Treatments

We provide advanced surgical treatment for hip and knee arthritis, including total and partial joint replacement, MAKO robotic-assisted surgery, and complex revision procedures.

Total Hip Replacement

Hip pain and stiffness can severely diminish your quality of life.  Even simple walks to the grocery store can seem like torture.  When treatment with physical therapy or anti-inflammatories fail to relieve your pain, Total Hip Replacement may be the treatment to get you back to things you enjoy in life.

What is Total Hip Replacement?

Total hip replacement is one of the most successful procedures in orthopedic surgery and can provide significant pain relief and improved mobility for patients with advanced hip arthritis.

During hip replacement, the damaged portions of the hip joint are removed and replaced with artificial components designed to restore smooth movement and stability.

Dr. Monazzam has fellowship training in adult reconstruction and performs both primary and complex revision hip replacement.

Approaches to Total Hip Replacement

There are typically two surgical approaches to access the hip joint, a posterior approach (side of the hip, slightly towards the buttocks) and a anterior approach (from the front).

The posterior approach is the traditional approach which provides for great exposure of the hip joint. With MAKO robotic surgery, risks of dislocation and other complications have been dramatically decreased. You will be taught to avoid certain hip positions hip to prevent dislocation especially during the first 3 months but rate is now similar to anterior approach.  The complication rate is lowest with a posterior approach. Now with the addition of robotic surgery, this is Dr. Monazzam’s preferred approach.

The anterior approach.   There are minimal to no dislocation precautions as the dislocation rate is very minimal but now with robotic surgery is similar to posterior approach.  Typically, intraoperative Xray is utilized throughout the case to ensure proper implant positioning.  The recovery in the short term may be slightly easier. This approach can be great for patients who need to get back to work as early as possible.  Again, patients with large bellies are at higher risk for infection. All nerve injuries and femur fractures are high risk with the anterior approach.

Ultimately, a successful Total Hip Replacement with either approach will be life changing in those patients suffering from osteoarthritis of the hip.

Total Knee Replacement

Knee pain and stiffness can also severely diminish your quality of life,  with every step causing pain.  Patients even come to dread vacations due to the anticipated pain from walking.  Treatment typically begins with weight loss, physical therapy to improve strength around the knee, anti-inflammatories and injections in an attempt to reduce the inflammation in the knee that causes pain.  Ultimately, when these nonsurgical treatments fail to relieve your pain and your osteoarthritis worsens, then a Total or Partial Knee Replacement should be considered.

What Is Total or Partial Knee Replacement?

Knee replacement is commonly performed for patients with advanced arthritis who continue to experience significant pain, stiffness, or limitations despite nonsurgical treatment.

Although the procedure is called a “knee replacement,” it is more accurately thought of as a resurfacing of the damaged portions of the knee.

During surgery, a small amount of damaged bone and cartilage is removed from the ends of the femur and tibia and replaced with metal components. A medical-grade plastic insert is placed between these components to create a smooth new bearing surface.

Depending on the location and severity of the arthritis, patients may be candidates for either:

• Total knee replacement
• Partial knee replacement

Dr. Monazzam performs both primary and revision knee replacement and uses robotic-assisted technology when appropriate.

Robotic Assisted Surgery with Mako

Dr. Monazzam has advanced training in MAKO robotic-assisted joint replacement, including:

• Robotic total knee replacement
• Robotic partial knee replacement
• Robotic total hip replacement

MAKO technology uses a CT scan to create a three-dimensional model of the patient’s anatomy before surgery. This allows the surgeon to develop a personalized surgical plan based on the size, shape, and alignment of the patient’s joint.

During surgery, the robotic system provides real-time guidance to help the surgeon carry out the planned bone preparation and implant positioning with a high degree of precision.

For knee replacement, robotic technology can also provide information about ligament tension and joint balance throughout the range of motion. This information can help the surgeon individualize implant positioning and soft-tissue balancing.

For hip replacement, robotic planning can assist with implant sizing, position, leg length, and overall reconstruction of the hip.

The robotic system does not perform the surgery independently. The surgeon remains in control throughout the procedure and uses the technology as an additional tool for surgical planning and execution.

Revision Hip & Knee Surgery

Some patients may continue to experience pain or other problems following a previous hip or knee replacement.

Potential reasons include:

• Implant loosening
• Infection
• Instability or dislocation
• Stiffness
• Wear of the implant
• Fracture around the joint replacement
• Bone loss
• Implant malposition
• Persistent pain
• Problems with the surrounding soft tissues

Revision hip and knee replacement requires specialized training because these procedures are often significantly more complex than primary joint replacement.

Dr. Monazzam completed advanced fellowship training in adult reconstruction and complex revision joint replacement at the University of Chicago.

Evaluation of a painful joint replacement typically includes a detailed history, physical examination, review of prior operative records when available, and appropriate imaging and laboratory testing. The goal is to identify the cause of the problem before determining whether revision surgery is necessary.

Not every painful joint replacement requires another operation. When possible, Dr. Monazzam will discuss nonsurgical options as well as the potential benefits and risks of revision surgery.

Carpal Tunnel Releases And Trigger Finger Releases

We offer carpal tunnel release and trigger finger release in our in-office procedure room using local anesthesia. These procedures generally do not require general anesthesia or an IV, allowing patients to return home shortly after the procedure and avoid many of the after-effects associated with sedation or general anesthesia.

Other Orthopedic Services

In addition to hip and knee replacement, Advanced Care Orthopedics treats a broad range of musculoskeletal conditions.

Services include:

• Fracture care
• Knee arthroscopy
• Meniscus surgery
• Shoulder arthroscopy
• Rotator cuff repair
• Carpal tunnel release
• Trigger finger treatment
• Sports and activity-related injuries
• Evaluation of acute and chronic orthopedic conditions

Treatment recommendations are individualized, with an emphasis on helping patients reduce pain, restore function, and return to the activities that are important to them.