Knee Surgery

Below is a list of the knee surgeries that I frequently perform:

 Sports Medicine

  • Arthroscopic- assisted Anterior Cruciate Ligament (ACL) Reconstruction
  • Arthroscopic-assisted Posterior Cruciate Ligament (PCL) Reconstruction
  • Arthroscopic medial and lateral menisectomy and meniscus repairs
  • Arthroscopic treatment of articular cartilage (joint cartilage) loss by microfracture and osteoarticular  (cartilage plug) transfer
  • Arthroscopic and open treatment of patella instability and dislocations
  • Surgical treatment of patella tendinitis
  • Repair of quadriceps and patella tendon tears

 Joint Replacement:

  • Primary Total Replacement
  • Partial (Unicompartmental) Knee Replacement
  • Revision Replacement

 The following X-ray images depict the before and after appearances of KNEE surgeries I have personally performed. In order to protect patients’ identities, their names have not been used and all identifying features have been removed from these images.

1. Patient “G”:  Total Knee Replacement for osteoarthritis of the knee with varus (bow leg) deformity.

XRay showing advanced osteoarthritis of the knee before surgery.

Before Knee Replacement Surgery.

XRay showing knee implant in position after Primary Total Knee surgery for advanced osteoarthritis of the knee,

After Knee Replacement Surgery.

Patient “G” was a 68 year old man with severe and disabling right knee pain. His pre-operative X-rays shows advanced osteoarthritis of the knee with a varus ( bow leg) deformity. The post op X-ray shows the knee replacement in place with the normal knee alignment restored.

2. Patient “H” : Total Knee Replacement for osteoarthritis with severe varus (bow leg) deformity.

XRay image of arthritic knee of patient with severe bow leg deformity, taken before surgery.

Arthritis with severe varus (bow leg) deformity.

XRay image of knee, after surgery for Varus ( bow leg), with total knee replacement implant in position.

Post-op image of total knee replacement for arthritis and varus (bow leg deformity).

Correction of knee deformities, whether varus (bow leg) or valgus ( knock knee), is an important and integral part of total knee replacement done for knee arthritis. This is shown in the pre and post op X-ray images of patient “H”, a 72 year old man who had severe bow leg deformity. Also seen on the early post-op X-ray image of patient “H” ‘s knee are the metal skin staples used for closure of his surgical wound.

3. Patient “I” : Partial Knee Replacement for unicompartmental arthritis of the knee:

XRay image of knee before surgery, with unicompartmental arthritis.

Before surgery for arthritis of medial (inner side) compartment of knee.

X-ray image of knee after surgery for unicompartmental arthritis of the knee, with partial knee replacement implant in

After partial knee replacement surgery for arthritis of medial ( inner side) compartment of knee.

.When a patient has severe arthritis involving only the medial (inner side) or lateral (outer side) compartment of the knee, a partial knee replacement is an excellent operation which is less invasive and involves an easier rehabilitation. This is shown in the above post-op X-ray of patient “I”, a 52 year old woman who had failed to respond to all non-surgical treatments.

4. Patient “J”: Revision Knee Replacements, using special implants, for painful loosening of previous knee replacements.

XRay image of Knees with previous knee replacements done 14 yrs. earlier showing loosening and wear of implant.

Before Revision Surgery, showing old knee implants from 14 yrs. ago.

Post- op XRay image of knees showing the revision prosthesis in place.

After Revision surgery of both knees.

By age 73, patient “J” had already had both knees replaced 14 years earlier at another institution. He had pain in his knees because of loosening of the components. The post-op X-ray shows the revision (re-do) prosthesis. Note the long stems used for stability to compensate for bone loss and ligament damage from his loosened initial knee replacements.

5. Patient “K”: Patello- Femoral (Knee Cap Joint) re-alignment surgery for patello-femural arthritis with mal-alignment.

XRay image of knee before surgery, showing patello-femoral (knee cap joint) arthritis with associated patella maltracking ( misalignment).

Before surgery showing severe patello-femural arthritis.

XRay image of knee after knee cap surgery for patellar realignment - Front view.

Post op X-ray showing central position of knee cap and restored joint space.

Xray image of knee joint after Surgery for Fulkerson Osteotomy (knee cap joint correction).

Post op X-ray showing central placement of patella (knee cap).

This 46 year old lady had severe left knee pain because of patella-femoral ( knee cap joint) arthritis with associated patella mal- tracking (mis- alignment). Her pain was completely relieved by a Fulkerson Osteotomy. This operation involves cutting and moving the bone at the sight of the patellar tendon attachment. Note the central position of the knee cap and the restored joint space seen in the post- op X-ray.

Stanley P. Michael, MD