What is a Total Knee Replacement

A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. The thigh bone (or femur) abuts the large bone of the lower leg (tibia) at the knee joint. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone (tibia) is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic “button” may also be added under the kneecap surface.… Read the Rest

What should the patient know?

Barry J. Waldman MD, Esther A. Schaftel CRNP?? www.totaljointjoint.com

Unfortunately, there is an epidemic of knee arthritis in the United States.?? The American Academy of Orthopaedic Surgeons, estimates that between 2006 and 2030, the number of knee implants performed in the United States will increase from 300,000 a year to nearly 3.5 million.?? Even more concerning, the average age of knee implant patients gets younger each year1.?? It is not unusual for patients as young as 40 to experience severe knee arthritis and require knee implant surgery.???? Women account for about 60% of patients who need a knee implant – a proportion that has remained steady for the past few decades.3Read the Rest

Young Men Greater Risk Infection after TKR

Young age and male gender cited as risk factors for in-hospital SSI after THA, TKA

Orthopedics Today, September 2012 ?? Read Study Here

A recently presented study identified age, gender and racial minority status as risk factors for perioperative surgical site infection following total hip and knee arthroplasty.

“Our regression model revealed that patient-related factors such as age younger than 44 years, male gender and [racial] minority were associated with the highest odds of [surgical site infections],” Lazaros A. Poultsides, MD, PhD…… Read the Rest

Cartilage Repair Worthless

By Gabe Mirkin, M.D.

Arthroscopic surgery to trim cartilage in the knee is a worthless procedure. I have seen many patients who have had cartilage removed by surgeons for an average charge of $5000 and then they must have a knee replacement several years later. The surgeon must know about the harm he is doing because he has to see the same patients for followup when they require knee replacement surgery.

A report in the New England Journal of Medicine (July 11, 2002) shows that knee surgery to remove cartilage is worse than doing nothing. The headline from Baylor Medical School, where the landmark study was performed, is that “Study Finds Common Knee Surgery No Better Than Placebo.” Patients with osteoarthritis of the knee who underwent placebo arthroscopic surgery were just as likely to report pain relief as those who received the real procedure. The researchers say their results challenge … Read the Rest

CMS proposes major initiative for joint replacements

July 9, 2015

Model supports quality and care improvements for patient???s transition from surgery to recovery

Hip and knee replacements are some of the most common surgeries that Medicare beneficiaries receive. In 2013, there were more than 400,000 inpatient primary procedures, costing more than $7 billion for hospitalization alone. While some incentives exist for hospitals to avoid post-surgery complications that can result in pain, readmissions to the hospital, or protracted rehabilitative care, the quality and cost of care for these hip and knee replacement surgeries still vary greatly among providers.

For instance, the rate of complications like infections or implant failures after surgery can be more than three times higher at some facilities than others, increasing the chances that the patient may be readmitted to the hospital. And, the average Medicare expenditure for surgery, hospitalization, and recovery ranges from $16,500 to $33,000 across geographic areas.… Read the Rest