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Lateral Approach Total Knee Replacement
I accompanied my wife for an Orthopedist consulatation at AOS (Advanced Ortho & Spine) for her bone on bone discomfort. They promote a New Era in Knee Replacement with Side Incision, claiming less pain and faster recovery with no muscle cutting. We reviewed patients on video walking naturally with no limping post two weeks TKR along with their testimony. I have had three traditional (vertical incision over the front of the knee) TKR surgeries, one being a revision, with the usual painful long term recovery.
Has anyone had this side incision procedure and will you share your pro/con experience. Thank you
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@steveinarizona
Five weeks ago I had my TKR. As in the case of my left hip replacement, zero meaningful post surgical pain. Once again I had a prescription for Oxycodone and never took a pill. On day 21 post surgery my physical therapist measured my ROM at 122. On day 27 post surgery I was on the golf course.
I did a ton of research to determine that I had the best doctor (I used to say in the state but now I say perhaps in the country). He did a mini midvastus method (comes in through the front but then slides down and goes under the tendon and through the muscle fibers), did NOT use a tourniquet, did a bicruciate retaining implant (Journey II XR -- kept my PCL and ACL intact) and did a Functional Alignment. Most importantly, he has done this exact procedure many times (I even found a video of him doing the exact same procedure in 2020 at an orthotics innovation conference). I went home the same day.
My heel pain is gone so it definitely was a nerve impingement caused by my pre-surgery misalignment.
My knee feels good although it is warm to the touch. My therapists are working on my quads and my ROM is up to 125. Now I have to work on my endurance as I spent the last nine months barely able to move.
@terrwynl My surgeon does not do a lateral approach either yet. It kind of seems that patient testimonies are all we can go by currently... but it concerns me to be one of the first in a surgeon's new way of doing things, no matter how great the testimonies. I was told those doing the "Jiffy" have done 10 procedures under Dr. Patel before starting their practices back home. Mind you, these are experienced ortho Drs already. The #s of surgeons trained with this approach is climbing.
I so appreciated the standards of care that I received from a Center of Excellence. I had received a binder-full of education for every step of the way. The road to recovery was aided by "Mychart" follow-up and great medication oversight (stomach, pain, anticoagulants...).
If I choose the new approach, will all those bases be covered? So much to consider. Shorter recovery time and better outcomes for flexion and extension will be my pursuit.
There are many approaches. Where you cut is just one of the decisions. some do lateral (like Jiffy knee), some do other subvastus methods, and some, like my surgeon, do mini midvastus. In all cases the goal is the same: minimize muscle, tendon and ligament damage while doing the replacement.
@cathymw
On day 21 post surgery my therapist measured my ROM at 122. Five weeks later it is hovering around 125/127. I don't know why I came out of the surgery with such good ROM and others much worse ROM. Was it the use of a bicruciate retaining implant? The Functional Alignment that Dr. Chow did to correct my severe misalignment and nerve impingement? The surgical skill of Dr. Chow? Pure luck? I wish I knew.
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1 ReactionCongratulations on your successful TKR outcome. The factors that contribute to either successful or unsuccessful surgeries are too many to list. The 80/20 good to bad stats indicates TKR surgeries are a crap shoot. Best wishes on your good fortune.