Q&A Topic: Chronic Knee Pain and Knee Replacement

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with David J. Yasgur, MD, FAAOS

Q. Walking is a challenge and climbing stairs near impossible. My physician said total knee replacement might be an option. Are there new procedures available?
A. 3D-modeling technology is now being used to simulate the placement of knee implants and design custom-made surgical instruments to assist with accurate positioning of knee replacements weeks before surgery takes place.

This technology lets surgeons generate a three-dimensional image of the damaged knee, view it from all angles, and produce a pre-operative plan that is then used to make pin placement guides to the patient’s exact specifications. Until recently, the only option for customizing knee replacements was to make adjustments during the actual surgery. Once the patient was under anesthesia and incisions were made, the surgeon would fine-tune the fit of the replacement joint.

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This process took extra time and often placed added stress on the patient. Now, surgeons have tremendous control in fitting the implant to meet each patient’s unique needs—how much cartilage is left in the joint, for example, or how a previous trauma like a fracture will alter wear and tear.

Q. What are the advantages of this to the patient?
A. Using the custom-made instruments, knee replacements have the potential to last much longer. And because the fitting is done in advance, patients spend 15 to 20 minutes less time in surgery, reducing the risk of infections, bleeding, and other complications. With a faster, less traumatic surgery, recovery time may be shorter.

Q. Would you recommend this technology?
A. I was somewhat hesitant to use this technology at first, but once I realized the benefits, I was convinced. Interestingly, I have a history with computer-aided design, having designed and developed prostheses for total joint replacement surgery in the past. Now, I’ve come full circle and I’m using computers again to customize knee replacements for my patients.

Northern Westchester Hospital
Director of Quality and Outcomes
Orthopedic and Spine Institute
Learn More About Dr. Yasgur

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