Knee Replacement Surgery Sterling CO
Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1980
Hospital: St Anthony Hosp Central, Denver, Co; East Morgan County Hosp, Brush, Co; Melissa Mem Hosp, Holyoke, Co; Sedgwick County Mem Hosp, Julesburg, Co; Sterling Regional Medcenter, Sterling, Co; Memorial Health Center, Sidney, Ne
Group Practice: Nor
Colorado Springs, CO
Colorado Springs Orthopaedic Group
Greenwood Village, CO
Orthopedic Surgery, Adult Reconstructive Orthopaedic Surgery, Sports Medicine
Colorado Springs, CO
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1971
Johnson Chiropractic P.C.
Back pain,Chronic pain,Foot pain,Leg pain,Lower back pain,Migraine headaches,Neck pain,Upper back pain
Chiropractic adjustment,Chiropractic care,Spinal manipulation
American Chiropractic Association,Colorado Chiropractic Association
Fort Collins, CO
Medical School: Univ Of Co Sch Of Med, Denver Co 80262
Graduation Year: 1977
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 ...