Knee Replacement Surgery Boulder City NV

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Archie C Perry, MD
(701) 731-1616
2800 E Desert Inn Rd
Las Vegas, NV
Business
Desert Orthopaedic Center
Specialties
Orthopedics

Data Provided By:
Ivan Mindlin, MD FACS
1036 New Creek Ave
Henderson, NV
Gender
Male
Education
Medical School: Manitoba
Graduation Year: 1955

Data Provided By:
Michael Stephen Ravitch, MD
(702) 564-1234
106 E Lake Mead Pkwy Ste 108
Henderson, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Oh State Univ Coll Of Med, Columbus Oh 43210
Graduation Year: 1966

Data Provided By:
Richard Michael Dix, MD
(702) 451-0517
PO Box 50129
Henderson, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tx Med Sch At San Antonio, San Antonio Tx 78284
Graduation Year: 1977

Data Provided By:
Michael S Ravitch
(702) 564-1234
1681 W Horizon Ridge Pkwy
Henderson, NV
Specialty
Orthopedic Surgery

Data Provided By:
Wilfred Krom, MD
(213) 749-4355
Henderson, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of The Witwatersrand, Med Sch, Johannesburg, So Africa
Graduation Year: 1959

Data Provided By:
Roger Alfred Fontes Jr, MD
106 E Lake Mead Pkwy Ste 108
Henderson, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Washington Univ Sch Of Med, St Louis Mo 63110
Graduation Year: 1993

Data Provided By:
Arthur Lowell Tracht, MD
Henderson, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Emory Univ Sch Of Med, Atlanta Ga 30322
Graduation Year: 1969
Hospital
Hospital: Dekalb Med Ctr, Decatur, Ga
Group Practice: North Dekalb Orthopedics Pc

Data Provided By:
Roger A Fontes
(702) 564-1234
1681 W Horizon Ridge Parkway
Henderson, NV
Specialty
Orthopedic Surgery

Data Provided By:
Dr.Ronald Koe
(702) 990-4555
1710 W Horizon Ridge Pkwy #120
Henderson, NV
Gender
M
Education
Medical School: Creighton Univ Sch Of Med
Year of Graduation: 1990
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
4.0, out of 5 based on 4, reviews.

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How to Delay That Knee Replacement

Patients with malalignment of the knee that leads to arthritis face some unique challenges. The alignment problems usually mean one side of the knee wears out faster than the other. They can't just have a knee replacement -- or even a unicompartmental procedure. Unicompartmental means just the side that's arthritic is replaced.

And why not? Because the cause of the arthritis is the way the bones fit together to form the knee. In most cases, there is too much pressure on the medial compartment (that's the side of the knee closest to the other knee). Replacing the joint (or the medial half of the joint) doesn't change the alignment issues. That's where a procedure called tibial osteotomy comes in handy.

In this operation, the surgeon removes a wedge- or pie-shaped piece of bone from one side of the tibia<>/i (lower leg bone). The purpose of the osteotomy is to correct the malalignment and take pressure off the medial compartment. There are two ways to do this surgery. Both remove bone from the upper tibia near the knee. The medical term for this type of osteotomy is high tibial osteotomy (HTO).

The first way to do the high tibial osteotomy is called a medial opening wedge tibial osteotomy. Bone is removed from the medial side of the tibia, shifting the weight off the medial compartment and more toward the midline. The two edges of remaining bone are held open with a metal plate or special device called a fixator.

The second method is a lateral closing wedge osteotomy. In this type of osteotomy, bone is taken from the lateral side of the tibia (side away from the other knee). The two edges of the bone are then allowed to shift closer together. The effect is the same as the opening wedge osteotomy: to take pressure off the damaged medial compartment.

There are advantages and disadvantages to each type of osteotomy. Many surgeons prefer the medial open wedge osteotomy because there's less chance of causing shortening of the leg and fewer complications with nerve injuries.

In this study, 106 medial opening wedge high-tibial osteotomies were done for patients who had malalignment leading to arthritis of the medial knee joint. The size of the osteotomy (determined by the amount of bone removed) depended on the overall condition of the knee.

For example, the surgeon looked at the other side of the knee during surgery to see what kind of arthritic changes might have been present there. Most of the time, they tried to correct the alignment to neutral but sometimes it was necessary to overcorrect, shifting weight past the middle to the other side.

The patients were active and interested in delaying joint replacement for as long as possible. In addition to the osteotomy, they also had a microfracture procedure. Microfracture involves drilling tiny holes in the damaged joint surface down to the first level of bone (subchondral bone). Blood seeping into the joint through the holes helps the healing process and ...

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