Treatment Options for your Knee Pain. HOW YOUR KNEE WORKS Anatomy of the knee Largest joint in body...
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Transcript of Treatment Options for your Knee Pain. HOW YOUR KNEE WORKS Anatomy of the knee Largest joint in body...
HOW YOUR KNEE WORKS
Anatomy of the knee• Largest joint in body
• Referred to as a hinge joint because it allows the knee to flex & extend; while hinges can only bend and straighten, the knee has the ability to rotate (turn) & translate (glide)
• 3 bones
• Shin bone (tibia)
• Thigh bone (femur)
• Kneecap (patella)
WHAT’S CAUSING YOUR PAIN?
It’s estimated 70 million people in the U.S. have some form of arthritis.1 Osteoarthritis is one of the most common types. •Osteoarthritis
• Wear and tear that deteriorates the “cushion” in your joints
• A degenerative condition—it won’t get better and may get worse
•Rheumatoid arthritis
• An autoimmune disease that attacks the lining of joints, causing swelling, possibly throbbing painand deformity
1. Landers, S. Another reason to exercise for those with arthritis. American Medical Association website. <http://www.ama-assn.org/amednews/2005/05/02/hlsc0502.htm>, 2005.
WHAT’S CAUSING YOUR PAIN?
Healthy knee The end of each bone in the joint is covered with cartilage, acting as a cushion so the joint functions without pain
Diseased knee (osteoarthritis) Wear and tear deteriorates natural cushion, leading to bone-on-bone contact, soreness and swelling
ASSESSING YOUR PAIN
• Does your knee hurt one or more days per week?
• Does the pain interfere with your sleep?
• Is it painful for you to walk more than a block?
• Are pain medications no longer working?
• Is knee pain limiting your participation in activities(e.g. family vacations or other functions)?
• Has inactivity from knee pain caused you to gain weight?
Little or no pain
Excruciating, debilitating pain
ASSESSING YOUR PAIN
• Rate your pain on a scale of 1 to 5
• For most people, the tipping point is about 4 or 5— that’s when the pain becomes too difficult and they turn to a surgeon for relief1
1. 2007 DePuy Orthopaedics, Inc. Knee Attitudes & Usage Study.
ASSESSING YOUR PAIN
Check your mobility
If you have difficulty performing any of the movements below, it may be time to talk to your doctor about next steps
Walk Bend at thehips and knees
Pretend to drive: push the gas/brake
Pretend to golf: swing a club
HOW CAN YOUR PAIN BE TREATED?
Water therapy• Soaking, ice packs, hot packs
Exercise & physical therapy• Also good for weight loss
Medications• Analgesics• Corticosteroids
Injections• Corticosteroids, hyaluronic acid
(e.g., ORTHOVISC®)
ORTHOVISC® is a trademark of Anika Research, Inc.
KNEE REPLACEMENT
• Implants replace damaged surfaces
• Helps relieve pain and restore mobility
•In 2011, more than 650,000 total knee replacements were performed in the United States1
•One study has shown that ten years after surgery, 99.6% of patients still depend on their SIGMA® Knees with fixed bearing option in their daily lives2
1. 2012 Premier, Inc.2. Dalury et al. Midterm results with the P.F.C. SIGMA Total Knee Arthroplasty System. The Journal of Arthroplasty
Vol.23, No.2, 2008: 175-181.
Femoral component
Tibial component
WHAT IS KNEE REPLACEMENT?
A surgical procedure that removes and replaces diseased joint surfaces with implants
Femoral component
Tibial component
Patellar component
Polyethylene insert
HOW DOES IT WORK?
• Diseased areas at top of shin bone (tibia) and bottom of thigh bone (femur) are removed and reshaped
• Femoral component covers the thigh bone (femur)
• Tibial component covers the shin bone (tibia)
• Polyethylene insert placed between femoral and tibial components
• Patellar component replaces the kneecap (patella)
DEPUY SYNTHES JOINT RECONSTRUCTION
SIGMA® KNEES
• SIGMA Knees come in a wide range of shapes, sizes and materials
• Your surgeon may be able to fit you with a SIGMA Knee designed to provide a natural feel and movement
• The SIGMA Knee is an example of a proven design that continues to evolve to meet the demands of today’s patients
FIXED BEARING KNEES
• Most widely used type of knee replacement in the U.S. today1
• Designed to enhance stability of the joint
• New designs and advanced materials - Helps reduce wear
1. IMS Health
SIGMA® ROTATING PLATFORM KNEES
Designed to rotate as it bends, imitating your natural knee movement
•The surfaces of the knee joint roll and glide against each other as you bend. In other words, your knee naturally rotates as it bends
•Designed for patients who want to remain active since it minimizes implant wear, compared to traditional knee replacements1
•One study has shown after 20 years, 97% of patients still depend on their rotating platform knees in their daily lives2
1. McNulty, D. et al. “In Vitro Wear Rates of Fixed-bearing and Rotating Platform Knees (Rev. 2).” 2003.2. Buechel F., et al. “Twenty Year Evaluation of Meniscal Bearing and Rotating Platform Knee Replacements.” Clinical Orthopaedics and Related Research July 2001: 41-50..
SHOULD YOU WAIT TO REPLACE YOUR KNEE?
Assess your pain and ability to function• Do you feel severe pain in your knee?• Has the pain and loss of function affected your quality of life?• Do you have difficulty sleeping or performing basic functions
(walking, driving, climbing stairs)? • Does medication no longer provide relief?
Consult your physician
Early diagnosis and treatment are important1
• Delaying may lower your quality of life2
Osteoarthritis is degenerative—it won’t get better and may get worse
1. Fortin PR, et al. Outcomes of Total Hip and Knee Replacement. Arthritis & Rheumatism. 1999;42:1722-1728. 2. Fortin PR, et al. Timing of Total Joint Replacement Affects Clinical Outcomes Among Patients With
Osteoarthritis of the Hip or Knee. Arthritis & Rheumatism. 2002;46:3327-3330.
IMPORTANT SAFETY INFORMATION
• As with any medical treatment, individual results may vary
• The performance of joint replacements depends on your age, weight, activity level and other factors
• There are potential risks, and recovery takes time
• People with conditions limiting rehabilitation should not have this surgery
• Only an orthopaedic surgeon can tell if knee replacement is right for you
SUMMARY
• The leading cause of knee pain is osteoarthritis
• Osteoarthritis is degenerative – it won’t get better and may get worse
• Early diagnosis and treatment for total knee replacement are important1
• An Arthritis Foundation® study shows knee replacement has a 90-95% rate of patient satisfaction2
• SIGMA Knees come in a wide range of shapes, sizes and materials, so your surgeon can recommend the implant that is right for you.
Arthritis Foundation® is a trademark of The Arthritis Foundation, Inc.
1. Fortin, Paul R., et al. Outcomes of Total Hip and Knee Replacement. Arthritis & Rheumatism 42 (1999): 1722-17282. The Arthritis Foundation. <http://arthitis.org/research/Bulletin/vol5no11/Printable.htm>, 2006.
ADDITIONAL SLIDES
The following slide is the SIGMA® High Performance Partial Knees module.
If desired, please select the appropriate slides to include within this
presentation.
REMOVE THIS SLIDE WHEN PRESENTING
SIGMA® HIGH PERFORMANCE PARTIAL KNEES
High Performance Partial Knees
Can replace any of the three areas of your knee; replacing only the damaged area maintains more of your natural knee
•May be an option for more active patients who require a high degreeof flexion but not total knee replacement
•Accommodates deep knee flexion, the movement needed for kneeling,squatting or sitting cross-legged
•Less invasive with potential for faster recovery than total knee replacement
ADDITIONAL SLIDES
The following 3 slides are the TRUMATCH® Personalized Solutions
module.If desired, please select the appropriate
slides to include within this presentation.
REMOVE THIS SLIDE WHEN PRESENTING
TRUMATCH® PERSONALIZED SOLUTIONS
What is TRUMATCH?
• Uses advancements in technology to provide surgeons with customized surgical guides that are designed specifically for your knee anatomy
BENEFITS OF TRUMATCH SOLUTIONS
• Helps your surgeon achieve consistency in the placement and positioning of your knee replacement
• TRUMATCH instruments help your surgeon to obtain a precise fit of the implant. The implant helps reduce a patient’s pain and restore their mobility
• Reduces number of surgical steps
TRUMATCH® PERSONALIZED SOLUTIONS
How does it work?
• A CT scan of your leg is taken
• A 3-D model of your knee is developed
• Personalized guides are created based on your unique anatomy
• Your guides help your surgeon position and place your new knee implant
• Guides are removed by your surgeon prior to your new knee being implanted
ADDITIONAL SLIDES
The following 3 slides are the SIGMA®
Partial Knee Alternative module.If desired, please select the appropriate slides to include within this presentation.
REMOVE THIS SLIDE WHEN PRESENTING
PARTIAL KNEE REPLACEMENT
Removes only the damaged area of the knee
Uses metal and plastic implants to replace the damaged area, helping to relieve pain and restore natural movement.
POTENTIAL ADVANTAGES OF A PARTIAL KNEE
• Maintains more of the healthy ligaments and bone, helping to restore the natural movement during activities
• Potential for faster recovery
• Minimally invasive procedure to reduce blood loss
• Possible reduced scarring
Unicondylar Patellofemoral
ADDITIONAL SLIDES
The following 3 slides are thegender-specific module.
If desired, please select the appropriate slides to include within this presentation.
REMOVE THIS SLIDE WHEN PRESENTING
IMPORTANT CONSIDERATIONS FOR WOMEN
• Osteoarthritis affects three times more women than men1
− Women are more likely than men to be disabled− The pain is more severe for women2
• Current knee replacements are designed to fit the anatomies of both women and men
1. Hawker, Gillian A., et al. "Differences Between Men and Women in the Rate of Use of Hip and Knee Arthroplasty.“The New England Journal of Medicine 342 (2000): 1016-1022
2. Harris Interactive research survey, April 2005
GENDER-SPECIFIC IMPLANTS
• All orthopaedic manufacturers have knee implant systems with sizes appropriate for both female and male patients
− Surgeons know which knee will fit each patient best, based on gender, age, size, activity levels and aspirations
GENDER-SPECIFIC IMPLANTS
• More than 60% of knee replacements have been implanted in women1
• Current knee replacement patients have a 90 to 95% satisfaction rate with the results of their surgery2
1. American Academy of Orthopaedic Surgeons<http://www.aaos.org/wordhtml/research/stats/Hipkneefacts.htm>, 2006.
2. The Arthritis Foundation<http://www.arthritis.org/research/Bulletin/vol51no11/Printable.htm>, 2006.
ADDITIONAL SLIDES
The following slide is the minimally invasive knee surgery module.
If desired, please select the appropriate slides to include within this
presentation.
REMOVE THIS SLIDE WHEN PRESENTING
MINIMALLY INVASIVE KNEE REPLACEMENT SURGERY
• SIGMA® Knees can be implanted using minimally invasive surgery
• Alignment affects:− How long your knee replacement lasts− Long-term success
ADDITIONAL SLIDES
The following 2 slides are thecomputer-assisted surgery module.
If desired, please select the appropriate slides to include within this
presentation.
REMOVE THIS SLIDE WHEN PRESENTING
COMPUTER-ASSISTED SURGERY
What is computer-assistedsurgery (CAS)?
− An approach to knee replacement
− The patient’s anatomy is simulated and displayed on a computer
− Computer provides information about where to place the components
POTENTIAL BENEFITS OF CAS
• CAS guides surgeon in areas that are difficult to visualize
• Relays specific measurements not previously available to surgeons, such as implant alignment and angle of cuts
• Gives precise, accurate data on your specific anatomy
• Allows surgeons to make decisions about implant placement based on detailed data from the computer