Knee & Hip
TOC PHYSICIANS SPECIALIZING IN JOINT REPLACEMENT
Total Knee Replacement
A knee replacement is recommended for patients with arthritis and certain knee injuries or diseases that have not responded well to conservative treatments such as anti-inflammatory medications or cortisone injections. The replacement devices are designed to relieve pain caused by cartilage damage, and usually last up to 20 years in most patients.
During the knee replacement procedure, the entire joint is replaced with an artificial prosthesis. The end of the femur is replaced with a metal shell, while the end of the tibia is fitted with a plastic cup and metal stem that fit into the shell. The posterior cruciate ligament and kneecap may be replaced if needed or may be left in place. This procedure can take up to three hours to perform and usually provides immediate pain relief and a return to regular activities. Our knee replacement surgeons use computer assisted navigation and robotics which allows for precise cuts and placement of the prosthesis resulting in better outcomes for our patients.
Partial Knee Replacement
MAKOplasty® partial knee resurfacing is a minimally invasive procedure for those suffering with painful early to mid-stage osteoarthritis of the knee. It is performed using the surgeon-controlled RIO® robotic arm system and offers more accurate resurfacing of the diseased portion of the knee, saving as much of the original knee as possible.
As a partial knee surgery, MAKOplasty can be performed on either the medial (inside) compartment, patellofemoral (top) compartment, or the lateral (outside) portion of the knee. It can also be performed as a bicompartmental procedure on both the medial and patellofemoral portions of the knee. In many cases, patients are permitted to walk soon after surgery, drive a car within two weeks and return to normal daily activities shortly thereafter.
The use of this highly advanced robotic arm technology can:
- Enable surgeons to accurately resurface the arthritic portion of the knee and preserve healthy tissue and bone
- Facilitate optimal implant positioning to result in a more natural feeling knee following surgery
- Result in a more rapid recovery and shorter hospital stay when compared to traditional total knee replacement surgery
- Promote a rapid relief from pain and return to daily activities
The RIO robotic arm system assists the orthopedic surgeon in several ways. First, it provides patient-specific three dimensional modeling for pre-surgical planning. Then, during the procedure, the combination of the robotic arm and stereo tracking technology provides the surgeon with real-time visual, tactile and auditory feedback, enabling reproducible precision and optimal positioning of the implant(s) within the knee. It is this level of accuracy that facilitates optimal implant positioning and alignment to result in a more natural knee motion following surgery.
Although the best treatment for each patient must be determined individually, typical MAKOplasty patients share the following characteristics:
- Knee pain with activity, usually on the inner knee, under the kneecap or the outer knee
- Start up knee pain or stiffness when activities are initiated from a sitting position
- Failure to respond to non-surgical treatments or non-steroidal anti-inflammatory medication
Like other knee arthroplasty procedures, MAKOplasty is typically covered by most Medicare-approved and private health insurance providers. Please speak with your physician to determine if MAKOplasty may be the right treatment option for you.
Currently Dr. Mittal is our only physician using this technology.
Total Hip Replacement
Hip replacement is usually a last resort treatment for patients with severe hip pain whose daily lives are affected by the pain, including those with arthritis, fractures, bone death or other conditions. In this procedure, the diseased bone and cartilage are replaced with a metal ball and plastic cup.
The artificial joint, called a prosthesis, may be cemented in place, may be cementless, or may be a hybrid of both. The prosthetic devices provide pain relief and restored function for 25 years or longer in most cases.
Most patients who undergo hip surgery achieve successful relief from their condition, including pain relief, restored function and an improvement to their overall quality of life. There are certain risks associated with hip procedures, including infection, nerve damage, blood clots and reactions to anesthesia, but these risks are considered rare and can be further reduced by choosing an experienced and skilled surgeon.
Your doctor will decide which procedure is best for you based on a thorough evaluation of your condition and medical history. It is important to discuss the details of your procedure with your doctor in order to achieve the best results.
Direct Anterior Approach to Hip Replacement
The Direct Anterior Approach to Hip replacement is advancement in minimally invasive surgery. The goal of Direct Anterior Approach is for the surgeon to minimize skin incision size and spare unnecessary damage to the underling muscles and nerves in the hip. Yogesh Mittal, MD is one of the only orthopaedic surgeons in Tulsa to perform this operation. To learn more about the Direct Anterior Approach to Hip Replacement, watch our new animation on this procedure.