Mako Robotic Total Knee Replacement.
Picture from Stryker Mako Brochure

We provide the latest in techniques and technological advanced Hip and Knee Replacements.

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 such as Advil or Aleve 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?

Also referred to as Total Hip Arthroplasty, it is a procedure in which the surgeon removes the damaged portion of the bone and cartilage.  The surgeon then replaces these with a stem and ball and a new socket thereby restoring the function of the hip and eliminating the pain from osteoarthritis.

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 newer anterior approach (from the front).

The posterior approach is the traditional approach which provides for great exposure of the hip joint especially in revision cases.  There can be a higher rate of dislocation for the first 6 weeks. You will be taught to avoid certain hip positions hip to prevent dislocation especially during the first 6 weeks.  The recovery in the short term (first 2-4 weeks) may be more difficult but at the 6 weeks both approaches yield similar results.  For patients with overhanging belly, the posterior approach will decrease the risk of infection. In cases of overhanging belly or a revision hip, Dr. Monazzam would utilize a posterior approach to decrease the risk of a complication. You can also always choose to have a posterior approach as everyone is a candidate.

The anterior approach, often considered a muscle sparing approach, has multiple advantages for the right patient.  There are minimal to no dislocation precautions as the dislocation rate is very minimal.  Typically, intraoperative Xray is utilized throughout the case to ensure proper implant positioning.  The recovery in the short term is typically 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. Dr. Monazzam utilizes this approach in the right patients who can take advantage of the faster recovery without an increased risk of complications.

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

Picture From Stryker Mako Brochure

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 physical therapy to improve strength around the knee, anti-inflammatories such as Advil and Aleve 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?

Also referred to as Total or Partial Knee Arthroplasty, it is a surgical procedure better thought of as a “knee resurfacing” than an actual replacement.  This is because the ends of the femur (thigh bone) and tibia (shin bone) at the knee are only minimally cut to remove the diseased cartilage (lining of the knee) and to fit a new artificial metal surface.  In between the two metal surfaces a special plastic bearing will be placed to allow the new knee to smoothly bend back and forth.  A Partial Knee Replacement is for patients in which only a part of the knee is diseased and only that area is replaced.  This means faster recovery, shorter hospital stays and often better function.  Not everyone is a candidate for partial knee replacement and it is something Dr. Monazzam would discuss at your consultation.

Robotic Assisted Surgery with Mako

Knee replacements are typically performed with metal jigs that help line up the cuts and make sure to both straighten the knee and balance the ligaments.  This can often be tricky and failure to balance the knee can result in a knee replacement that is unstable and painful.  This is why robotic assisted surgery was developed to give better tools to help the surgeon both straighten the knee and balance the ligaments.   A CT scan of the knee is obtained prior to surgery.  The surgery is preliminarily planned prior to the day of surgery with powerful computer software.  More data is captured during the time of surgery to assess the tension of the ligaments.  A final plan is developed on the computer at time of surgery.  The Robot is then brought in to help guide the bone cuts based on the plan developed.  This technology has the potential to greatly reduce complications from errand cuts and to better balance the knee.   Research is still being conducted to demonstrate the advantages of this technology.  The downside is typically 2-4 extra small incision on your femur and possible your tibia (less than 1cm each) for the pins to guide the robots, 10-15 min longer surgery time and a need for a CT scan prior to surgery.  Additionally, not all hospitals have adopted Mako Robotic surgery and depending on your insurance this technology may or may not be available at the hospital your insurance is contracted with currently.

Revision Surgery

Have you had a total knee or total hip replacement that is still painful or feels unstable?  Then you may need a revision surgery.  Very few orthopedic surgeons have both the training and willingness to take on these difficult cases.  If it has been more than 6 months since your surgery and you are not improving, call to make an appointment for a consultation.  Dr. Monazzam has specifically subspecialized to both diagnose and treat these difficult problems.

Carpal Tunnel Releases And Trigger Finger Releases

We are excited to provide carpal tunnel release and trigger finger release surgery in the convenience of our state of the art procedure room located in our office. Both type of surgeries are conducted with just a simple one time numbing injection. No general anesthesia or IV insertion needed. You can drive to and from the office on your procedure day and get on with the rest of your day without any of the after effects of general anesthesia. The surgery is safe, effective and convenient.

Other Orthopedic Services

We do provide other general orthopedic services such as Shoulder Arthroscopy, Rotator Cuff Repairs, Carpal Tunnel Release, Knee Arthroscopy, and Fracture care.   We unfortunately do not provide pediatric care and we limit patients to 18 years and older.