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bost1751
07-23-2010, 13:20
I am curious if any of the Dr, PAs or 18Ds have any knowledge or experience with partial knee resurfacing? The trade name for the procedure is Makoplasty. The medial cartilage is all but gone with some very good narrowing on the medial side. I also have a good deal of arthritis in it. The knee was opened several years ago when I was in Tolz and scoped 2 years ago. The ortho told me I would be able to continue to run after the partial but now after a total. Are any of you familiar with this procedure and what are your opinions? The patella tracks good but has a bunch of crepitation.

Thanks

Boomer-61
08-05-2010, 11:20
Boost,
The critera for a uni compartmental replacement is that only one of your three knee compartments is involved. The knee is divided into three, the medial, or inside of the knee, the lateral, or outside and the patella-femoral or knee cap to thigh bone. You've indicated that your medial compartment is the one involved. If you have noise coming from your knee cap that can be a variant of normal as long as it is not painful.
As for activity after either total or partial knee replacement I beg to differ in opinion with what you've heard. Both knee systems are mechanical devices like the brakes on your car, the more you use them, the more they wear. The way to wear them out quickly is with impact loading activities i.e. running and jumping. I tell my patients you can do what you want but to make your knee last as long as it can, think about low impact sports like swimming and cycling. Your best knee replacement is your first.
As for the Mako system it is a standard unicompartmental knee replacement save the guidence and robotics. We tested the original guidence systems here and our impression was, why do you need a GPS to tell you how to drive home? Meaning, if a surgeon knows how to do a given surgery and does it routinely and well, he/she shouldn't need a system to tell him/her about your anatomy. As for robotic arms, I have no experience with them.
I think the best advice you can get is to choose your surgeon based on reputation and not marry a technique. Ignore market driven information and relay on surgical outcome information. Be wary of the latest and greatest.
If you have a very active lifestyle and want to keep it that way and can deal with the level of discomfort you have now; I'd recommend keep on doing it. When you are severly limited, wake at night with pain and conservative modalities are no longer effective, then think about surgery. Choose the best surgeon you can find in your area and go with his/her recommendations. By best I mean a joint fellowship trained, all they do is hip and or knee replacements, surgeon. Ask them how long they've been in practice and how many they do a month. A good busy surgeon should be doing about 40 joints a month.
I hope this helps. This is somewhat the Readers Digest answer to your question. If you need more info PM me.
Boomer

bost1751
08-05-2010, 20:30
Boomer-61:

Thanks for the information. I have been using a good surgeon here, but he said the only thing left for me was a knee replacement. I also see another great surgeon for my hip. Unfortunately, I only have years left on this contract before I have to take another running, dummy dragging test. I am not quick to get cut on, had enough of that already. I appreciate your information and it will be very strongly considered. I really appreciate the info from a non marketing, impartial view.

Thanks,