Dr. Sechrest: Hello, I'm Dr. Randale Sechrest, your host for eOrthopod.TV. Today I have as my guest, Dr. Jim Mazzara. Dr. Mazzara did his medical school training at New York Medical College. He then went on to complete an orthopaedic residency at St. Luke Roosevelt Hospital, which is a teaching hospital affiliate of Columbia University. Good morning, Dr. Mazzara.
Dr. Mazzara: Good morning.
Dr. Sechrest: Dr. Mazzara, what I would like to discuss next is artificial replacement of the knee. Now, this has been around for years and years and years in this country and even longer in Europe, and I think people got pretty used to the notion that when the knee wears out we replace it. There has been a lot of change over the last few years in terms of knee replacement, so what I want you to do is bring us up to speed in terms of where we are with total knee replacements, how you use that in your practice, and a little bit about how it's done. So bring us up to speed about artificial knee replacements.
Dr. Mazzara: Well, total knee replacements are actually very effective reliable treatments for end-stage knee osteoarthritis in patients who have tried and not responded to other, less invasive, treatments. So, if somebody comes into the office with knee pain, if they have had conservative treatment with medication or activity modification or injections or sometimes therapy, they can become a candidate for a total knee replacement if all other options have been exhausted. It's something that we used to restrict to older patients, and the earlier philosophy was that you used to have to wait you're 65 to have your knee replaced, but with new technology today we're actually finding that it's a very effective reliable way to treat even younger patients. I have patients in their 30s and 40s who've had to have their knee replaced for one reason or another, after having exhausted all other non-operative, and even some surgical, treatments that don't require replacement of the joint. In the patient who comes in who needs a knee replacement, they are counseled and we discuss the options, including living with the pain and discomfort. If they can live with it, that's not entirely a bad thing. Generally patients are at a point where they have exhausted their options, they've decided they can't live with it, they have pain every day, and their quality of life is so adversely affected by their knee pain, that their only realistic choice is to have their joint replaced. So, after a thorough discussion of the risks and benefits of surgery, they might be scheduled for a replacement. Technically, what we're really doing is resurfacing the knee. While some patients may ask, "Well, are you removing the entire part of the joint?", really what we're doing is removing the end of the bone, resurfacing by cutting the arthritis off the end of the bone and replacing that with a metal prosthesis in-between which is a surface of polyethylene or plastic giving u...