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 Central Illinois Orthopedic Surgery March 02, 2014
By Becky Wiese

Central Illinois Orthopedic Surgery (CIOS) combines longevity with cutting edge, a challenging balance in today’s technology-driven pace of life. For more than 30 years, CIOS has served the residents of Bloomington-Normal and the surrounding communities with personalized attention and high quality orthopedic care. Founded in 1980 by Dr. Lawrence Nord, CIOS is known for treating acute and chronic problems, as well as helping patients avoid future issues by teaching preventive strategies and overall health improvement.

Dr. Nord has performed thousands of procedures, including total joint replacements (primary arthroplasty), revision arthroplasty, and minimally invasive arthroplasty of the hip and knee. When Dr. Brett Keller joined the practice in 2005, CIOS became a leader in the diagnosis and treatment of complex problems not only of the knee and hip, but also the shoulder and sports-related injuries.

Focus on each individual patient is a priority, as circumstances, prior medical and injury histories, and recovery times will vary from person to person. One of the best ways to treat an injury, as well as prevent future injuries, is through education — helping the patient understand what has happened and why, as well as what to expect from surgery and during recovery. Resources provided by CIOS include patient education pamphlets, videos, and detailed animation of injuries and surgeries. The physicians also discuss potential non-surgical options, allowing patients to more actively contribute to the management of their orthopedic needs.

Not content to maintain the status quo, CIOS has recently undergone a variety of updates all geared to better serve patients. “We’ve completed a renovation of our office technology,” explains Dr. Aaron Rossi, himself a new addition to the administrative personnel, serving as practice administrator. “We’ve updated our facility and added new nursing and administrative staff to provide the best patient care possible.” They have also completed a major website re-design that includes patient portal access for the convenience of their patients.  In addition, they have integrated an ENT (Ear, Nose, and Throat) practice to the office with Dr. Finn Amble.

Cutting-Edge Procedures
“Minimally invasive” describes various procedures to repair damaged and painful joints that involve as little cutting as possible. Minimally invasive surgeries on knees and shoulders have become quite common, much to the patients’ benefit. Even full hip and knee replacement surgeries are now common, enabling those with pain that significantly alters their lifestyle to enjoy most, if not all, the activities they participated in prior to their injury.

As often happens with new technology and procedures, time, experience, and ongoing research can make a great thing even better. To stay abreast of the newest developments regarding procedures, CIOS has taken part in pioneering studies and received expert instruction.

Case in Point: Navigation Assisted Partial Knee Resurfacing
“Dr. Keller recently received instruction from Dr. Keith Schroeder, an orthopedic surgeon in the Chicago area who has been on the forefront of navigation assisted partial knee replacement procedures,” explains Dr. Rossi.

Also referred to as unicompartmental knee replacement, unicondylar knee arthroplasty, and unicondylar knee resurfacing, partial knee resurfacing is becoming a feasible and, at times, preferable procedure for those suffering from knee pain caused by osteoarthritis, specifically when the disease is concentrated or confined to one area, or compartment, of the knee.

The knee joint is composed of three compartments: the medial (inner) compartment, the lateral (outer) compartment, and the patellofemoral joint. The medial and lateral compartments are formed by the joining of the bottom of the thigh bone (femur) and the top of the shin bone (tibia). The kneecap (patella) and the front of the femur make up the patellofemoral joint, which is the third compartment.

Cartilage is a substance made up of protein that serves as a cushion between the bones that come together to form the knee joint. Osteoarthritis is a degenerative disease in which the cartilage breaks down and eventually wears away, causing the bones to rub together. The medial (inner) compartment is the portion of the knee most often affected by osteoarthritis; the lateral compartment is affected less often.

Age, injury, repetitive strain, exercise or sports-related stress, and being overweight are all factors that can contribute to the development of osteoarthritis. Stiffness, pain, and swelling are common symptoms, especially noticeable when getting up from a sitting or prone position, during activities, and when going up or down stairs. Approximately 20 percent of Americans will develop some form of knee arthritis. Many will treat it non-surgically with lifestyle changes to diminish the stress on their knees and/or with over-the-counter medications, steroid injections, and physical therapy.

When pain progresses to the point that non-surgical strategies no longer control the discomfort, knee replacement surgery becomes an option. Although total knee replacement may be the only option for those whose arthritis is severe, that is, affecting all compartments, for those with osteoarthritis in only one compartment (typically the medial), partial knee replacement may be a better, less invasive option.

“Partial knee replacements are typically done for younger patients who only have unilateral, medial wear,” explains Dr. Keller. “Replacing the entire knee is not always necessary” especially if there is unaffected cartilage in the rest of the knee. Up to 15 percent of all patients with knee pain due to osteoarthritis may benefit from partial knee replacement surgery.

Benefits are “Less”
The comparison between total and partial knee replacement, when a partial is sufficient based on the amount of osteoarthritis, is a case of “less is more.” Less cutting is necessary — the incision is smaller (usually 4 to 6 inches), and fewer tendons, muscle, bone, and other tissues are cut during the procedure. The trickle-down effect is significant; the patient typically experiences less pain and stiffness, less blood loss, and fewer complications.

“Recovery is the best part,” says Dr. Keller. “Since a partial knee replacement is a minimally invasive procedure and does not cut through tendon and muscle, the patient has a much quicker recovery.” Patients therefore have less down time (most are walking with assistance the same day as surgery), shorter hospital stays (some procedures can be done in outpatient facilities), and less rehab time. “A PKR patient still goes through rehab, but definitely not as long,” Dr. Keller explains. Less rehab also means less time to wait before getting back to normal activities, including most extracurricular activities.

How the Procedure Works
Once a patient is considered to be a good candidate for a partial knee replacement, the surgeon uses computer navigation intraoperatively, which allows him to be extremely precise when removing the damaged bone tissue and positioning the prosthesis. Once the incision is made, he uses computer-assisted techniques to remove the damaged cartilage and bone tissue while saving as much of the patient’s healthy bone and surrounding tissue as possible.

The prosthesis, which is made of metal (titanium) and plastic (polyethylene), is inserted and secured using special cement. The preservation of the patient’s own bone and tissue, along with the computer-assisted technology, makes the resurfacing procedure (i.e., removal of damaged tissue) patient-specific, which may also result in a more natural feeling knee. Once everything is in place, the incision is closed up and the patient can begin the process of recovering.

The physicians, nurses, and staff at Central Illinois Orthopedic Surgery are excited to offer patients the option of navigation assisted partial knee replacement. As technology and research continue to develop ways to alleviate orthopedic pain and suffering, CIOS will offer their patients the latest procedures and practices in order to improve their health and quality of life.

For more information about CIOS, navigation assisted partial knee replacement, or other orthopedic questions, call 309-662-2278 or visit their new enhanced website
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 Central Illinois Orthopedic Surgery| March 02, 2014
Categories:  Feature
Keywords:  Feature Story

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