Knee Procedures

Muscle Sparing Knee Surgery / Subvastus Approach

In knee replacement surgery, the more appropriate term for the procedures Dr. Meere performs is muscle-sparing surgery. Here, the key muscle of the knee, known as the vastus medialis, is not divided from the rest of the quadriceps muscle. Instead, it is peeled from its inferior boundary and gently retracted without any cutting. This allows for remarkably improved speed of recovery, strength, and less pain.

An added cosmetic advantage is a smaller scar, which is individualized to the patient's size and needs but generally measures less than four inches in the hip and slightly more in the knee. The minimally invasive surgery technique should not be used in complex cases involving correction of severe deformity, revision of failed implants, or hip resurfacing arthroplasty technique. In such cases the exposure is determined by the existing wound and the need for greater exposure. Dr. Meere strongly believes in selecting the best surgical technique to spare tissue and minimize dissection whenever feasible, yet is prepared to extend the incision if necessary to perform the work adequately and safely.

 

Computer-Assisted Navigation

This refers to the use of a computer as a tool to assist in the positioning and insertion of a hip or knee implant. It is important to realize that unlike a robot, it is not intended to replace the actual human performance of the procedure. Severe cases are especially suited to this adjunctive technology. Dr. Meere has been involved with the development of computer-assisted navigation since its early inception. He supports the view that computer-assisted navigation ensures a more predictable result through enhanced precision in positioning and balancing the joint. Overall this should lead to a better, more stable and more predictable outcome and potentially increased mechanical longevity of the implant.

 

Makoplasty Uni-Compartmental and Bi-Compartmental Knee Arthroplasty

This technique is a further refinement of computer assisted surgery. In addition to visual feedback as in a GPS navigation system, the new science of haptics allows for direct robotic instrumentation by means of a mechanical arm, handled by the surgeon and based on a virtual model created by a preliminary CAT scan of the knee. A virtual firewall or electronic fence boundary ensures both accuracy and safety. Mako Corp. has pioneered this application for knee surgery. The technology is currently available for partial or double-partial knee replacements. The superior accuracy of the instrumentation afforded by this technique is very promising and should yield much improved function and durability for partial replacements.

If you are interested in learning more about any of our Knee Procedures,
call 212-263-2366 today to schedule an appointment.