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Lawrence Kohan, Orthopaedic Surgeon
MB, BS(HONS) F.R.A.C.S. F.A.Orth.A.
Unicompartmental Knee Resurfacing
Joint Orthopaedic Centre
99 Spring Street Bondi Junction NSW 2022
Telephone: (02) 9387 5985 9387 2877
Facsimile: (02) 9287 5557
32 Norton Street, Leichhardt NSW 2040
Telephone: (02) 9569 8272
Mailing Address:
PO Box 240, Bondi Junction NSW 1355
Web:
www.jointreconstruction.com
Dr LAWRENCE KOHAN
M.B, B.S (Hons) F.R.A.C.S., F.A. ORTH.A.
What motivates my work as an orthopaedic surgeon is helping
people to maintain quality of life. My work makes it
possible for very ill or injured people to regain - and keep
- their health and independence.
We live much longer lives these days, because of advances in
medicine, nutrition and hygiene. We hope for active lives in
strapping good health. But we cannot always protect
ourselves from illnesses or accidents such as degenerative
joint disease, rheumatoid arthritis, or severe injury to the
joints.
The surgery I perform, such as hip and knee replacements,
knee reconstructions and arthroscopic surgery, improves the
mobility and function of the injured joint.
For older people this can mean many more years of valuable
independence and active life. For younger people,
particularly those with knee injuries, surgery can save them
from permanent disability, and in some cases will see them
right back onto the football field!
Once more they can trust their body to brace them for the
brisk pace of life in today's world. I watch my patients
progress from pain and fear, to rehabilitation, and then in
most cases to a return to normal life. It gives me a great
deal of satisfaction. It's my lifelong professional
commitment
Medial unicompartmental knee resurfacing (Repicci),
results for 588 implants at 56.8 months average
follow up.
Original Link
L Kohan, R Cordingley, D Kerr (Joint Orthopaedic
Centre)
Introduction:
This is a descriptive, prospective, longitudinal
analysis of functional outcomes and component
survival in 588 medial unicompartmental knee
resurfacing procedures. A consecutive series over
6.8 years with all implants the Biomet Repicci 11
(Biomet). An overall 97.8% implant survival rate was
achieved.
Method:
All surgical implantations were carried out by
one surgeon using a minimally invasive approach. All
patients underwent an early mobilisation
rehabilitation programme. No patient was lost to
follow-up. The age range for the knee resurfacing
components was 43-92 years, with 367 males and 219
females. The average age was 68 years. SF-36 and
Womac Health Questionnaires were completed. The
patient inclusion criteria for this cohort included
articular cartilage changes no greater than grade 2
(outerbridge) in lateral compartment and more than
half of the ACL intact.
Results:
Total survival was 97.8%. 588 knees were
resurfaced with a mean elapsed time since
re-surfacing of 56.8 months (Median 64 months,
maximum 82.6 months).There were 13 failures that
required revision. 2 from deep infection, 1 loose
femoral component, 1 ACL failure and instability and
9 progression of arthritis. There was one DVT in a
patient that remained in hospital for 5 days. 87% of
patients were discharged from hospital 23 hours
after surgery. SF-36 and WOMAC scores were assessed
preoperatively, 6, 12 months and annually post
operatively. Function, pain, stiffness, social
functioning, physical function and role physical all
improved dramatically in the first 6months after
surgery then remained static out to 6.8 years.
Dr. Kohan Interview
Original Link
1. What is the difference between total knee
replacement and unicompartmental knee resurfacing?
Knee replacement is removing the edges of the
joint that have been diseased by degeneration or
trauma.
Knee resurfacing is like a retread. The only part
of the joint that is resurfaced is the side of the
joint that is diseased.
2. How long is the hospital stay?
Unicompartmental knee resurfacing is considered
day only surgery.
3. What type of anaesthetic will I have?
The anaesthetic is a light general anaesthetic.
You will be asleep for approximately 2 hours.
4. How long is the operation?
The operation is approximately 2hrs and 1hr in
recovery.
5. Will I need help at home?
The advantage to unicompartmental knee
resurfacing is the fact that you can return to your
normal daily activities soon after surgery. You may
need someone to stay with you the first couple of
nights but you should feel independent by the third
day.
6. What about stairs?
You will not be discharged from hospital until
you can manage the stairs.
7. When can I walk?
Walking begins a couple of hours after your
surgery. The physiotherapist will aid you.
8. How long must I use the crutches?
The crutches can be discarded when you feel
strong enough or after one week.
9. How long must I wear the knee brace?
The knee brace must stay in place for 48hrs.
10. How long will my knee be swollen?
The initial swelling appears in the first week
after surgery. Some patients experience the some
form of swelling up to 12 months following their
operation.
11. Can I get my knee wet?
You must try to keep your incision dry until the
skin clips are removed. If you get the incision wet
you will increase the chances of you getting an
infection. Also, it is not wise to swim for 2 weeks
following surgery, for skin needs time to heal.
12. How long is the incision?
7-10 cm over the front of your knee.
13. Do I need Physiotherapy?
The physiotherapists will attend at the
hospital, as a general rule but you will not require
any physiotherapy after your surgery.
14. When can I drive?
Approximately one week following surgery. Please
check with Dr Kohan before you drive your car.
15. When are the skin clips removed?
10-14 days after surgery.
16. How much walking should I do?
Walking or weight bearing is very important in
your recovery phase. You should walk around as much
as you can during the day. Motion is Lotion for your
knee.
17. Can I participate in high impact activity?
Running and jumping is not recommended for
unicompartmental knee resurfacing. The implant can
crack or wear out before their time.
18. What is the implant made up of?
The metal component is steel and the plastic is
a high-density polyethylene.
19. What is the life span of the implant?
Approximately 8-10 years depending on use.
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