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Traditional methods of surgical treatment for painful arthritic hip and knee joints have provided excellent outcomes for years. Ninety percent of total joint patients do very well. However, there are still some things that we struggle with from a joint replacement standpoint. The most common is that about ten percent of patients really struggle with chronic pain after a joint replacement. Some patients struggle with chronic pain when the weather changes while other people say, “You know it's fine. I can do what I want to do. But it just kind of aches.”
About three to five percent of patients struggle with knee stiffness after knee replacement surgery and some patients struggle with dislocations in hip replacement surgery. The biggest thing we get concerned about is the post-operative period of blood clots. Unfortunately, about one percent of joint replacement patients still struggle with severe complications such as infection. Infection can be a very debilitating complication; it can be life changing. That's why we take everything very seriously from the medical history to intraoperative techniques to minimize the risk of infection as much as we can.
Fortunately, new techniques are building upon excellent historical outcomes. We're working to improve outcomes and minimize those outliers. We're trying to decrease the risk of infection and decrease the risk the knee stiffness and dislocation.
We’ve started using new approaches in joint replacement for the hip joint that are improving outcomes. The direct anterior approach which is in the front of the hip and the mini-posterior approach which is in the back of the hip; both provide - less muscle trauma and are more muscle sparing. Both are more inherently stable than traditional approaches meaning they would have a less likely risk of dislocation in the end.
There are some new approaches to the knee joint as well like the medial parapatellar approach the mini-subvastus and the mini-midvastus. All in all, it’s important to know that all of these approaches are smaller than the traditional approaches. They provide less local muscle trauma which allows you to get back to functional life sooner.