Nanoknee, is it better or merely hype?

If NANO Knee is so good why aren't top hospitals doing this surgery.My husband who is sober 40 yrs did it because of adds on TV.He didn't know it was going to be a partial knee replacement until they cut him opened.I saw his XRAYS they didn't even look that bad.He drives 130 miles a day 4 to 5 times a week at 72 yrs of age.He did great with the surgery,didn't do a lot of rehab took half an oxy,day and night.He has no pain driving anymore.The scar is not that small.
I need a full knee replacement and also have a knock-knee.Bone on bone with a lot of arthritis.I am 67 and am still active in sports.Softball,pickelball and biking.I am looking for the best surgery possible and have my reservations regarding the NANO knee.Shouldn't they know before cutting you opened if you will have TKR or PARTIAL.IS IT REAL OR MARKETING.

If NANO Knee is so good why aren't top hospitals doing this surgery.My husband who is sober 40 yrs did it because of adds on TV.He didn't know it was going to be a partial knee replacement until they cut him opened.I saw his XRAYS they didn't even look that bad.He drives 130 miles a day 4 to 5 times a week at 72 yrs of age.He did great with the surgery,didn't do a lot of rehab took half an oxy,day and night.He has no pain driving anymore.The scar is not that small.
I need a full knee replacement and also have a knock-knee.Bone on bone with a lot of arthritis.I am 67 and am still active in sports.Softball,pickelball and biking.I am looking for the best surgery possible and have my reservations regarding the NANO knee.Shouldn't they know before cutting you opened if you will have TKR or PARTIAL.IS IT REAL OR MARKETING.

@sheliae
Mostly but not entirely. My surgeon could tell from the x-rays that I appeared to have arthritic results in all three compartments BUT he said he would check once he opened me up and if he could do a partial instead, he would. He said he keeps a full complement of partial and full implants in the operating theater.

So it is possible that he would do a partial for me without knowing for sure before hand. But that should be part of the pre-surgery discussions with the surgeon.

If you really want the best, I would suggest coming to Phoenix to see my guy -- Jimmy Chow. He has an active travel practice. He is the primary inventor of the Superpath method of minimally invasive hip replacement and he did my left hip four years ago. I had no post surgery pain. My right knee failed a little over a year ago and he replaced my right knee. Once again, no pain post surgery.

The caveat on Dr. Chow is that he does not take insurance and has withdrawn from Medicare. I had to pay his fee directly to him but the rest was covered by my Medicare Advantage PPO plan. Amazingly, his fee is less than the Nano Knee fee.

I had constant but manageable pain in my right knee before surgery. But I was also severely misaligned (valgus) and if I stepped the wrong way an extremely sharp pain ran down my leg. Presumably a nerve impingement. I also had ankle pain and even went to a foot/ankle surgeon to confirm that it was referred pain from the knee.

I was not afraid of the surgery. What I was afraid of was general anesthesia. I confirmed that his regular practice was a spinal with a temporary nerve block but I also confirmed that when I met with the anesthetist before the surgery. I was his last surgery of the day (another story) and I was still home before dark.

Dr Chow did a mid vastus cut and did NOT use a tourniquet. He had initially determined from the MRI that my ACL and PCL were intact and strong and told me that it appeared that he could do a bicruciate retaining implant (BCR). In 99+% of all TKRs the ACL is removed and in a substantial portion the PCL is removed as well. in a BCR, the ligaments are retained and protected. But it is more complex surgery and very, very few do it. Dr. Chow is one of the very few who not only do it but does it regularly. There is even a video of him doing the exact procedure for an orthopedic innovations conference in 2020. Very few manufacturers of implants even have a BCR version. Dr. Chow did a BCR for me so post surgery I still have all my ligaments.

I have a bunch of criteria for a knee replacement surgeon. Dr. Chow satisfied all of them:

1) Uses a minimally invasive method -- subvastus or midvastus;
2) Does NOT use a tourniquet;
3) Uses a robot to assist him;
4) Does a Functional alignment to repair my misalignment. A kinematic or inverse kinematic alignment would have been acceptable but not the traditional mechanical alignment;
5) HAS EXTENSIVE EXPERIENCE DOING THE EXACT PROCEDURE THAT HE WOULD DO FOR ME;
5) Has great hands; and
6) Has a great mind.

I have been trying to figure out why my procedure went so well and others not so much even though they may have done much the same procedures. I have now tentatively concluded that the answer lies in #s 5 and 6 above. Images can give guidance and help the surgeon build a model implant but exactly where to cut and how much is still an art form. That is where great hands and a great mind come into play.

Before my surgery I told Dr. Chow that I wanted to be back on the golf course by the end of four weeks. He replied that it was an aggressive target but he was up to it if I was. I was. He was. On the 27th day after my surgery, I was playing golf.

I am an 81 YO male. I recently had my six month checkup with him. He told me I had no limitations. I asked if that meant I could go on trampolines with my grandkids; he said yes. I asked him if that meant I could run; he said if I wanted to.

See @sailnsun's comments experience reflected in this post in this forum:
https://connect.mayoclinic.org/discussion/3rd-knee-replacement-in-a-year-and-a-half-on-same-knee/
Good luck.

Steve

@sheliae
Mostly but not entirely. My surgeon could tell from the x-rays that I appeared to have arthritic results in all three compartments BUT he said he would check once he opened me up and if he could do a partial instead, he would. He said he keeps a full complement of partial and full implants in the operating theater.

So it is possible that he would do a partial for me without knowing for sure before hand. But that should be part of the pre-surgery discussions with the surgeon.

If you really want the best, I would suggest coming to Phoenix to see my guy -- Jimmy Chow. He has an active travel practice. He is the primary inventor of the Superpath method of minimally invasive hip replacement and he did my left hip four years ago. I had no post surgery pain. My right knee failed a little over a year ago and he replaced my right knee. Once again, no pain post surgery.

The caveat on Dr. Chow is that he does not take insurance and has withdrawn from Medicare. I had to pay his fee directly to him but the rest was covered by my Medicare Advantage PPO plan. Amazingly, his fee is less than the Nano Knee fee.

I had constant but manageable pain in my right knee before surgery. But I was also severely misaligned (valgus) and if I stepped the wrong way an extremely sharp pain ran down my leg. Presumably a nerve impingement. I also had ankle pain and even went to a foot/ankle surgeon to confirm that it was referred pain from the knee.

I was not afraid of the surgery. What I was afraid of was general anesthesia. I confirmed that his regular practice was a spinal with a temporary nerve block but I also confirmed that when I met with the anesthetist before the surgery. I was his last surgery of the day (another story) and I was still home before dark.

Dr Chow did a mid vastus cut and did NOT use a tourniquet. He had initially determined from the MRI that my ACL and PCL were intact and strong and told me that it appeared that he could do a bicruciate retaining implant (BCR). In 99+% of all TKRs the ACL is removed and in a substantial portion the PCL is removed as well. in a BCR, the ligaments are retained and protected. But it is more complex surgery and very, very few do it. Dr. Chow is one of the very few who not only do it but does it regularly. There is even a video of him doing the exact procedure for an orthopedic innovations conference in 2020. Very few manufacturers of implants even have a BCR version. Dr. Chow did a BCR for me so post surgery I still have all my ligaments.

I have a bunch of criteria for a knee replacement surgeon. Dr. Chow satisfied all of them:

1) Uses a minimally invasive method -- subvastus or midvastus;
2) Does NOT use a tourniquet;
3) Uses a robot to assist him;
4) Does a Functional alignment to repair my misalignment. A kinematic or inverse kinematic alignment would have been acceptable but not the traditional mechanical alignment;
5) HAS EXTENSIVE EXPERIENCE DOING THE EXACT PROCEDURE THAT HE WOULD DO FOR ME;
5) Has great hands; and
6) Has a great mind.

I have been trying to figure out why my procedure went so well and others not so much even though they may have done much the same procedures. I have now tentatively concluded that the answer lies in #s 5 and 6 above. Images can give guidance and help the surgeon build a model implant but exactly where to cut and how much is still an art form. That is where great hands and a great mind come into play.

Before my surgery I told Dr. Chow that I wanted to be back on the golf course by the end of four weeks. He replied that it was an aggressive target but he was up to it if I was. I was. He was. On the 27th day after my surgery, I was playing golf.

I am an 81 YO male. I recently had my six month checkup with him. He told me I had no limitations. I asked if that meant I could go on trampolines with my grandkids; he said yes. I asked him if that meant I could run; he said if I wanted to.

See @sailnsun's comments experience reflected in this post in this forum:
https://connect.mayoclinic.org/discussion/3rd-knee-replacement-in-a-year-and-a-half-on-same-knee/
Good luck.

Steve

@steveinarizona It's sailnsun Steve. Thought I'd chime in with an update. I had my 6 week follow up with Dr. Chow yesterday (May 11). He's very pleased with my progress and says I'm way ahead of the game. I developed a stomach ulcer from all the NSAIDS (Ibuprofen or Meloxicam inflammatory meds). I'm not taking any pain medication now, so my inflammation is up and that's to be expected if not taking anything. My range of motion (ROM) fluctuates between 120 - 130 degrees, depending on what I did during the day. I always measure late afternoon. The amount of swelling will affect the ROM I'm able to achieve. Prior to surgery my ROM was 112, not enough to properly peddle a bike. I can easily peddle my bike now with not pain and no clunking feeling in my knee. The surgery was done on my right knee. I can now walk up stairs leading with my right and zero pain!

I had a TKR in Lithuania by a Professor Sarunas Tarasevicius. He was supposed to do a patella femoral replacement and did not. He wanted to do a TKR. I told him 3 surgeons in Alberta told me a TKR would not help me, that I needed a PFR. He pushed for a TKR and finally convinced my husband and I to go the TKR route, because he told us he would resurface my patella and showed us how it is done on his computer. He never touched my patella and now says that it is not standard practice in Europe to resurface the patella when performing a TKR.

I'm thankful that I posted my story on this website and Steve saw it, because Steve directed me to Dr. Jimmy Chow and I am so grateful. While I still have stiffness and soreness, I'm early in the healing process. In another 6 weeks, I expect to be 100% pain and swelling free and have an ROM of 130.

Dr. Chow is a rare doctor, that will go in and fix the errors of other surgeons. He reshaped my patella, then burned off all the scar tissue using radiation. He lined my patella with a newborn's umbilical cord as it is strong, lubricant and would aid in preventing too much scar tissue from forming. He replaced the plastic femoral part of the knee implant with a larger metal one. The plastic was 10 mm in size and the metal was 12 mm. This has stopped the clunking I was feeling when I peddled a bike or came downstairs. After surgery, Dr. Chow came to talk to my husband and I. He said the amount of scar tissue he removed was larger than the size of his hand. No wonder I couldn't achieve a good ROM before.

A couple of months prior to surgery, Dr. Chow spoked to me on the phone and gave me one exercise he wanted me to do 3 times a day. I followed his instructions. It strengthened my quad.

After the surgery they applied an Inkwell tattoo on my leg on side of my knee. I take 3 photos daily. I put a black sticker in place (noted by the tattoo) and it measures the temperature of my leg and percentage of swelling. The next photo measures my ability to straighten my leg. It's perfectly straight. The 3rd photo is one where I bend my knee as much as I can and it will measure the ROM. It is very accurate as one day I was at my physiotherapists and he measured my ROM to be 126 degrees. The Inkwell tattoo measured it to be 125 a few hours later.

After my TKR, I was walking around with one crutch like cane and by afternoon, if I had been on my feet too long, then every step became painful. I could barely make it up the stairs it hurt so much.

So, thank you Steve for directing me to Dr. Chow, as he really is an awesome surgeon! I expect my life to be back to normal by June, which is what he expects as well.

The other thing I should mention, when we spoke yesterday he said we would have another follow up appointment in 6 months and then another follow up appointment in 2 yrs. I didn't have to worry about calling them for that as his office staff will put it in their calendar and they will contact me in advance. That's amazing. I've never had a surgeon care about having a follow up appointment in 6 months, let alone in 2 years!

He is so amicable and easy to talk to. But best of all, he is an amazing surgeon. Brilliant and talented hands. He wants to do the best job in can.

I thought what is this going to cost me? As it is well known that surgeries in the US can cost tens of thousands of dollars. His fee was under $8K. The highest cost was the hospital, which was just under $18K. It would have cost me that much to go to a private clinic in Canada! But, 1) no surgeon in Canada would touch me, because I had my TKR done in Lithuania ; 2) no surgeon in Canada would have done the procedure that Dr. Chow performed. I told my Sports doctor what was going to be done and he had never heard of that being done before. He was once the head physician for the Calgary Flames, so I think over the span of his career he's witnessed alot.

I'm very grateful to Dr. Chow. I'm 66 and wasn't ready to be immobile for the rest of my life. I want to play and chase after our 2 year old granddaughter. Cycle, travel and hike! This has all been on hold for me for the past 4 years. Our first meeting with Dr. Chow he asked me what I wanted to be able to do again, that I can't do now. All those things. I told him and accident downhill skiing was what started all this. He said I could ski again. I don't want to. I don't want to risk another such accident. This one cost me 4 yrs of my life.

Oh, I also want to mention my scar. So, after my TKR in Lithuania, I had a 6"-7" scar and it was about 1/16 to 1/8 inch wide. Dr. Chow followed that scar line precisely. My scar now is a pencil line thin and is practically invisible in some spots. It might all turn invisible over time. I couldn't be more pleased!

@sheliae
Mostly but not entirely. My surgeon could tell from the x-rays that I appeared to have arthritic results in all three compartments BUT he said he would check once he opened me up and if he could do a partial instead, he would. He said he keeps a full complement of partial and full implants in the operating theater.

So it is possible that he would do a partial for me without knowing for sure before hand. But that should be part of the pre-surgery discussions with the surgeon.

If you really want the best, I would suggest coming to Phoenix to see my guy -- Jimmy Chow. He has an active travel practice. He is the primary inventor of the Superpath method of minimally invasive hip replacement and he did my left hip four years ago. I had no post surgery pain. My right knee failed a little over a year ago and he replaced my right knee. Once again, no pain post surgery.

The caveat on Dr. Chow is that he does not take insurance and has withdrawn from Medicare. I had to pay his fee directly to him but the rest was covered by my Medicare Advantage PPO plan. Amazingly, his fee is less than the Nano Knee fee.

I had constant but manageable pain in my right knee before surgery. But I was also severely misaligned (valgus) and if I stepped the wrong way an extremely sharp pain ran down my leg. Presumably a nerve impingement. I also had ankle pain and even went to a foot/ankle surgeon to confirm that it was referred pain from the knee.

I was not afraid of the surgery. What I was afraid of was general anesthesia. I confirmed that his regular practice was a spinal with a temporary nerve block but I also confirmed that when I met with the anesthetist before the surgery. I was his last surgery of the day (another story) and I was still home before dark.

Dr Chow did a mid vastus cut and did NOT use a tourniquet. He had initially determined from the MRI that my ACL and PCL were intact and strong and told me that it appeared that he could do a bicruciate retaining implant (BCR). In 99+% of all TKRs the ACL is removed and in a substantial portion the PCL is removed as well. in a BCR, the ligaments are retained and protected. But it is more complex surgery and very, very few do it. Dr. Chow is one of the very few who not only do it but does it regularly. There is even a video of him doing the exact procedure for an orthopedic innovations conference in 2020. Very few manufacturers of implants even have a BCR version. Dr. Chow did a BCR for me so post surgery I still have all my ligaments.

I have a bunch of criteria for a knee replacement surgeon. Dr. Chow satisfied all of them:

1) Uses a minimally invasive method -- subvastus or midvastus;
2) Does NOT use a tourniquet;
3) Uses a robot to assist him;
4) Does a Functional alignment to repair my misalignment. A kinematic or inverse kinematic alignment would have been acceptable but not the traditional mechanical alignment;
5) HAS EXTENSIVE EXPERIENCE DOING THE EXACT PROCEDURE THAT HE WOULD DO FOR ME;
5) Has great hands; and
6) Has a great mind.

I have been trying to figure out why my procedure went so well and others not so much even though they may have done much the same procedures. I have now tentatively concluded that the answer lies in #s 5 and 6 above. Images can give guidance and help the surgeon build a model implant but exactly where to cut and how much is still an art form. That is where great hands and a great mind come into play.

Before my surgery I told Dr. Chow that I wanted to be back on the golf course by the end of four weeks. He replied that it was an aggressive target but he was up to it if I was. I was. He was. On the 27th day after my surgery, I was playing golf.

I am an 81 YO male. I recently had my six month checkup with him. He told me I had no limitations. I asked if that meant I could go on trampolines with my grandkids; he said yes. I asked him if that meant I could run; he said if I wanted to.

See @sailnsun's comments experience reflected in this post in this forum:
https://connect.mayoclinic.org/discussion/3rd-knee-replacement-in-a-year-and-a-half-on-same-knee/
Good luck.

Steve

I am so curious to find this out, too! On Facebook, there is a Nanoknee and Jiffy knee (I think the same type of surgery) and most have great outcomes. From my research, they 'can' use (maybe you have to ask for it) an On-Q pump that gives numbing for up to 3 days...which is why I am researching having mine done with one of them. The surgeon I have seen (NOT Nano or Jiffy) says the nerve block is only approx 12 hours for him, and that scares the heck out of me!

@steveinarizona, would you be able to share Dr. Chow’ contact information, I would be interested to follow up with him. Thank you 🙏