TMH Living Well: What to expect with knee surgery
July 24, 2015
Are "bad knees" keeping you from doing the things you love to do? Maybe in the past you were an avid hiker and today you are lucky to make it around the neighborhood. If so, it may be time to consider knee surgery.
"Pain that interferes with activities of daily living may mean it's time to consider knee replacement surgery, especially if you've exhausted non-operative treatments such as anti-inflammatory medications, glucosamine and chondroitin sulfate supplements, pain medications, assistive devices for walking, physical therapy, cortisone injections into the knee joint, platelet-rich-plasma injections, viscosupplementation injections and weight loss," said Dr. Kevin Borchard, fellowship-trained orthopaedic surgeon with the Northwest Colorado Orthopaedic & Total Joint Center, a combined program between The Memorial Hospital and Pioneers Medical Center.
While arthritis is the most common reason for knee replacement surgery, injuries from sports is also common and can lead to arthritis down the road.
Types of knee surgery
When considering knee surgery, find a surgeon who has mastered a minimally invasive method, which means less pain and a faster recovery for you. You may need a total knee replacement or a partial knee replacement, depending on whether the arthritis is localized in one area of the knee or not. When osteoarthritis and rheumatoid arthritis is especially advanced, surgery in both knees may be required.
"The approach I use for knee replacement surgery is called the subvastus approach. In this approach I avoid cutting into the quadriceps tendon. The subvastus approach has been shown to have a more rapid recovery, better pain scores, less blood loss and better knee range of motion at one year when compared to more traditional approaches," Borchard said.
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In addition to the approach, a surgeon has to correctly place the components for the knee to function correctly. Dr. Borchard has used many different techniques to perform knee replacement surgeries and believes the gap-balancing technique is the best for giving patients a reliable, stable and more natural feeling knee replacement. He performed 400 knee replacements during his recent fellowship training and another 50 plus revisions—and more during his years as an orthopaedic surgeon with the Air Force.
Recovery from knee surgery takes typically six weeks. During this time it's important not to twist or pivot the knee and to minimize climbing stairs. You will receive physical therapy afterwards, so make sure you follow the guidelines to avoid dislocation of your new joint.
"One of the biggest advancements in knee replacement surgery is multimodal pain control, which has significantly improved pain control following surgery. Previously, patients were provided a patient controlled analgesia (PCA) devise, which dispensed powerful narcotic medicines and required the patient to be hooked up to an IV pole. It makes if very hard for patients to actively move around following surgery," Borchard said.
At the Northwest Colorado Orthopaedic & Total Joint Center, patients can expect to receive physical therapy before surgery as well as after — a current best practice. Studies show that getting ready 6 to 12 weeks before surgery with exercise and physical therapy helps patients recover faster and have better outcomes. Rehabilitation afterwards usually extends 10 to 12 weeks.
"Rehab after a knee replacement is incredibly important. Fifty percent of the overall outcome after surgery depends on rehabilitating the knee with exercises, range of motion maneuvers and physical therapy," he concluded.
The Memorial Hospital is pleased to bring Dr. Kevin Borchard's advanced training and skills in orthopaedic surgery to the region. The Northwest Colorado Orthopaedic & Total Joint Center will operate from both locations, TMH and Pioneers Medical Center.
Dr. Borchard starts taking appointments Aug. 1; call 970-826-2400 for an appointment or visit http://www.thememorialhospital.com and select orthopaedics under services for more information.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig — improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.