Minimally Invasive Knee Replacement
What is it ?
Minimally Invasive Knee Replacement is more precisely described as knee resurfacing, focuses on replacing only the worn knee joint surfaces. The procedure is performed through a small incision of approximately 10 cm (4–6 inches), significantly reducing tissue disruption and accelerating recovery. Developed and perfected by Dr. Samih Tarabichi over than two decades, the technique avoids exposure of muscles and ligaments, preserving the knee’s natural anatomy. The damaged surfaces are carefully removed with minimal thickness and replaced with advanced titanium metal components, along with a new artificial cartilage layer to restore smooth movement and eliminate pain. The incision is then closed using specialized methods designed to promote rapid healing and early mobilization. This innovative approach delivers precision, durability, and faster return to daily activities setting a new benchmark in modern knee arthroplasty.
When the surgery is recommended?
There are several reasons why Dr Tarabichi may recommend it to you. People who benefit from total knee replacement often have: severe knee pain or stiffness that limits everyday activities, including walking, climbing stairs, and getting in and out of chairs, it may be hard to walk more than a few blocks without significant pain and it may be necessary to use a cane or walker, moderate or severe knee pain while resting, either day or night, chronic knee inflammation and swelling that does not improve with rest or medications, knee deformity, bowing in or out of the knee, failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries.
Is it suitable for your age?
There are no absolute age or weight restrictions for total knee replacement surgery, recommendations for surgery are based on a patient’s pain and disability, not age. most patients who undergo total knee replacement are age 50 to 80, but orthopedic surgeons evaluate patients individually, total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.
What are the preparation steps for the procedure ?
Before the surgical procedure, the patient undergoes a comprehensive assessment by a specialist in internal medicine and an anesthesiologist. Extensive laboratory tests are conducted to evaluate most of the body’s vital functions to determine the feasibility of performing the surgery.
How its done?
There are three basic steps to the minimal invasive knee replacement surgery:
- Prepare the bone: The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
- Position the metal implants: The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or “press-fit” into the bone.
- Insert a spacer: A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.
Which Knee Implant Systems will be used?
Dr. Samih Tarabichi is committed to using the latest artificial knee joints available worldwide. These knee implants are made from biocompatible materials, with no reported cases of body rejection. Several artificial knee joint systems have been developed globally to provide the most suitable joint for each patient, depending on the condition and degree of wear.
At Dr. Tarabichi’s Center for Joint Care, we ensure that we offer all available options to provide the best care for patients. Examples of the surgical systems available include:
- Partial Knee Replacement System: Designed for cases of partial wear in the knee joint. The worn part of the knee joint surface is covered with a metal shell to compensate for the damage and restore pain-free movement.
- Cementless Knee Replacement System: Intended for patients under 50 years old with strong bone structure. This system is designed with a component that allows the bone
to integrate and grow onto the implant back surface, ensuring proper stability and restoring natural pain free movement. - Cemented Knee Replacement System: Suitable for patients over 50 years with bone osteoporosis. The artificial joint is fixed using medical cement to restore natural pain free movement.
- Custom 3D Knee Replacement System: The most advanced system currently available. It involves taking X-ray images of the natural joint according to a special protocol to precisely match the measurements of the patient’s natural joint. These measurements are sent to a specialized manufacturer in Switzerland to create a custom-made artificial joint, which is then installed to restore natural pain free movement movement.
All artificial knee implants available at our center are designed and manufactured to allow full flexion, similar to natural human joint.
Robotic and Artificial Intelligence Systems: Available in the operating rooms, Dr. Tarabichi uses robotic and AI technology when needed or requested by the patient.
What About the Pain Management?
Pain is an inherent part of any surgical procedure, and its intensity varies among individuals. We are committed to managing pain effectively and safely, avoiding addiction while ensuring the patient’s recovery is as swift as possible. Our approach includes:
Before Surgery: Based on the patient’s medical history, the most appropriate pain medications are prescribed. Cryotherapy is used several days before the surgery to target specific nerves around the knee responsible for pain. This procedure involves cooling these areas to numb the pain receptors, thus alleviating pain during the recovery period.
During Surgery: The preferred method is spinal regional anesthesia. This is supplemented with sedatives to help the patient relax and sleep during the procedure. This option typically has lighter effects on the body upon waking up.
After Surgery: A small PCA (Patient-Controlled Analgesia) pump is connected to the patient’s IV line, allowing them to control and administer the medication as needed. The medical team closely monitors the patient and provides appropriate medications during their hospital stay. Upon discharge, the patient is given suitable pain medications to aid in their recovery and help them during physical therapy until full recovery.
What About the Surgical Procedure and Recovery Period?
The knee replacement surgical procedure typically takes about one hour.
However, there is an additional preparation time in the operating room, which lasts approximately one hour. During the surgery, the latest equipment is used to ensure the procedure is performed safely.
After the surgery, the patient is transferred to the recovery room, where they stay for about an hour before moving to their hospital room or, if needed, to the intensive care unit for closer monitoring throughout the day.
Patients usually start walking with the assistance of a walker the next day after the surgery although some patients managed to walk few hours after the surgery. The hospital stay generally ranges from four to seven days, depending on whether one or both joints are replaced. During this time, the patient is closely monitored to ensure their safety, and appropriate medications are prescribed based on the patient’s condition.
Upon discharge, the patient receives specific instructions regarding wound care, follow up intensive physiotherapy program at our specialized center and home exercises. Patients can generally walk easily with the help of a walker after leaving the hospital.
What About the Follow Up Visits?
Post-hospital care and follow-up are essential parts of the recovery process. In addition to the customized two-month physical therapy program, our center provides a comprehensive follow-up plan, including periodic visits. The schedule is as follows:
One week after discharge: The first follow-up visit.
Monthly for three months: Subsequent visits to monitor progress.
Annually: An annual check-up.
During these visits, a clinical examination is conducted to assess the patient’s progress. The patient is questioned about their activities, such as walking, climbing stairs, sitting on the floor, and other daily tasks. X-rays are also taken to ensure that the new joint is functioning properly.
What About Rehabilitation After the Surgery?
Physical therapy is the essential phase that complements the surgical procedures, aiming to rehabilitate patients to achieve full mobility, such as kneeling on the ground. This is done under the supervision of highly skilled therapists in this field. Therefore, we advise patients to pay significant attention and commitment to the physical therapy program, which is specifically designed to meet each patient’s physical and functional needs.
To ensure the best possible recovery in the shortest time, we have provided the latest equipment in our physical therapy department. Our goal is to help patients regain muscle and ligament flexibility, strength and pain-free movements in the shortest period
What to Expect after the minimally invasive knee replacement?
"Realistic activities following minimally invasive knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports"
The Video from the AAOS youtube channel
Frequently Asked Questions about Minimally Invasive Knee replacement Surgery
A. More than 70 % of the patients have injuries in the two knees. As the problem will not
be solved by replacing one joint, we make sure to perform the surgery for the two knees
at the same time. The dual surgery results are excellent and save money, time and
exposure to two surgeries. The only thing is that the patient stays in the operations
room for another hour, and stays in the hospital for 7 days.
A. The patient has to pay attention to infections in the first year following the surgery.
Any surgeries performed shall be accompanied with wide-range antibiotics before and
after the surgery, even when it comes to dentistry. Also, the patient has to treat any
infections in the first year with wide-range antibiotics, to avoid any infection that will
spread to the joints.
A. Most patients are elderly, and many operations were performed for patients above 80
and 90 years successfully, while assuring their readiness to surgery before
performance.
A. Most patients who suffer from chronic diseases such as diabetes & heart diseases
have had surgeries performed successfully after referring them to the specialized
physician for screening to obtain his approval for the surgery.and 90 years successfully, while assuring their readiness to surgery before
performance.
A. Obesity complicates surgery, yet surgeries were successfully performed for patients
who are above 100-140kg. It is rather challenging to ask the patient to lose weight, as
his/her weight may increase difficulties in movement and cause decreased activity
after surgery.have had surgeries performed successfully after referring them to the specialized
physician for screening to obtain his approval for the surgery.and 90 years successfully, while assuring their readiness to surgery before
performance.