Dr. Meneghini specializes in adult hip and knee reconstruction. He uses the latest technology and advancements in implant materials and joint preservation techniques to allow patients to keep up with an active lifestyle after surgery.
Arthritis and injuries can severely damage the knee, making it difficult to perform everyday activities. Dr. Meneghini offers different knee replacement procedures to relieve knee pain and restore function.
During a total knee replacement, the damaged cartilage within the knee joint is removed, along with a small amount of underlying bone. These surfaces are then replaced with metal components designed to recreate the knee joint, and the implants are cemented into place. A plastic spacer is inserted between the two metal components so that the new joint can glide smoothly when bending and straightening the knee. In some cases, the inner surface of the kneecap is trimmed and resurfaced with a plastic button.
At times, arthritis damage may be limited to just one section, or compartment, of the knee. For these patients, partial knee replacement may be an option. With a partial knee replacement, only the damaged compartment of the knee is replaced, and the healthy cartilage and bone is left alone. In the right candidates, partial knee replacement can be very successful.
Dr. Meneghini also offers both total and partial knee replacements on an outpatient basis for patients who are healthy and wish to recover at home. Dr. Meneghini uses the same technology and implants for an outpatient knee replacements as he does for an inpatient knee replacement.
Revision Total Knee Replacement
Knee replacements can allow patients to live active lives for many years. However, the implants can loosen and wear down over time, causing pain, stiffness, or instability. In these cases, a revision total knee replacement may be recommended. During a knee revision procedure, the original implants are carefully removed to preserve as much bone as possible, and new implants are put in place. If there is significant bone loss, metal augments and platform blocks can be added to fill the space.
Hip pain from arthritis or a fracture can make everyday activities difficult, if not impossible. If hip pain interferes with your daily life, hip reconstruction may be right for you.
If nonsurgical treatment for hip arthritis fails to relieve pain and stiffness in the hip, total hip replacement may be right for you. The hip is a ball-and-socket joint, with the “ball” at the upper end of the femur (thighbone) fitting into a socket in the pelvic bone. Cartilage covers these surfaces to allow for easy movement within the joint. A total hip replacement uses implanted components to mimic a healthy hip joint. During the procedure, the damaged ball at the head of the femur is removed, and a ball with a metal stem is inserted into the center of the femur. The damaged cartilage is then removed from the socket, and the socket is lined with a metal cup. A plastic spacer is inserted between the two metal components to allow for ease of movement.
Minimally Invasive Total Hip Replacement
During a traditional total hip replacement, one large incision is made on the side of the hip and the muscles are detached from the hip to access the joint. This can lead to a lengthy recovery time. However, some patients may be eligible for a minimally invasive hip replacement. During a minimally invasive total hip replacement, one or two smaller incisions are made. The muscles are still split or detached from the hip, but to a lesser extent than is needed for a traditional hip replacement. This approach allows for a shorter recovery time and less blood loss than a traditional total hip replacement.
If a patient is healthy and would prefer to recover at home, Dr. Meneghini may offer outpatient hip replacement. Many patients feel more comfortable recovering at home, and may also have cost savings by avoiding an overnight hospital stay. The process is the same as an inpatient procedure, with the exception of the hospital stay.
Direct anterior hip replacement, which involves making the incision at the front of the hip rather than the side, has been lauded by many as the “best” approach for hip replacement. However, Dr. Meneghini and his colleagues have published pioneering studies on direct anterior hip replacement that highlight the risks of this procedure, including implant loosening and early fracture. Dr. Meneghini advises that patients choose a surgeon based on their experience, not the surgical approaches they use to market themselves.
Advancements in technology have allowed for new approaches to joint replacement.
Computer-Assisted Joint Replacement
Computer-assisted joint replacement technology assists Dr. Meneghini in placing the implants for the best alignment possible. This approach allows for better imaging of the anatomy, providing more precise results than the traditional approach to joint replacement.
Knee implants are traditionally cemented into place. However, some implants are now made with a textured, porous, or coated surface that encourages bone growth. With these cementless knee implants, new bone grows into the implant, holding it in place. These implants can require a longer healing time than cemented implants, but can be just as effective and stable.