Total knee replacement

Some injuries and some cases of arthritis are just too extreme to repair biologically. Accepting that you need an artificial implant is tough to do—but it’s the right decision when natural therapies are not effective. Here is some hopeful news about the decision to replace your joint.

This year, in the US alone, the number of total knee replacements will exceed 600,000. Eighty percent of these are unnecessary. Here is why.

Stem cells are both in and out. It was once thought that if these cells were injected into joints, they would turn into cartilage. Two problems arose. First, patients (unless they are infants) have very few stem cells left. Second, the injected cells died after releasing their instructional growth factors, never turning into cartilage. But what we have learned is that an increasing number of concentrated growth factors, immune stimulants, and even some drugs can induce the migration of the body’s own progenitor cells—some of them stem cells—cells that direct healing—to the injured area. These cells then optimize the environment around the injury to effect healing.

Total knee replacement has been a godsend for many people with severe bone-on-bone arthritis. Many of my patients are skiing, hiking, and playing sports on replaced knees at levels they have not done in years, or even decades.

Artificial knee replacement surgery used to mean the reduction of sports activities like golf, swimming, and cycling. Yet with severe arthritis affecting younger and younger people, we are currently pushing the envelope of sports participation with joint replacements and learning as we go.

Every surgeon has a different skill set—and it’s important that their preferences align with yours.

Total and partial joint replacement has finally moved out of the hospital! This has been made possible by enhanced computerized surgical planning, the use of human-guided robotic arms, and novel ways of preventing pain.

After a total joint replacement, is it possible to get back to sport? Yes! And here's why it's important that you do.

If you're due to have a total knee replacement, here are some steps you can take to have the best possible outcome.

The answer is not obvious. Doctors know enormous amounts of data and have years of clinical experience. But what do they know about which devices and implants to use?

A CT scan of your knee is used to build a computer model, which robotically guides the surgeon to precisely replace the joint, resulting in better alignment and reducing the risk of early wear. However, getting your insurance company to cover this cost is not easy.