Knee Replacement Surgery Royal Oak MI

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Timothy Martin Steiner, MD
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: In Univ Sch Of Med, Indianapolis In 46202
Graduation Year: 2001

Data Provided By:
Michael Hayden Boothby, MD
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Columbia Univ Coll Of Physicians And Surgeons, New York Ny 10032
Graduation Year: 2000

Data Provided By:
Brian C Najarian, MD
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 2003

Data Provided By:
Joshua Marc Gitlin, MD
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 2002

Data Provided By:
Dilip Kumar Sengupta, MD
3601 W 13 Mile Rd
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll, Univ Of Calcutta, Calcutta, West Bengal, India
Graduation Year: 1981

Data Provided By:
Daniel Bruce Cullan II, MD
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Creighton Univ Sch Of Med, Omaha Ne 68178
Graduation Year: 2000

Data Provided By:
Theodore J Fisher, MD
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 2001

Data Provided By:
Paul William Grutter, MD
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mo, Columbia Sch Of Med, Columbia Mo 65212
Graduation Year: 1999

Data Provided By:
David Michael Montgomery, MD
(248) 280-8550
30575 Woodward Ave Ste 100
Royal Oak, MI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 1982
Hospital
Hospital: William Beaumont Hospital -Ro, Royal Oak, Mi; William Beaumont Hosp/Troy, Troy, Mi
Group Practice: Royal Oak Management

Data Provided By:
Matthew J Siskosky
(248) 280-8550
30575 Woodward Ave
Royal Oak, MI
Specialty
Orthopedic Surgery

Data Provided By:
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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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