Knee Replacement Surgery Edgewood MD

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Constantine A Misoul, MD
(410) 682-5500
901 Eastern Blvd
Essex, MD
Business
Multi Specialty Healthcare
Specialties
Orthopedics

Data Provided By:
Jay Yale Rudo, DDS
(410) 679-2523
1401 Pulaski Hwy Ste V
Edgewood, MD
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Douglas Gregory Wright, MD
(410) 569-3690
2012 S Tollgate Rd Ste 109
Bel Air, MD
Specialties
Orthopedics
Gender
Male
Education
Medical School: New York Med Coll, Valhalla Ny 10595
Graduation Year: 1983

Data Provided By:
Joseph La Ponzina, DDS
2105 Laurel Bush Rd Ste 103
Bel Air, MD
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Todd John Tredinnick, MD
(410) 879-0090
520 Upper Chesapeake Dr Ste 304
Bel Air, MD
Specialties
Orthopedics
Gender
Male
Education
Medical School: Pa State Univ Coll Of Med, Hershey Pa 17033
Graduation Year: 1995

Data Provided By:
Cyrus Pezeshki MD
(410) 282-2211
6730 Holabird Ave
Baltimore, MD
Specialties
Orthopedics

Data Provided By:
Carl Alvin Johnson, MD
(410) 550-2117
Kingsville, MD
Specialties
Orthopedics
Gender
Male
Education
Medical School: Johns Hopkins Univ Sch Of Med, Baltimore Md 21205
Graduation Year: 1977

Data Provided By:
Douglas Wright
(410) 569-3690
2012 S .Tollgate Rd.
Bel Air, MD
Specialty
Orthopedic Surgery

Data Provided By:
James Nicholas Leyko, DDS
(410) 256-5577
4204 Forge Rd
Perry Hall, MD
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Edward G O'Mara
(410) 877-1666
1131 Baltimore Pike
Bel Air, MD
Specialty
Orthopedic Surgery

Data Provided By:
Data Provided By:

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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