An innovative and minimally invasive approach to knee replacement surgery is currently being performed in the United States at Rush-Presbyterian-St. Luke’s Medical Center in Chicago and at its affiliate, Oak Park Hospital.
Dr. Mitchell Sheinkop, an orthopedic surgeon, has pioneered a new technique for unicompartmental knee replacement surgery by using a special prosthesis and new surgical instrumentation. The technology implemented in this procedure allows the surgeon access to a patient’s knee through a small incision. The incision in traditional knee replacement surgery can be as long as 18 inches; Dr. Sheinkop’s method reduces the incision to about 3 inches. This short incision is good news for patients. It speeds the patient’s time to reach maximum medical improvement and offers greater function than a total knee replacement. It also cuts down on time spent in the operating room and the hospital.
A patient who has a partial knee replacement through the traditional approach may spend as many as four days in the hospital and as many as five days for a full knee replacement. Patients being operated on by Dr. Sheinkop may leave the hospital as early as 24 hours later. Long term effects and recovery are usually two of the most important factors in a patient’s decision to have knee replacement surgery and Dr. Sheinkop’s hope is that his patients will be able to participate in activities like tennis, bike riding, bowling, dancing, and skiing.
Doctors generally recommend knee replacement surgery to individuals over 55 years of age whose knees are so damaged from arthritis that they suffer severe pain and limited activity. Treatment options vary and include: medications, cellular and cartilage transfers, arthroscopy, and other less complex surgical procedures to realign the knee. In cases where these measures failed to provide relief or repair damage to the patient’s knee, knee replacement surgery may be an option.
Individuals most likely to benefit from Dr. Sheinkop’s unicompartmental knee replacement surgery are those who have been diagnosed with arthritis that affects only one part of the knee, such as degenerative or osteoarthritis and post traumatic arthritis, which is caused by a previous injury or fracture.
European orthopedic surgeons brought unicompartmental knee replacement surgery to Rush in the 1980s. As a result, doctors at Rush have done extensive research and clinical work with this procedure. Dr. Sheinkop wanted to develop this minimally invasive instrumentation approach to unicompartmental knee replacement surgery because of his desire to prolong a high level of athletic activity for individuals in their 50s and 60s.
Nine pieces of equipment comprise Dr. Sheinkop’s instrumentation. A surgeon inserts a cutting guide device into the knee through a small hole to guide the angles of the cuts of the bone so that there is perfect alignment for the placement of the prosthesis with the existing bone. The knee prosthesis includes a polyethylene surface that acts like natural cartilage and is attached to metal that replaces the bone. The metal bone replacement glides along the polyethylene surface in the same manner that bone moves along the surface of the cartilage in a healthy knee.
Surgeons at Rush Hospital perform about 250 knee replacement surgeries each year. Presently, Dr. Sheinkop sees approximately seven patients a week for surgical consultation and he expects to perform at least 100 more unicompartmental knee replacement surgeries by this fall.
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