One of the biggest challenges in performing knee replacement surgery is ensuring the implant – or “new knee” – is perfectly balanced. The goal is to give patients a knee that feels natural. By balancing the surrounding soft tissues, the implant will last longer.
Henry Ford Macomb orthopedic surgeon Eddie El-Yussif, DO, is one of only a handful of surgeons in the nation and the only one in Michigan to use a new surgical device that helps him take cues from the patient’s own anatomy as he is fitting the implant. Dr. El-Yussif learned this procedure while completing his fellowship at the Anderson Orthopedic Research Institute, in Alexandria, Vir., one of the nation’s premiere joint replacement centers.
It is called “tissue-guided surgery” and is performed in patients who are having a partial knee replacement (see sidebar). During knee replacement surgery, the implant is placed against the bottom of the femur bone. Getting the best implant fit depends on how much bone tissue is shaved off and the contour of the new surface. Tissue-guided surgery uses a pressurized mechanism placed in the joint. The knee is put through its natural range of motion and the device measures the tension – in millimeters – in the ligament, muscle and tendon tissue surrounding the knee to indicate how much bone to shave. In essence, it mimics the knee motion to give the surgeon a way to more accurately position the implant and recreate the patient’s natural knee motion.
“The long-term benefit with this surgery is the knee will be more balanced,” says Dr. El-Yussif. “One of the biggest problems patients have is that the knee doesn’t feel normal or the implant may loosen over time. Using tissue-guided surgery, I can position the implant much more accurately and precisely and give the patient a more natural-feeling knee.”
For younger or more active patients the big payoff is the increased likelihood of resuming sports activities they would not have been able to do with a traditional total or even partial knee replacement surgery.
Pain from a combination of an injury from a fall and arthritis made partial knee replacement necessary for 68-year-old Sandra Treichel of Lenox. Dr. El-Yussif used the tissue-guided surgery procedure and Sandra said she feels great. She was back to normal activity – which includes playing with her three young grandchildren – about three weeks after surgery.
“I’m doing everything,” she said. “I was even on my knees digging in the garden with pressure right on my knee. It’s been good.”