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Nanoknee, is it better or merely hype?
Unfortunately, I have been diagnosed with arthritus in my left knee and told that it will eventually need a TKR. I have a friend who has had both knees replaced and heard horror stories about how painful it is. Searching the web I found a site (nanoknee.com) that claims that there knee replacement method is faster, better and less painful. Is this true? It seems that if it were better it would be used more often than titanium replacements. Supposedly it has been used for 10 years so there must be patients who have undergone it. Any advice would be helpful.
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@imaginger was paying the 8500 causing the regret? Sounds less painful?
All 3 Mayo Clinics use Mako. I trust their orthopedic surgeons more than commercial for profit centers only in it for the money.
@catheem
Jiffy knee and Nano knee use a subvastus method. My surgeon used a midvastus method and the 12 hour nerve block. My surgeon is incredible and after the nerve block wore off I still had no meaningful pain. 21 days post surgery and I was measured with my flex being 122. Then I went to my golf club and tried hitting some balls on the range. I swung very easy but I could hit the ball and I will be playing with my regular foursome on Tuesday which will be 27 post surgery.
Jiffy and Nano are marketing gambits but they do work well for non problematic cases. My surgeon said he used the midvastus method instead of the subvastus method for two reasons: (1) he is leaving a path for any future revisions should it become necessary; and (2) He was doing a bicruciate retaining implant (BCR) and a functional alignment (I was severely misaligned) and these two require more complex surgery and the midvastus approach gives him a wider field to work in.
The subvastus approach goes under the tendon and muscle; the mini midvastus approach goes through the muscle fibers and also skips the tendon. The subvastus approach gives slightly less pain than the midvastus but both are way superior to the traditional approach which cuts both the muscle and tendon and then repairs them at the end.
My surgeon is an engineer by training and is the principal inventor of the Superpath method for hip replacements and has a number of patents. Nonetheless, he says (and I agree) that the most important qualification is extensive experience doing the exact same procedure. I would look for at least several hundred such procedures. If a surgeon had been doing traditional hip surgery, had recently moved on to Superpath but had only done 15 of them so far, both my doctor and I would rather have that surgeon use the traditional (most likely painful) method because he is not extensively experienced on the Superpath method.
So go ahead and check out the Jiffy and Nano surgeons. For example, there is a Jiffy knee surgeon in my area that has extensive experience. My surgeon is also a revision surgeon (he spends about 20% of his time revising others' work) and he told me that he has not seen anything bad out of this Jiffy doctor. That is a compliment.
At the end of the day, there is still an element of chance involved. But selecting the right surgeon can significantly improve your chances of getting a good recovery.
For whatever it is worth, here are my surgeon requirements:
(1) subvastus or midvastus approach
(2) BCR implant (95% of knee surgeons remove the ACL and a large proportion also remove the PCL. They then let the implant try to serve the function of those ligaments. A BCR retains both ligaments. So after surgery I still have all my ligaments and they are working. But the surgery for doing this is more complex.
(3) Modern alignment repair meaning NOT mechanical alignment (which was always the gold standard and is now fools gold). Preferably Functional alignment but kinematic or inverse kinematic would be okay.
(4) NO routine use of a tourniquet
(5) Extensive experience doing the above
(6) great mind
(7) Great hands.
I found someone who met all 7 of these. But if you can't, #5 is the most important.
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2 Reactions@imaginger
Nano and Jiffy are marketing gambits. They focus on the initial cut but there is far more to a knee replacement than how one enters the leg. There is the choice of implant materials (are you allergic to metals?), implant brand, implant type (a BCR requires a different type of implant than a posterior stabilized implant which removes both the PCL and the ACL), the use of a tourniquet, the type of alignment, etc.
Nano and Jiffy are a good starting point. But look for someone doing a similar method (subvastus or midvastus) with lots and lots of successful experience.
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1 Reaction@gratefulbob
My incredible surgeon does not take medicare nor insurance. But his office will process the surgery with your insurance company. So my surgeon's fee was $5,500 but the rest of the cost (outpatient facility, robot use, etc.) was covered by my Medicare Advantage PPO plan (which, incidentally, is the only Medicare Advantage Plan accepted by the Phoenix Mayo Clinic).
Incidentally, I am 80 years old and that $5500 is the best money I have ever spent. Finding the superb surgeon is not easy. There are too many out there and the ones I definitely don't want are the ones who fill the HMO networks. Unfortunately, the really outstanding physicians are beginning to withdraw from insurance forcing some hard decisions. My Neurologist is the top rated neurologist in the greater Phoenix area but he doesn't take insurance. The same applies to my Rheumatologist. My former internist went concierge and I found another top rated internist to replace him although I did like the first one and my pain doctor also just went concierge so I replaced him with another top rated pain doctor. Have to decide which ones I am able and willing to pay for.
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1 Reaction@barbfred
I disagree. I think Jiffy knee is minimally invasive as it avoids cutting the muscle and tendon. But there are many options out there that just don't bear the trademarked name.
As I explained to someone else, my doctor did a mini midvastus method. He didn't cut the tendon nor the muscle but did go through the muscle.
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1 Reactionwhat is the name of your doctor phone number clinic or address
Dr, Jimmy Chow
https://www.chowhipandknee.com/
He has an international practice.
My Mako knee replacement covered virtually everything except a $250 copay. I have Medicare Advantage through an HMO and was referred since the HMO didn't have orthopedic surgeons on staff. Since this a Mayo site contact them to see if your insurance covers it.
Note I am a former Mayo patient who no longer resides near a Mayo Clinic and had my TKR done at Eisenhower Medical Center in Rancho Mirage. I highly recommend Eisenhower if you are in SoCal. I can recommend the surgeon there if interested.
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1 Reaction@imaginger
Hi,
I am considering nano surgery.
Would you recommend it over regular TKR ?
Do you think it is worth the $8500 cost to reduce the recovery time and pain?
In your experience is the recovery that mucj quicker?
Thanks
,Jay