Q: If you are knock-kneed, should you replace both knees at the same time for better alignment?
A: Replacing both knees at the same time is more of a safety issue than a mechanical one. If both knees are contracted (stuck in a bent position), that would be a definite reason to consider double replacement. For some patients, however, doing both knees at the same time is not as safe as doing a single knee replacement procedure.
Q:What is your opinion of ligament-sparing total knee replacement?
A: Arthritis can result in damage to the knee ligaments. If they are spared, it is nice to try to use them. If not, it is better to use devices and designs that don't rely on them.
Q: Are there a variety of implant sizes to fit various knee sizes?
A: Yes there are. However, statistically, there may always be 5% of patients whose geometry is not exactly matched to the size of the implant. There are techniques to address this surgically, so designing a custom part for that patient "outlier" isn't really necessary. (We tried that in the past. It doesn’t seem to make a difference clinically.)
Q: If you replace your knees, are you setting yourself up for problems with your hips?
A: No. (That's the quick answer.) Hip arthritis and knee arthritis are often not related, but they can be found in the same patient. Statistically, knee arthritis is five times more common in women, whereas hip arthritis is about 50-50.
Q: What type of infection can affect a knee replacement? How do you prevent it?
A: Any bacteria (bug) can cause infection around an artificial device. It is to be avoided at all costs. That being said, it is impossible to avoid infection 100% and the more complicated the surgery, the higher the risk. In the best of hands, infection should be a 3/1000 incidence for primary joint replacement, with the national quality standard set at less than 1% (10/1000). Ask your surgeon what steps he or she takes to minimize infection.
Q: Are foreign body reactions still a problem with joint replacements?
A: Allergy to implants is very rare. All implants are, in theory, "foreign bodies." Implants are very well-tolerated because the materials are non-allergenic alloys. When implants begin to deteriorate due to wear, the body will react to them, but it is due more to the wear process than to an allergy.