Knee replacement is a major surgery. Just ask anyone you know who has had it done. It’s a big deal, and it honestly should be. Your knee is a crucial part of your body, and it plays a major role in virtually every move you make from the waist down. If you have regular knee pain, it can make even the slightest of those movements excruciating. When you decide to do something about it, there’s a good chance you’ll experience a little more pain on the road to getting better, not to mention the weeks you’ll spend in rehabilitation to get back on your feet after surgery. Of course, once they do recover, most knee replacement patients consider the surgery life-changing, allowing them to function pain-free just as they did before knee pain became a concern.
Blount Memorial orthopedic surgeon Dr. Shane Asbury says, in addition to traditional knee replacement surgery, a procedure called subvastus knee replacement can help reduce some of the pain involved. “With any arthroplasty or joint replacement procedure, there’s going to be some pain and some recovery time,” Asbury said. “However, with the minimally invasive subvastus approach, there is significantly less pain and recovery time. In this procedure, the quadriceps muscles and tendon are spared. In a traditional knee replacement, the quadriceps tendon, or the large tendon on the front of the knee, is split in two. This results in the complete disruption of the vastus medialis muscle from the patella. In a subvastus approach, the tendon is completely spared. This is accomplished by elevating the vastus medialis muscle rather than splitting the tendon,” he explained.
“The potential benefits of the suvastus procedure include increased post-operative strength and less pain,” Asbury continued. “Sparing a large muscle group allows these muscles to function more appropriately in the immediate post-operative period, which, therefore, allows for a quicker and more-aggressive rehab, which, in turn, leads to faster return to function. I generally ambulate the patient the same day as his or her surgery, so it’s not uncommon for a patient to be able to move between 300 and 600 feet just a few hours after the procedure. Generally, a walking aid still is recommended in the early period, but the expectation is to quickly transition from a walker to a cane to nothing at all over a two- to three-week period,” he said. “With subvastus, too, knee extension strength is better preserved, allowing better transfers from a seated position. There’s also less risk of patella tracking problems with the subvastus approach. Plus, by minimizing the incision, pain can be improved,” he explained.
Asbury says Blount Memorial’s newly acquired Mako Orthopedic robot helps with these procedures, as well. “The Mako robot is fully compatible with these less-invasive approaches,” he said. “Mako also allows for a much more accurate placement of implants, which results in a more balanced and functional knee overall. The technology and added precision that this new tool gives us just reflects how we’re working to anticipate the future health care needs of the community,” he explained.
However, Asbury says you still should plan on some recovery time, even if it is reduced. “This procedure, like all arthroplasties, still requires roughly six to eight weeks of rehab,” he said. “However, one other advantage of the subvastus approach is the shorter hospital stay. The average length of stay for my patients has dropped significantly, from three days to about one day. Some patients can even be eligible for day-of-surgery discharge,” he explained. “While the long-term results tend to be equal for both knee replacement approaches, I have seen positive results for patients who have had the subvastus procedure, particularly in the early post-operative period. It is still a major surgery, but I believe that it allows for a more-rapid recovery when combined with appropriate rehab and pain-control techniques. I also feel that subvastus patients have less pain, particularly compared to the traditional approach,” he added.
Dr. Asbury sees patients in his office at OrthTennessee Maryville, located at 827 E. Lamar Alexander Parkway in Maryville. For more information or to schedule an appointment, call 865-984-0900.