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 www.ciosortho.com.