How Is Total Knee Replacement Surgery Performed?

How is total knee replacement surgery performed? In this video, Scott M. Desman, M.D., F.A.A.O.S., a board-certified orthopaedic surgeon specializing in joint replacement surgery at South Florida Orthopaedics & Sports Medicine, discusses how he performs knee replacement surgery using patient-specific instrumentation and computer assistance.

“The goal of a total knee replacement is to replace the surfaces of the knee,” says Dr. Desman, as he demonstrates on a model of the knee. “And this is a model of a knee replacement with the implant on the surface of the knee. The job of the surgeon is to make sure that (the implant) is put in perfectly straight. Using computer assistance, we preoperatively plan the surgery on a computer model of the patient's knee and then execute the plan at the time of surgery. This gives a perfect result consistently every time, to give the patient the best result possible.”

“To execute a computer-assisted patient specific plan, we first do either a CT scan or an MRI of the patient's knee,” Dr. Desman continues. “This allows us to create a three dimensional model of the patient's knee on a computer that looks something like this. This would be the end of the thigh bone, and this would be an exact replica of the patient's knee. And this would be an exact replica of the lower tibia bone, and they would go together like this.”

“The whole procedure is done on a computer before any surgery is performed. We place the implants precisely the way we want them to be at the end of the surgery. And the computer generates a 3D printer model of what we call a cutting block. And in surgery, we would get a plastic block similar to this, and that block would fit on the patient's bone in a very specific way. It just locks on; you can only put it in one way. It has little holes that we put pins in to secure it, and you can see through the top, there's a line and a space, and the saw blade would go through that and make a cut on the bone. This would give us the exact cut of the femur that we planned preoperatively.”

“The tibia has a similar cutting device. This piece would show up in surgery and fit very precisely on the patient's bone in a one-way method, that locks in with pins through some holes in the implant in the cutting block. You can see there's a slot here that allows the saw blade to go through that slot and cut the bone in an exact way to make sure it's perfectly straight. By making these cuts very straight, all the guesstimates of manual surgery are removed. And the results are that the cuts are perfect. And in terms of the femur, we don't have to drill a hole in the bone to line it up the way we normally would do. And this reduces bleeding, reduces pain, and improves the patient's recovery.”

Conveniently located on the Treasure Coast, South Florida Orthopaedics & Sports Medicine is dedicated to improving your musculoskeletal health by delivering comprehensive, state-of-the-art orthopaedic care in a warm, welcoming and highly professional environment.

Our eight board certified, exceptionally trained orthopaedic surgeons specialize in providing the finest care in minimally invasive surgery, joint surgery, arthroscopic surgery, reconstructive and revision surgery, spine surgery, ACL repair, trauma and fracture care, general and pediatric orthopaedics, workers' compensation and sports medicine.