What is Knee Resurfacing?

James B. Duke, MD

Knee resurfacing replaces only the damaged portion of the knee without replacing the knee entirely with a hinge. During a total knee replacement, surgeons insert artificial implants to relieve arthritis in a specific area of the knee. Eight to nine millimeters of worn cartilage on the end of the bone is removed and resurfaced with titanium/cobalt chrome and polyethylene, a medical-grade plastic. 

Surgery to replace or resurface joints is an option if one’s quality of life is greatly diminished by their condition. Total and partial knee resurfacing offers patients the opportunity for improved outcomes by targeting arthritis and preserving the normal biomechanics and anatomy of the patient’s knee, thus allowing them to regain a high level of function.

Who is a candidate?

Patients who have bone-on-bone arthritis, significant pain, and limited function during weight-bearing activities, such as walking, standing, kneeling or squatting, may be good candidates for total or partial knee resurfacing. If a patient has failed to improve with conservative care options and still experiences pain that interferes with their lifestyle, it may be time to speak with an orthopaedic surgeon about their options.

What are the techniques used for knee resurfacing?

The orthopaedic physician will try to do the surgery with minimal trauma to the soft tissue in the specific area, which allows for a quicker recovery in patients getting back to a high level of function. There are two ways of implanting both the total and partial knee: 

Bone cement

Bone cement is used in joint replacement surgeries, particularly those involving partial and total knees. The cement is applied between the prosthetic and the bone to help secure implants and keep them in place. This is a very reliable technique and typically has a 20-year life span or longer.

Biologic fixation

Orthopaedic physicians now have the technology to allow the patient’s bone to grow into the implant.  This technique is referred to as “biologic fixation”, and is used in younger and more active patients. For those that participate in more dynamic activities, like softball or pickleball, this type of implant allows them to be more aggressive and competitive. This technique can result in a 25 to 30-year life span of the implant.

What is the recovery time?

The expected recovery time can vary from patient to patient, but it typically takes 2-3 weeks after surgery for most patients to start walking independently. As far as dynamic activities, it can take  6-8 weeks for patients to be ready to resume sports and vigorous exercise,.

Dr. Duke recommends that patients should give themselves about a year for the true final outcome in which all the scar tissue is remodeled and swelling is no longer present.

What are the risks associated with the operation?

The two biggest complications of any kind of total joint surgery, whether it’s hip or knee, total or partial replacements are infections and blood clot formation. Because a foreign object containing metal and plastic is being inserted into the patient’s body, infection can be a rare complication. At The Orthopaedic Institute, the physicians wear bodysuits from head to toe during the surgery, use antibiotics perioperatively, operate in rooms with ultrahigh filtered airflow, and utilize special types of irrigation to help reduce the risk of infection. All of this has allowed our organization to have extremely low infection rates.

One of the best ways to lower the risk of complications is by choosing a surgeon who performs the procedure regularly. Dr. Duke has done over 11,000 implants and feels as though he has certainly seen just about everything during these procedures. He commonly states to his patients, “you really can’t throw me a curveball I haven’t seen.”

The second biggest risk is blood clot formation. Any time patients have surgery on their hip or knee, they have a chance of forming a blood clot. Dr. Duke and his team take the appropriate precautions with blood clots by anticoagulating every patient through surgery and up to 6 weeks postoperatively. 

Choosing an orthopaedic surgeon

Dr. Duke believes that patients should seek a board-certified orthopaedic surgeon that specializes in adult reconstruction of the  knee and hip. Numbers and experience are also important factors when it comes to choosing the right doctor to perform partial or total knee resurfacing. Dr. Duke finds that patients want to see a physician that has a passion for what they do and someone that has shown excellent results and communicates with them before and after surgery. Dr. Duke states, “I try not to just be a technician. I want to be a compassionate surgeon who takes care of their patient like a family member.” Dr. Duke and his team customize the way each patient is cared for during the operation and post-op recovery phase, as well as their pain management, anesthesia, and medical care.

Dr. Duke believes that patients should find an orthopaedic doctor who has a keen interest in musculoskeletal care and belongs to Specialty Societies, getting the latest cutting edge information in their field. Dr. Duke belongs to both the American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons. Both of these groups and his team of colleagues and staff at The Orthopaedic Institute have allowed Dr. Duke to provide the highest quality musculoskeletal care to his patients. 

Learn more about total or partial knee resurfacing and see if you may qualify by scheduling your appointment today: https://www.toi-health.com/appointment/