Knee Replacement Surgery in Kirkland, WA

Knee Arthritis

Knee arthritis is a common condition that may be caused by prior trauma, rheumatoid arthritis and degenerative arthritis (osteoarthritis). Symptoms of knee arthritis include pain, swelling and stiffness. Sometimes the knee may catch or feel like it is unstable. Over time it may become increasingly difficult to exercise and perform normal activities. Initially, knee arthritis is treated with activity modification, medications and possibly injections. Some patients benefit from bracing and physical therapy/exercise. When non-operative treatments are no longer effective knee replacement surgery is very effective in relieving pain from arthritis.

Knee Replacement

Knee replacement surgery involves removing the damaged areas of cartilage and a small amount of bone and then placing metal and plastic components in their place. In a total knee replacement all joint surfaces, (tibia, femur, and patella) are replaced. In cases where only a part of the knee is arthritic, a partial knee replacement can be done.

Dr. Clinton uses minimally invasive techniques for knee replacement. This results in smaller incisions and less soft tissue damage. The result is less post-operative pain and a quicker recovery. We also use computer navigation and robotics to aid in placing the knee in ideal alignment while using small incisions.

While knee replacement can be a painful surgery we now have much better methods for post-operative pain control. We use long acting local anesthetic or joint blocks at the time of surgery. This is very effective at controlling pain for the first 48-72 hours. Following this, we use multimodal pain management techniques for effective pain control.

While traditional knee replacement often required a 3-4 day hospital stay with minimally invasive techniques many patients are now able to have knee replacement as outpatients go home the same day; most others go home the day following surgery. While full recovery takes 6-12 months, patients begin walking right away and most can return to work within 4-8 weeks.

Partial knee replacement refers to replacing just one part of the knee. Sometimes arthritis affects just one portion of the knee (under the knee cap, inside of knee (medial) or outside of knee (lateral)  When this is the case just the affected portion of the knee can be replaced. This is less invasive than a total knee replacement and can lead to an even more normal feeling knee. If a partial knee replacement wears out it can then be changed to a total knee replacement.

Computer Navigation or computer-assisted surgery allows us to have real time information about your knee alignment and motion in the operating room. Small trackers are attached to the bones of the leg and communicate with a computer in the operating room. This gives us very precise information about the alignment and motion of the knee as well as any bone deformity. Bone cuts and placement of the total or partial knee replacement are then planned accordingly. This reduces any risk of malalignment of the knee while also allowing us to use minimally invasive techniques.

Makoplasty™ is robotic arm assisted surgery. Prior to surgery, a CT scan is done. This allows for 3D modeling of the knee. Similar to computer navigation trackers or arrays are attached to the bones of the leg. This corresponds to a computer in the operating room which also has the CT and 3D modeling loaded on it. Using this information and real time information in the operating room of the knee motion and stability we are able to very precisely plan our bone cuts and implant placement. A robotic arm then is used to assist in making very precise bone cuts. Makoplasty™ can be used for total and partial knee replacements.

Many patients can now have a knee replacement and go home the same day. This is possible due to improved surgical techniques which allow for smaller incisions, less soft tissue damage and less pain. In addition, with current medications and surgical techniques, blood loss is much less than it was for traditional knee replacement. Pain control is much better and many patients have relatively mild pain following surgery due to joint blocks and multimodal pain management techniques.