo) surgeries to fix problems that may have occurred elsewhere. In addition, UVa has an entire network of nurses, therapists and others specially trained to take you through every phase of joint replacement surgery, from diagnosis to recovery.

Dr. Quanjun Cui is an orthopaedic surgeon at University of Virginia Health System specializing in joint replacement and adult reconstructive surgery.


More infornation

Visit for more information on orthopaedic surgery at UVa.



Vital Signs

Vital Signs is a community health promotion column sponsored by University of Virginia Health System, Martha Jefferson Hospital, Region Ten and the Thomas Jefferson Health District.

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