The region's most comprehensive musculoskeletal treatment center.

Pioneering Minimally Invasive and Arthroscopic Surgery.

Peter M. Bonutti, MD

Bonutti Orthopedic Clinic, Effingham, IL

Total Joint Replacement Surgery in the 21st Century

Total Knee Replacement Surgery in the 21st Century

This page presents current, reliable information on the latest advances in total joint replacement, to help guide patients in making important healthcare decisions. It is provided by Dr. Peter M. Bonutti, MD, FACS, FAANA.

New “Limited-Incision” Total Knee Replacement Offers Important Advantages

^{Total joint replacement was one of the most significant
advances in orthopedic surgery in the 20th Century, and enabled millions of
patients suffering from severe joint pain and stiffness to return to active and
rewarding lives. In total knee replacement (TKR), diseased or damaged bone and
cartilage in the knee joint is removed and replaced with an artificial joint called a prosthesis.}

^{Performed since the 1960s, TKR is one of the safest and most successful types
of surgery. Now, a breakthrough surgical technique has been developed for TKR in
Effingham, IL, at The Bonutti Clinic – the L-I ApproachTM or Limited-Incision
Total Knee Replacement. This procedure adapts the latest advances in minimally
invasive arthroscopic surgery and instrumentation to TKR. I want to stress that
limited-incision TKR is a total knee replacement (not a partial or
unicompartmental knee replacement), and it promises to make TKR in the 21st
Century safer and more effective than ever.}

Joints – The Body’s Natural Hinges

Joints are connecting points in your body where two separate bones meet, and they enable your skeleton to rotate or swivel. The ends of the bones are connected by thick bands of tissue called ligaments. For example, the knee joint is formed by the upper end of the shinbone (or tibia) and the lower end of the thighbone (or femur). Cartilage, a smooth, plastic-like tissue, coats the ends of some bones and lines the joint sockets to prevent the bones from rubbing against each other. A delicate membrane called the synovium produces a lubricant to reduce friction and wear in the joint. Normally, all parts of the joint work together, and the joint moves easily without pain.

Conventional TKR

In total knee replacement, the prosthesis is composed of metal, to replace diseased bone, and of polyethylene (a durable, plastic articulating surface), to replace diseased cartilage. One part is attached to the end of the thighbone where diseased bone has been removed, and another is anchored to the shinbone. The standard TKR procedure takes about 2 hours. An 8- to 12-inch incision is made in the knee area, cutting through muscles and tendons and pushing them aside to expose the joint. After the prosthesis is in place, the muscles and tendons are reconstructed and the incision is closed. Frequently, it takes several months to recover from the large incision and muscle disruption.

Advanced Limited-Incision TKR

^{The L-I ApproachTM total knee replacement
procedure utilizes a different leg position and streamlined instruments and
techniques that I have developed and patented. The same high-quality,
time-proven TKR prosthesis components are used and are held in place with
cement. The actual removal and replacement of the damaged joint is also similar,
but the surgical incision is only 3 to 4 inches long. The incision is actually
smaller than the joint implant itself. In addition, the surgeon does not have to
disturb as many muscles and tendons, for a more natural reconstruction and a
quicker rehabilitation.}

^{Our advanced, minimally invasive L-I ApproachTM
total knee replacement procedure takes only 1 hour and results in many
advantages for the patient, including:}

^{Shorter
time in surgery}
^{Decreased tissue and muscle trauma}
^{Less
blood loss}
^{Fewer
complications}
^{Quicker
time to recovery}
^{Reduced
risk of infection}
^{Less
postoperative pain}
^{Far
less scarring}
^{Faster,
easier rehabilitation}
^{Better motion}

World Renowned TKR Expert Observes New Procedure

^{Dr. Kenneth A. Krackow, a
board-certified orthopedic surgeon and Chief of Orthopedics at
Buffalo General Hospital in Buffalo, NY, recently visited our
clinic to study the L-I ApproachTM
total knee replacement procedure. Dr. Krackow is respected
worldwide for his research and development of dozens of
surgical techniques, devices, and instruments that have
advanced TKR surgery. Dr. Krackow was intrigued by what he saw
during the procedure, and he took written and verbal notes as
well as digital photos of the technique. Dr. Krackow plans to
further study potential benefits to patients of this Minimally
Invasive TKR procedure.}