A Minimally Invasive Quad-S paring Approach
By Laura Freeman
The Achilles heel of human mobility isn’t necessarily found in the foot. Knees are the joints that often fail first, which is why total knee replacement is such a high demand orthopedic procedure.
For many patients, this can offer a life-changing difference in preserving and extending mobility. But even after years of improvements in surgical techniques, undergoing and recovering from the standard procedure can be challenging. Beyond cutting into bone and replacing the joint, the traditional approach also cuts through muscles and damages ligaments and tendons, leaving patients dealing with severe pain and an extended recovery time.
Now the minimally-invasive Jiffy Knee procedure is offering many patients who need a total knee replacement a way to achieve the benefits with less pain and faster recovery.
“When we learned about the advantages of the Jiffy Knee approach, we were very pleased that three of our orthopedic surgeons, Drs. Scott Seibert, J. Dory Curtis and Patrick Rowan, were interested in pursuing the specialized training to offer this option. We’re proud and supportive of their efforts, which have made our patients at UAB Medical West the first in Alabama able to choose this new approach,” Christina Bunn of UAB Medical West said,
“The skin incision is made along the inner part of the knee as opposed to the direct front, and access to the knee joint is obtained by going around the quad muscle without having to cut through the muscle or tendon,” Patrick Rowan, MD said. “Leaving the quad muscle and tendon intact as opposed to cutting through them and later repairing is less traumatic to the soft tissues. By making the incision over the inner part of the knee, less tension is exerted to the healing skin while bending the knee compared to an incision made directly over the front. Many patients often report benefits in their early post-operative rehabilitation such as having less pain, faster return to walking independently, and greater overall satisfaction than they expected.”
Scott Seibert, MD has also been impressed with the outcomes he is seeing.
“I now perform the Jiffy knee as my preferred technique for total knee replacement with the possible exception of revision knee replacement,” he said. “There are no specific differences in the rehabilitation protocol, but we have noticed that our patients are progressing more quickly through therapy with faster improvement in range of motion, less time to discontinue using a cane, and less time till driving. There are no differences in the implants used or how long we can expect them to last compared to a traditional knee replacement.”
J. Dory Curtis, MD concurs.
“We use an incision that is medial relative to the kneecap and our deep incision does not cut any muscles or tendons,” he said. “We move all the muscles and the patella off to the opposite side. Also part of the Jiffy Knee procedure is to have patients start therapy very early within four hours before they go home. We then like patients to work with outpatient physical therapy rather than home therapy for their rehab, as it is typically more effective.
“Knee strength is regained more rapidly compared to the old-fashioned incision where we cut into the quad tendon. About half the patients say their pain is completely gone or very minimal after two weeks. Patients typically can get back to driving more rapidly, in around 10 days instead of the usual six weeks.”
The best candidates for the Jiffy Knee approach are patients in good general health, with good tissue without bone deformities or scarring from previous injuries or surgeries. With conditions like diabetes, blood sugar should be well controlled. Clotting disorders, the presence of a pacemaker, an infection or severe obesity are considerations that could influence risks or the likelihood of a successful outcome.
Overall, aside from patients needing a revision, many patients who would be good candidates for traditional knee replacement surgery would likely benefit from the Jiffy Knee approach. The procedure can also usually be performed faster than traditional knee replacements. Some surgeons in other areas who have been performing the procedure for a while report completing some procedures in as little as half an hour, which offers the added advantage of helping to reduce time under anesthesia.
When knee pain becomes severe and can no longer be controlled with more conservative measures, it could be time to seek an evaluation for knee replacement surgery. The Jiffy Knee is a new option that offers advantages many patients will want to consider.