Texas Hill Country Orthopaedics and Sports Medicine, P.A.
813 S Milam St
Fredericksburg, TX 78624
To Schedule An Appointment
Call 830-997-4043
Personalized Knee Care
Complex and Minimally Invasive Total Knee Arthroplasty
If your knee is badly damaged by arthritis or an injury, everyday activities like walking or climbing stairs may become difficult. You may even feel pain while sitting or lying down.
If treatments without surgery, such as medication or walking aids, no longer help, you may want to consider total knee replacement surgery. This surgery can reduce pain, correct problems with leg alignment, and help you return to your normal daily activities.
Total knee replacement surgery was first performed in 1968. Since then, improvements in surgical tools, materials, and techniques have made the procedure much more successful. Today, total knee replacement is one of the most successful surgeries in medicine. According to the American Academy of Orthopaedic Surgeons, more than 700,000 total knee replacement surgeries are performed in the United States each year. Our surgeons are specially trained to handle all types of primary and revision joint replacement procedures. In fact, we are a referral for the Hill Country Area for complex revision joint replacement.
The most common cause of chronic knee pain and disability is arthritis. This is an age-related wear-and-tear type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness
Minimally Invasive (subvastus) Knee Replacement
In minimally invasive total knee replacement:
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The surgical procedure is similar to a traditional total knee replacement, but there is less cutting of the tissue surrounding the knee.
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The artificial implants used are the same as those used for traditional total knee replacement. However, specially designed surgical instruments are used to prepare the femur and tibia and to place the implants properly.
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The procedure is performed through a shorter incision — typically 6 to 8 inches versus 8 to 10 inches for a traditional total knee replacement. A smaller incision allows for less tissue disturbance.
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In addition to a shorter incision, the technique used to open the knee is less invasive. In general, techniques used in a minimally invasive total knee replacement are "quadriceps sparing," meaning they avoid trauma to the quadriceps tendon and muscles in the front of the thigh. The technique is called "midvastus" or "subvastus" where a small incision is made along side of the muscle instead of through the muscle. Because the techniques used to expose the joint involve less disruption to the muscle, the patient may have less post-operative pain and a reduced recovery time than with a traditional total knee replacement.
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The hospital stay is similar to the length of stay after a traditional total knee replacement. Most of our patients go home on the day of surgery, making this an outpatient procedure. With the advancement in surgical techniques and using multiple modes of pain control, you are able to get up and walk the same day of surgery and recover in the comfort of your home.
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Physical therapy is a critical component of recovery, as it is for a traditional total knee replacement. Your surgeon or a physical therapist will provide you with specific exercises to help increase your range of motion and restore your strength.
Knee Arthroscopy and ligament reconstruction
Anyone can tear their ACL, but it usually happens when someone quickly changes direction, turns, or jumps and lands with their leg straight. These movements are common in sports like volleyball, soccer, football, and basketball.
Most ACL injuries happen without being hit directly in the knee. Instead, the injury happens when too much force is placed on the knee at once. The ACL cannot handle the sudden pressure, making it difficult for the knee to stay stable.
If you tear your ACL, you may need surgery to help your knee work normally again. This depends on a few things, including how badly the ACL is injured, your age, how much wear and tear your knee has, whether your knee feels unstable, and how active you are.
A "torn ACL" means that the ligament has been damaged or completely torn. This can happen in the middle of the ligament or where it connects to the bone. The injury happens when too much force is placed on the ligament, causing it to tear.
ACL injuries can also happen along with damage to other parts of the knee, such as the MCL or the medial and lateral meniscus. Texas Hill Country Orthopaedics surgeons are specially trained to treat all types of knee injuries with the latest technonolgy.
PRP and OrthoBiologics
What is PRP?
Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets). The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors that are very important in the healing of injuries.
PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.
To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased by spinning the blood down during a process called centrifugation. These platelets are then injected into the injured site.
How Does PRP Work?
Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP may potentially speed up the healing process.
To speed healing, the injury site is treated with the PRP preparation. PRP is especially useful to help treat arthritis and tendinitis. In some cases, PRP has been able to help heal patients and avoid surgery.
What are "Stem Cell? injections?
Currently, scientists are unable to create an injection that makes cartilage re-grow in your arthritic joint. There have been many attempts but they have all failed to improve the actual growth of cartilage in a human joint. One of the newer products on the market which is currently FDA approved is a product from the umbilical cord of newborn babies. After a successful C-section, the umbilical cord is usually discarded but now, the Wharton's jelly from the cord can be donated for preparation into an effective joint injection. Wharton’s jelly is a tissue found inside the umbilical cord that contains mesenchymal stem cells (MSCs), which have the potential to support the body's natural healing and repair processes. These cells also contain important substances, such as collagen and hyaluronic acid, that help support healthy tissues. Wharton’s jelly is collected from donated umbilical cords after birth and may be used in regenerative medicine. When injected into areas affected by musculoskeletal conditions, it may help reduce inflammation, support tissue repair, and improve joint and tissue function. It is being studied as a possible treatment for injuries and conditions affecting muscles, tendons, ligaments, and joints. Although early research shows potential benefits, more studies are needed to fully understand its safety and effectiveness. We currently offer a "stem cell" injection derived from umbilical cord Whartons jelly collected at the time of scheduled successful C-sections. We currently use it to help treat arthritis in patients who want to avoid surgery. Although this is a relatively new branch of medicine, we are able to offer this to patients and potentially improve their pain and function.