Our goal at The Leone Center for Orthopedic Care when performing knee replacement surgery is to perfectly re-align the limb to create a neutral mechanical axis and to balance the complex soft tissue sleeve so that natural motion is reestablished and the supportive ligaments experience equal tensions on both the inside (medial) and outside (lateral) of the knee. When this is accomplished, pain is relieved and people are again able to be very active.
Traditionally, surgeons have relied on bulky mechanical cutting blocks and instruments while depending on visual landmarks, to realign the limb and to guide component placement. Decisions to balance the soft tissue sleeve and re-create normal knee kinematics were achieved through the “art-of-feel-based” decision-making.New techniques and technologies have been developed, which include use of sophisticated computers and pressure sensors. These tools have vastly improved the consistency of achieving surgical goals by allowing us to recognize and correct subtleties in balancing the soft tissue sleeve and then optimize limb alignment.
Two computer systems: I perform total knee replacement with the aid of one computer system, which allows me to fine-tune the boney cuts so when the prosthesis is implanted, optimal limb alignment is achieved. It’s like a GPS in my operating room, because I can see on a computer screen in “real time” proposed bone angles and levels which need to be made, in order to create the desired limb alignment. Using a different computer system, I measure specific pressures and their location between the inside and outside of the joint and visualize the movement of these forces as I flex and extend the knee. This data allows me to more precisely balance the soft tissue envelope.These technologies have been a game changer.
What this means for my patients is more consistent, excellent results with less soft tissue damage, a faster recovery and a pain-free quality of life. Patients also report that their knees feel more natural.