Minimally invasive knee surgery as an effective solution for fast and complete healing.
The knee is the joint that supports much of the body weight and is one of the most susceptible to arthritis, caused by cartilage degeneration.
Over time, indeed, the cartilage gradually thins until it completely wears out.
The main symptoms of knee arthritis are stiffness in movement and intermittent pain, which can limit daily activities such as walking, working, climbing stairs, sleeping or even just standing.
When the pain is so strong as to prevent even the simplest movements, it is possible to turn to an orthopedic specialist.
The first visit is essential to understand the situation and choose the most suitable solution with safe treatments such as:
- total knee replacement;
- partial knee replacement;
- conservative therapy.
In Tuscany it is possible to quickly return to daily habits without pain thanks to a system called Rapid Recovery and minimally invasive knee surgery.
The concept of minimally invasive knee replacement, in addition to the aesthetic advantage, aims above all at less surgical trauma and a quick patient recovery.
Understood as a less invasive overall patient management, it starts from a lesser surgical trauma to tissues, reduces blood loss and postoperative pain and above all, aims to accelerate the patient’s recovery after knee replacement surgery.
This minimally invasive approach is applicable to all patients undergoing knee replacement, both partial and total.
The minimally invasive prosthesis is “perceived” as less foreign, more faithful to the anatomy and biomechanics of the body.
The surgery
Arthritis that has not yet reached a high degree of degeneration can be treated with injections and therapies.
Severe, disabling knee osteoarthritis that no longer responds to medication in terms of pain, stiffness and swelling can be resolved with minimally invasive prosthetic surgery.
The procedure involves replacing the cartilage and the joint damaged by arthritis or part of it with a personalized state-of-the-art prosthesis.
The choice of implant type depends on the type of arthritis, the patient’s age and level of activity, but also on the quality of the bone.
Most ligaments and tendons are left in place, allowing for natural knee movement.
Depending on the patient’s condition, it is possible to implant a total or partial knee prosthesis (called unicompartmental).
Prosthetic surgery today can be performed with minimally invasive surgery that respects the body’s noble tissues and allows for rapid functional recovery.
Much of the knee’s strength comes from the quadriceps muscles.
When this muscle group and tendon are cut off for example with traditional techniques, repair and recovery may require longer hospital stays and slower rehabilitation.
During minimally invasive surgery there is no opening or violation of the medullary canal, neither of the femur nor of the tibia, as with traditional techniques.
Minimally invasive total knee prosthesis
A total minimally invasive prosthesis is used if the knee is damaged in all three of its compartments (medial femoro-tibial, lateral and femoro-patellar).
During the procedure an incision is made in the medial parapatellar area, avoiding cutting the tendon and its muscle fibers.
This prosthesis spares the posterior cruciate ligament, responsible for sensitivity to stimuli and the stability of your knee.
Unicompartmental or partial minimally invasive prosthesis
In some patients arthritis develops in only one area of the knee: in these cases partial or unicompartmental prosthesis may be the best solution.
It is a minimally invasive prosthesis that replaces only the damaged compartment of the knee: it involves less surgical stress with less blood loss, less pain and faster functional recovery.
Additionally the healthy joint part is preserved.
There are partial prostheses for the internal, external and patellar compartments.
Femoro-patellar prosthesis
Indications for this type of prosthesis are very selective: it must be ensured that the internal and external femoro-tibial compartments are not damaged.
It is suitable for patients who develop selective patellar arthritis and mainly exhibit symptoms in flexed knee movements such as getting up from a chair or climbing stairs.
It is called a femoro-patellar prosthesis, because it replaces only the femoro-patellar compartment.
Surgical technique that respects the patient and its advantages
Fundamental in this new technique is working on the patient’s psychophysical well-being.
Before surgery the minimally invasive approach involves educating and physically preparing the individual: information allows for greater participation and motivation in surgical intervention.
Physical preparation helps limit inevitable muscle loss after surgery.
Minimally invasive knee replacement surgery involves the use of smaller, stronger and technologically advanced prostheses tailored to the patient, based on their physical conformity.
The prosthesis is adapted to the individual patient.
They are made of biocompatible advanced materials (titanium, ceramic, tantalum, polyethylene with vitamin E). The risk of rejection is eliminated and the lifespan is increased to 20-25 years, sometimes even longer.
The minimally invasive knee prosthesis is perceived by the patient as a more natural element and faithful to the body’s biomechanics.
Minimally invasive surgery preserves the integrity of the medullary canal, the femur or the tibia and involves greater preservation of bone mass and soft tissues.
In the case of knee prosthesis implantation healthy parts are spared, including the anterior and posterior cruciate ligaments, essential for physiological joint movement, kinematics and sensitivity.
Compared to traditional surgery, minimally invasive surgery has numerous advantages.
In particular it reduces:
- operation time, hospital stay, rehabilitation and recovery;
- reduced incision and consequently less visible scar;
- glue for better skin healing;
- bleeding during and after surgery;
- trauma (pain and swelling);
- postoperative complications, e.g. infections.
All this maximizes patient recovery.
Hospital stay, rehabilitation and recovery times
The path in knee prosthetic surgery aims to allow the patient to quickly return home and resume daily life.
Multidisciplinary management of the patient before, during and after surgery greatly reduces psychophysical stress and postoperative pain and facilitates movement recovery.
The first goal of rapid recovery is to get the patient up and walking within 5/6 hours after surgery, aiming for early functional recovery.
The aim is to activate the muscles immediately, alleviate pain and prevent cardiovascular and respiratory complications.
Coordination between the various figures involved is essential: orthopedic surgeon, anesthetist, physiotherapist.
Rapid Recovery allows walking with aids on the same day as the operation after 5 hours and climbing stairs the next day.
Through a targeted physiotherapy program to be followed for several weeks, dedicated internist support and careful pain control the patient returns home within 3-5 days of surgery.
Until complete healing occurs, which will take about 2-3 months.
If you want to delve into the topic, also read this article.
