CORE Orthopedics offers a wide range of treatments and procedures for knee injuries and knee pain, including several minimally invasive surgeries and total and partial knee replacements.
As the body’s largest joint, the knee allows the leg to bend in only one direction. The knee is one of the most important joints in sports and in general, as it supports your body’s weight as you stand, walk, run, and jump.
The knees are vulnerable to injury and osteoarthritis because of the heavy load they bear. CORE Orthopedics offers treatments, procedures, and surgeries for many knee conditions.
CORE Orthopedic’s knee surgeon, Dr. Kuesis, is a specialist in hip and knee joint replacement, hip and knee disorders, minimally invasive hip and knee surgery, hip and knee arthroscopy, anterior hip replacement, same day outpatient hip surgery, and sports medicine. Dr. Kuesis has performed more than five hundred hip and knee procedures within the past year.
In the ACL reconstruction Arthrex Tightrope procedure, a damaged ACL (anterior cruciate ligament) is replaced with a tendon graft. The graft is sometimes taken from the patient’s body during the procedure and in other times harvested from a donor before the procedure.
The patient is anesthetized in preparation for the procedure and an arthroscopic camera is used to guide the surgeon.
The surgeon begins the procedure by drilling two small tunnels through the femur and tibia, leading down to the joint. After guiding the TightRope devices through the femoral tunnel to the tibial tunnel, the ACL TightRope is attached to the tendon graft and the graft is pulled up through both tunnels. The TightRope device is then pulled tightly against the femur, providing a stable anchor point for the graft. The lower portion of the graft is secured with a screw.
The patient will be able to begin limited exercise with a knee brace within two to three weeks and will then progress to a physical therapy program.
The ACL reconstruction patellar tendon graft technique repairs the knee after the ACL has been torn. In this technique, a damaged ACL is replaced with a patellar tendon graft.
The patient is anesthetized in preparation for the procedure.
The surgeon starts the procedure by removing a portion of patellar tendon and bone to use as a graft to replace the damaged ACL. Using surgical instruments and an arthroscopic camera, the surgeon removes the damaged ACL. The graft is then inserted into the space where the ACL was. The tendon is anchored and over time, new tissue will grow along the graft, strengthening the joint.
After the procedure, the knee is bandaged and sometimes placed into a splint or brace. The patient will regain normal function of their knee.
The ACL reconstruction with a hamstring ligament is used to repair a damaged ACL by replacing it with a portion of hamstring tendon from the patient’s leg. An arthroscopic camera is used to help guide the surgeon.
The surgeon first separates portions of the patient’s semitendinous and gracilis tendons from the hamstring muscle but leaves them connected to the tibia. These strips of tendon are then braided to create autograft. Next, the damaged ACL is removed and the surgeon drills tunnels through the tibia and femur. The hamstring grafts are pulled through the tibial tunnel and secured with a horizontal screw that is inserted through the femoral tunnel.
After the procedure, the knee will be tested for its full range of motion.
ACL reconstruction with hamstring using ARTHROTEK and EXLoc Devices is a similar procedure to ACL reconstruction with a hamstring ligament. It is also performed to repair a damaged ACL in the knee joint.
The difference is that instead of attaching the braided hamstring tendon graft to a horizontal screw through a femoral tunnel, the graft strand is attached to an EZLoc implant and is pulled through the tibia tunnel. After passing all the way through the tunnel, the EZLoc device is opened and pulled back firmly against the bone surface. This anchors the graft.
This procedure replaces damaged cartilage in the knee joint with cartilage cells that are harvested from healthy portions of the knee and grown in a lab for implantation.
An arthroscopic camera and other surgical tools are inserted into the knee joint to remove healthy cartilage cells. The cells are then sent to a lab for about four to six weeks. During this time, the cells are cultured to grow new cartilage cells.
Cartilage repair treats and repairs cartilage defects by regenerating the patient’s healthy hyaline cartilage.
Using an arthroscope, the surgeon identifies the defect in the joint. A small amount of healthy cartilage is then removed from the joint and sent to a laboratory for about 4-6 weeks. In the lab, the cartilage cells are cultured to produce millions of new cells.
The patient then returns to the operating room for a second surgery. Over time, the new cells will form a new layer of weight bearing cartilage tissue.
The high tibial osteotomy procedure is performed to correct “genu varum”, also known as bow-leggedness.
In the procedure the fibula may be temporarily moved to the side in order to expose the side of the tibia. The surgeon removes a wedge of bone from the tibia and attaches a metal plate to the bone above the open space where the bone was removed. The space is then closed, straightening the tibia. A screw is inserted into the bottom portion of the metal plate, securing the tibia. The fibula is then reattached.
This minimally invasive, outpatient procedure is performed to remove debris from the knee joint that has broken free and is floating in the joint.
The patient is anesthetized, and the surgeon creates a few small openings in the knee for an arthroscopic camera and various surgical instruments. Once the debris has been identified in the knee joint, the surgeon uses a grasping instrument to remove the debris from the knee.
The knee will only take a few weeks to heal.
This is a minimally invasive procedure that repairs damaged cartilage in the knee joint. During the procedure, small holes are drilled into the bone at the base of the damaged area in order to stimulate the growth of healthy scar cartilage.
Before the procedure, the patient is anesthetized. Incisions are made on either side of the patella. The surgeon removes any loose or damaged cartilage before inserting a small, sharp awl and creating several small holes in the bone. The incisions are then closed with sutures or surgical staples.
The patient can leave the hospital the same day as the procedure, but weight should not be put on the knee for six to eight weeks. Full recovery usually takes between four and six months.
OATS Cartilage repair surgery is performed to replace damaged cartilage with grafts of the patient’s healthy articular hyaline cartilage.
With the guidance of an arthroscopic camera, healthy cartilage is harvested from a region that has little contact to the tibia. The diseased cartilage is then removed, creating a socket for the graft. The graft is inserted into the socket and tapped into place until the surface is level with the surrounding cartilage. If the damaged area is larger, the surgeon will repeat the process with multiple grafts until the entire damaged area is filled.
Following the procedure, the patient will undergo rehabilitation therapy and may need the assistance of crutches for a few months.
This is a less invasive knee replacement surgery to the total knee replacement surgery. In a partial knee replacement, only the damaged parts of the knee are replaced. Metal and plastic implants that are designed to last longer are used to replace the damaged parts of the knee.
The surgeon begins by making an incision in the knee and removing damaged portions of the femur and parts of the damaged meniscus. To make room for the new metal tibial component, some bone is removed from the tibia. Then, a small portion of bone is removed from the damaged femoral condyle and it is reshaped in order to fit the metal femoral component. After a groove is cut into the tibia surface and cement is applied, the metal tibial component is inserted. Next, bone cement is applied to the prepared femoral surface and the metal femoral component is inserted. A plastic implant is inserted in between the tibial and femoral implants.
Instead of being fixed into place, the plastic insert moves when the knee moves. This will reduce wear on the implant, allowing it to last longer.
Tibial tubercle osteotomy is a bone realignment procedure that is designed to improve the movement of the patella and to correct patellar tracking disorder.
The patient is usually hospitalized, and general anesthesia is administered.
The surgeon begins the procedure by making a four to six-inch incision over the tibial tubercle. Using a bone chisel or a surgical saw, the surgeon partially or completely detaches the tibial tubercle from the tibia. The patellar tendon stays connected to the tubercle. The tubercle is then realigned so that the patellar is in the correct position for when the knee bends, allowing for proper movement. The tibial tubercle is then reattached to the tibia with a metal plate, wires, or screws.
The incision is closed, and a knee immobilizer or cast is placed on the knee to restrict movement. The staples or sutures used to close the incision will be removed after two weeks and the patient may have to use crutches for four to six weeks. Complete recovery for a tibial tubercle osteotomy can take six months to a year.
A total knee replacement procedure is performed when the patient’s knee has been severely damaged, most commonly from arthritis.
In this procedure, the surgeon replaces severely damaged parts of the knee with the following artificial parts: a metal femoral component, a metal tibial component, a plastic spacer, and sometimes a small plastic patellar component.
After an incision to the front of the knee, the knee cap is moved out of the way, exposing the joint to the surgeon. The surgeon then removes and trims the damaged ends of the femur and tibia. Cartilage and a small amount of bone is also removed to reshape the bones, providing a stable platform for the artificial components. The surgeon inserts the metal femoral and tibial components and a plastic spacer is secured to the tibial component, allowing the femoral component to glide smoothly as the knee flexes and extends.
The surgeon may also choose to resurface the knee cap by carefully trimming away the back of the knee cap and replacing it with a small, plastic cap.
The new components will then be tested to make sure the knee flexes and extends in a fluid, natural motion. After the procedure, the patient will need physical therapy, an important part of the recovery process.
An ultrasound-guided injection is a non-operative, outpatient procedure performed to alleviate pain from arthritis of the knee.
After administering a regional anesthetic, the physician positions a handheld ultrasound probe that will allow the physician to see the anatomy of the knee and accurately inject an inflammation-reducing steroid into the knee. Inflammation in the knee joint is reduced and the patient’s knee pain will be relieved.
An outpatient knee replacement surgery is very similar to the traditional knee replacement surgery. What is done during the procedure is almost the exact same. Just like in a traditional knee replacement, the surgeon replaces severely damaged parts of the knee with the following artificial parts: a metal femoral component, a metal tibial component, a plastic spacer, and sometimes a small plastic patellar component.
The difference lies in the location of the operation, the length of time spent in the hospital after the procedure, and the recovery time. The recovery time for an outpatient procedure is much quicker.
One reason outpatient total knee replacements are now possible is because of recent advancements in anesthetic techniques, like femoral regional blocks. These new anesthetic techniques do not require hospital stay.
Outpatient knee replacement surgeries are also possible because of the minimally invasive techniques that Dr. Kuesis specializes in. Instead of many large incisions to the knee, he approaches the knee through a few small incisions, protecting the surrounding tendons and muscles from being cut. This allows for a much faster recovery.
Dr. Kuesis offers knee replacement surgeries with the increasingly popular, patient-specific custom cutting blocks. With computer-assisted preoperative planning, we are able to provide patient specific instruments. Using custom cutting blocks tailored to individual patients has proven to cut down operative times and improve implant alignment. All the planning for the surgery is done virtually on a computer before the surgery even begins.
Dr. Kuesis specializes in short stay joint replacements that allow for a faster, more comfortable recovery. With his minimally invasive techniques, patients are able to walk out of the hospital or medical center on their own after a short stay joint replacement surgery.
See the information below to learn more about your knee condition and about some of the treatment options available to patients at CORE.
He received his medical degree from Northwestern University and completed his surgical internship and orthopedic residency at Duke University Medical Center. During his tenure at Duke, he was a physician for the Duke University and North Carolina Central University sports teams and the US Airborne and Special Forces divisions at Fort Bragg.
Dr. Kuesis continued his medical training with a fellowship at New England Baptist Hospital in Boston and has published numerous papers on joint replacement, alternate-bearing surfaces for total hip replacements, and sports-related injuries. Dr. Kuesis is a member of the honorary medical society,Alpha Omega Alpha, and he graduated Magna Cum Laude from Illinois Benedictine College.
555 Biesterfield Road Elk Grove Village, Illinois 60007-3306 Phone : (847) 690-1776
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