Joint replacement surgery involves replacing irreversibly damaged cartilage and bone with artificial surfaces. The goal is to alleviate pain and improve function. With advanced implants the artificial joint lasts longer and the limb has improved motion.
With the Zimmer trabecular metal implant, components are cementless. Trabecular metal is an innovative material made with tantalum in an interconnecting, 3-dimensional lattice structure which is 80% porous. It closely resembles the microstructural architecture and mechanical properties of bone making it an ideal material for orthopedic implants. When used in joint replacements, human bone grows right into and through the trabecular metal in a rapid fashion creating a very strong bond. This allows the orthopedic surgeon to implant artificial joints without the use of bone cement. Bone cement can weaken and crack over time and generate debris. By eliminating bone cement from the implant, we can perform a simpler procedure that can last longer than the traditional cemented implantation.
Late November, 2007, Dr Michael Greller, MD, FAAOS, President of the Advanced Orthopedics and Sports Medicine Institute, and I performed the first fully cementless, minimally invasive total knee replacement using trabecular metal technology in the history of CentraState Medical Center, Freehold, New Jersey. The patient, a 50 year old retired police officer from Jackson, was referred to the Advanced Orthopedics and Sports Medicine Institute when the constant grinding pain from his knee, the stiffness and the lifestyle changes necessary because of reduced mobility overcame his fear of joint replacement surgery. Osteoarthritis, trauma, genetic factors and 25 years in the police force probably all contributed to the irreversible damage to his knee. Joint pain, swelling, stiffness and loss of mobility are symptoms experienced by about 450,000 Americans who seek surgical treatment each year.
We used a minimally invasive procedure through incisions now less than half the length of incisions made in traditional surgery in the past. Mini-incision or minimally invasive knee replacement surgery combined with new techniques in pain management and anesthesia has a significant advantage; shorter hospital stays, faster recovery, lower rates of complications. There is no violation of the quadriceps muscle with the quad-sparing approach.
The patient opted for an advanced anesthetization, a femoral nerve block, which meant less post-operative pain and a further contribution to his rapid recovery. He remained awake throughout listening to music on his iPod. A Zimmer sales assistant remained in the operating room throughout the procedure, a common approach to ensuring the product is implanted correctly. Post-op x-rays showed the Zimmer cementless trabecular metal knee replacement in perfect alignment with the patient's upper and lower leg.
This technology has the most potential benefit for young, active patients in need of knee replacement surgery.
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