I treat the pain of early arthritis with a combined, conservative approach. A good first step is trying over-the-counter pain and anti-inflammatory medication.
It’s important to check with your primary doctor to make sure you are allowed to take these medicines. If over-the-counter medications aren’t working, I can prescribe you a prescription-strength, long-acting anti-inflammatory like Celebrex or Meloxicam.
For people who still have knee pain, injecting medicine directly into the knee can provide months of relief for some patients. This is a quick and relatively painless procedure that can be done in the office during your appointment. Joint injections are available in a few different formulations and can be repeated every 3-6 months if they are providing excellent relief.
In addition to medications and injections, strengthening and supporting the muscles around the knee can also relieve knee pain for some patients.
Conservative management is always the first step of treatment. For many patients, conservative treatment can offer months to years of pain relief without the risks of surgery.
While joint replacement is one of the safest surgeries, all surgeries carry the risk of infection, nerve or blood vessel injury, or complications from anesthesia.
My approach is considered minimally invasive, which minimizes or avoids damage to muscles, tendons, and ligaments around your knee joint while still replacing the arthritic joint. The steps of a knee replacement are as follows:
The goal of every total knee replacement is to have one operation that lasts the rest of your life. In the United States, about 20% of knee replacements require repeat surgery in the first 20 years, which means that at the 20-year mark 80% of patients are still doing well.
The implants that I use today have the highest satisfaction rating of any other implant on the market today boasting a survivorship of 97.6% after 20 years.
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Yes. Dr. Keating has access to every surgical robot on the market. Most patients are eligible for Dr. Keating’s preferred approach which uses custom instrumentation to perform a minimally invasive operation. Patients who are not candidates for the custom instrumentation can still have robotic surgery.
Every joint replacement has a plastic bearing that can be removed and replaced without disturbing the metals parts fixed to your bones. This allows a new bearing to be placed with a minor surgery compared to the first joint replacement surgery you had.
No! Dr. Keating does not restrict his patients from doing things that they love after surgery. However, patients must understand that the plastic bearing of their joint replacement will wear out faster with higher impact activities.
Every patient is different. Patients are up walking on a knee replacement the same day of surgery, usually with a device like a cane or walker for balance. By three weeks, most patients are off strong pain medication. By 6 weeks, most patients are back to doing most activities and at this point can ease back into higher levels of activity. By 12 weeks, patients are able to return to heavy activity levels.
Total and partial knee replacements are designed to last your whole life, but can wear out over time. At 15 years after joint replacement, about 85% of patients are still doing very well without repeat surgery.
Yes, Dr. Keating is not currently affiliated with a teaching hospital. He performs the incision, entire surgical approach, and personally implants the joint replacement. Dr. Keating works with a surgical team that helps close the surgical incision with plastic-surgery techniques.
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