As the most common form of arthritis, osteoarthritis is a degenerative joint disease that causes deterioration of cartilage between bones. Factors that may cause the development and progression of the disease include aging, genetics, obesity, and joint injuries from sports, work, or accidents. There are an estimated 21 million people in the United States who suffer from osteoarthritis.
A healthy knee is designed to move and endure the forces of everyday activities. Cartilage that covers the ends of our bones acts like a cushion or shock absorber to prevent joints from grinding. For those who suffer from osteoarthritis of the knee, the cartilage of the affected joint is roughened and becomes worn down, causing the bone ends to rub against each other.
Osteoarthritis usually affects the weight-bearing sections of the knee, which include the junction of the lower leg bone (tibia) with the upper leg bone (femur), and beneath the kneecap (patella). The disease may affect only one section of the knee, leaving the two other sections relatively healthy. While anti-inflammatory drugs, cortisone injections, and physical therapy are short-term solutions to managing the pain, many people eventually require knee replacement surgery.
Individuals with osteoarthritis may experience aching, stiffness, and eventual loss of mobility within the knee joint. Inflammation may or may not be present. The pain may be severe at times, followed by periods of relative relief. It often worsens after extensive use of the knee and is more likely to occur at night than in the morning. Stiffness tends to follow periods of inactivity, such as sleep or sitting and can be eased by stretching and exercise. Pain also seems to increase in humid weather. As the disease progresses, the pain may occur even when the joint is at rest and can keep the sufferer awake at night.
Osteoarthritis is often visible on X-rays. Cartilage loss is indicated if the normal space between the bones is narrowed, if there is an abnormal increase in bone density, or if bony projections or erosions are evident. A blood test for rheumatoid is often taken to rule out rheumatoid arthritis.
Your surgeon will conduct an examination of your knee, including range of motion and detection of deformities (conditions better known as "knock-kneed" or "bowlegged"). You will be asked to describe the pain in your knee.
Your physician will also record your medical history, often asking you a series of questions about injuries, infections, ailments you have experienced, and any medications you are taking.
From this information and examination, your physician will choose the most appropriate treatment option.
Once your doctor diagnoses osteoarthritis, you should discuss with him the possible treatment options and which one best suits the severity of your condition.
The NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee is the latest in total knee replacement options from Zimmer. The NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee is specifically designed to safely accommodate flexion of up to 155 degrees. Generally, knee replacements have been designed to accommodate flexibility up to 125 degrees.
Flexion is the action of bending a joint, such as your knee or elbow. The opposite motion is extension, which is the act of straightening a joint, such as the knee when you are standing.
Your need and desire for high flexion may be dictated by your favorite activities or cultural background. Many daily activities require the ability to bend the knee beyond 125 degrees. Climbing stairs, for example, requires a range of motion from 75 to 140 degrees while sitting in a chair and standing up again requires a 90-to-130-degree range of motion. Other activities, like gardening, playing golf, or kneeling for prayer involve motions that require up to 130 to 150 degrees of flexion to perform.
The NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee is specifically designed to safely accommodate up to 155 degrees of flexion in patients who had this ability before surgery. This means that with appropriate rehabilitation a patient can resume an active lifestyle after total knee replacement—deeply bending the knee for recreational, religious, and other day-to-day activities. Patients today want to continue their previous lifestyles—even after total knee replacement. The NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee may be an option for many patients to help them achieve this goal.
A number of factors can determine whether a patient is qualified to receive the NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee. These factors will also help determine how successful the overall outcome will be. The ideal candidate will be one who is capable of fairly high flexion before the surgery and who is willing and able to undergo the rehabilitation (physical therapy) necessary to regain flexion after surgery. Other factors such as weight and activity level are considered in determining if the NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee is the most appropriate implant solution. You should discuss this question with an orthopedic surgeon to assess whether the NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee is the best option for you.
To find the closest physician in your area who can implant the NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee, call the toll-free number 1-866-FIND-MIS or search this Web site for a physician in your region. Click on Find a Doctor section of the site to get a list of physicians in your area.
Call the toll-free number 1-866-FIND-MIS to order free patient education materials from this site
The surgery for the NexGen Complete Knee Solution LPS-Flex Fixed Bearing Knee basically is the same as for other total knee replacements. You will first be taken into the operating room and given anesthesia. After the anesthesia has taken effect, the skin around the knee is thoroughly scrubbed with an antiseptic liquid. The knee is flexed about 90 degrees and the lower portion of the leg, including the foot, is placed in a special device to securely hold it in place during the surgery. Usually a tourniquet is then applied to the upper portion of the leg to help slow the flow of blood during the surgery.
An incision is then made that typically extends from just above the knee to just below the knee. The incision is gradually made deeper through muscle and other tissue until the bone surfaces are exposed.
The damaged bone surfaces and cartilage are then removed by the surgeon. Precision instruments and guides are used to help make sure the cuts are made at the correct angles so the bones will align properly after the new surfaces (implants) are attached. Small amounts of the bone surface are removed from the front, end, and back of the femur. This shapes the bone so the implants will fit properly. The amount of bone that is removed depends on the amount of bone that has been damaged by the arthritis.
An implant is attached to each of the bones. These implants are designed so that the knee joint will move in a way that is similar to the way the joint moved when it was healthy. The implants are attached using a special kind of cement for bones. If necessary, the surgeon may adjust the ligaments that surround the knee to achieve the best possible knee function.
When all of the implants are in place and the ligaments are properly adjusted, the surgeon sews the layers of tissue back into their proper position. A plastic tube may be inserted into the wound to allow liquids to drain from the site during the first few hours after surgery. The edges of the skin are then sewn together, and the knee is wrapped in a sterile bandage. The patient is then taken to the recovery room.
Your doctor may recommend that you try and do some exercises in the weeks before surgery to help condition your muscles to support flexion when the new joint is implanted. Talk with your doctor to learn if he or she has any recommendations.
Since rehabilitation is crucial to a successful outcome, your doctor may recommend an early and aggressive rehabilitation regimen after surgery and after you leave the hospital. After discharge, your physician will refer you to a physical therapist. Your therapist will work with you to help you regain your strength, balance, and range of motion. Your commitment to following proper prescribed home exercises and additional rehabilitation is critical to the success of the surgery.
The Zimmer MIS 2-Incision Hip Procedure is one of the least invasive surgical options available for hip replacement today. When performing the procedure, surgeons make two incisions as small as 1½ to 2 inches each, and generally separate the muscles and tendons to access the hip joint. Traditional surgery typically involves a 10- to 12-inch incision and the cutting of those key tissues.
Zimmer makes specialized instruments and provides training in minimally invasive surgical techniques that allow orthopedic surgeons to access the hip joint and perform the surgery through a much smaller incision than is used for traditional hip replacement.
It’s mainly the healing of cut muscles and tendons that can make recovery from traditional hip replacement surgery so long and painful. Because those tissues generally aren’t cut in the Zimmer MIS 2-Incision Hip Procedure, potential patient benefits include:
Long-term study is ongoing. However, more than 500 patients have received the procedure.
MIS Risk Statement:
Your results will depend on your personal circumstances. Not everyone is a candidate for minimally invasive hip replacement. Talk with your surgeon to determine if this procedure is the best option for you.
Your results will depend on your personal circumstances. And just like a natural hip, how well the materials in an artificial hip withstand the wear and tear that come with everyday use and rotation of the hip joint contributes to how long the artificial hip will last.
No. The replacement hip—comprised of a stem, ball, and socket—is the same high-quality, prosthesis that is used in traditional surgery.
There is no reason to believe that the longevity of a hip replaced with the Zimmer MIS 2-Incision technique will be different than one replaced with traditional surgery. Of course, as with any surgery, individual results will vary. How long a hip replacement lasts—no matter how the procedure is performed—varies depending on a number of factors, including bone quality, weight, activity level, and other health factors.
Although most people who are eligible for traditional hip replacement surgery are candidates for the Zimmer MIS 2-Incision Hip Procedure, there are exceptions. You may not be a candidate if you are very muscular, have recently or have already had hip replacement surgery on the same hip. However, you may still be a candidate for traditional surgery or the Zimmer® MIS Mini-Incision Total Hip Procedure, another less-invasive technique with similar patient benefits.
No. Surgeons must receive training through The Zimmer Institute to perform the Zimmer MIS 2-Incision Hip Procedure. For more information, Find A Doctor or call toll-free, 1-866-FIND-MIS.
Yes. Although insurance plans vary, the Zimmer MIS 2-Incision Hip Procedure is usually covered by insurance in the same manner that traditional hip replacement surgery is covered. Check with your insurance plan in advance to be sure.