Total Knee Replacement

Dr. Kozinn is the #1 surgeon to see for the best total knee replacement in Scottsdale, AZ!

In a typical total knee replacement, the implants that replace the diseased portion of your knee are made from metal and plastic. The tibial component (bottom portion) replaces the top of the tibia. It is made up of two parts: a metal tray that is attached directly to the bone and a polyethylene (medical-grade plastic) spacer that provides the bearing surface between the tibial and femoral components. The plastic used is very tough and durable and has recently been improved by a cross-linking process which can make the knee last much longer. The femoral component (top portion) replaces the two femoral condyles and the groove where the patella runs. The femoral component is made of cobalt-chrome, a biocompatible metal. The patellar component is made of plastic (kneecap portion) and replaces the joint surface on the backside of the patella that rubs against the femur in the femoral grove. Modern knee replacements are VERY successful. Dr. Kozinn utilizes state of the art minimally invasive techniques that minimize damage to the muscles under the skin. This coupled with pain management techniques such as regional anesthesia and femoral nerve blocks leads to a more rapid recovery.

Get the Best Total Knee Replacement in Scottsdale!

Dr. Kozinn is the best knee replacement specialist in Scottsdale, Arizona. His knee replacement surgeries are performed by using the latest technologies combined with 25 years of experience. If you are a candidate for a total knee replacement it is important to see a knee specialist that performs only hip and knee surgeries. A frequently asked question is about the role of computers in Knee Replacement. Frankly, at this time, there is NONE. Dr. Kozinn was one of the first surgeons in Arizona to use the "computer" to do total knees. It soon became clear to him and most other surgeons, that the present technology not only did not improve the results of knee replacement, but it made it WORSE. Unfortunately, it has been used as a "marketing tool" by some surgeons to gain hopeful patients, but with no proof of effectiveness. The best technology available is techniques which limit pain, and improve recovery with "tissue sparing" approaches. These are not measured by the length of the skin incision, but by how the muscle tissue is handled underneath. Dr. Kozinn uses a variety of "quadriceps-sparing" techniques to maximize recovery.

How Total Knee Replacement Works

The prostheses Dr. Kozinn uses  are generally attached with cement. This is the BEST choice in knee replacement technology right now, and has the "gold-standard" track record.  Knee joint design and biomechanics is different than that of the hip joint (where cementless implants are better!). A cemented prosthesis is held in place by a type of epoxy cement that attaches the metal to the bone. The choice of implant is usually made by the surgeon and is based on your health, age and lifestyle.  Dr. Kozinn typically uses implants with a long record of success (such as the Biomet Vanguard series which comes in a large number of sizes to fit both women and men's knees).  We also utilize a rotating platform total knee ( made by Johnson & Johnson ) which is available for very young, active, or heavy patients and may provide increased motion and the hope of decreased long term wear. Other total knees may be used in special situations, and the truth is, all modern total knee systems are more similar than different. Each surgeon will master the knee system that he feels is best for his patients. How the knee is "put in" is probably more important than which implant is used! That is why it is good advice for you to  choose a total knee surgeon who does over a hundred total knees a year, and one that has been doing them for a long time. Dr. Kozinn has completed a fellowship in knee replacement at Harvard Medical School and typically does about 300 total knees each year. He is Medical Director of the Total Joint Center at Scottsdale Healthcare and has been doing Total Knee and Partial Knee surgery for 24 years in Scottsdale with excellent results.



We specialize in joint replacement surgery of the KNEE, HIP, and SHOULDER.  If you are in the Phoenix, Arizona area and need a specialist that focuses on these types of surgeries, the Scottsdale Joint Center should be your first choice. If you have any questions, please feel free to contact us, visit our website at www.scottsdalejointcenter.com or check out our Knee Replacement Frequently Asked Questions for more information.



Uni-Compartmental Knee Replacement

Osteoarthritis is one of the leading causes of progressive deterioration of the knee joint. Depending on the stage of the disease, different treatment options exist to help ease your pain and restore your knee to more normal function. A uni-compartmental knee replacement is just one of several treatment options. Dr. Kozinn is an expert in partial knee replacement, and has authored the classic scientific paper published in the Journal of Bone and Joint Surgery on the indications for its use. He has been doing partial knees in appropriate patients for 24 years in Scottsdale.

The uni-compartmental knee is designed to resurface one-third, or one compartment, of the knee when only one compartment is diseased. Because only one side of the knee is replaced, less of your bone is removed and recovery time is usually quicker than it is for someone who has a total knee replacement. The implant used consists of a metal femoral and a plastic tibial component (also known as prostheses) that are used to resurface the diseased portion of the knee. A minimally invasive approach is routinely used, and some motivated patients can go home the same day as surgery.

Dr. Kozinn has lectured nationally and has done clinical research on uni-compartmental knee replacements. He presently prefers to use the Oxford Uni-Knee system made by Biomet. It is a mobile bearing system, and has results similar over the long term to traditional full knee replacement in selected patients.

 

Arthroscopic surgery

Dr. Kozinn and Dr. Evangelista are accomplished arthroscopic knee surgeons. Sports injuries and arthritic conditions can be repaired with minimally invasive techniques to debride the knee joint and repair torn cartilage and ligaments. Dr. Kozinn uses laser surgery to help decrease bleeding and scarring in the knee. An MRI is usually ordered after your office visit to help determine what is damaged in the knee. The surgery is done at Greenbaum Outpatient Surgery Center on the Scottsdale Healthcare Campus.

Meniscus Surgery

Meniscal tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscal tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.

The most common symptoms of meniscal tear are: pain, stiffness, swelling, catching or locking of your knee or the sensation of your knee "giving way" and/or the inability to move your knee through its full range of motion. Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause your knee to slip, pop or lock. 

The outside one-third of the meniscus has a rich blood supply. A tear in this "red" zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear. In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this "white" zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away. 

How our surgeons will treat your tear will depend on the type of tear you have, its size, and location. Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan. If surgical repair is required, knee arthroscopy is one of the most commonly performed surgical procedures.

ACL Ligament Surgery

An ACL injury occurs when the anterior cruciate ligament becomes damaged through either a pull, twist, tear or other disruption of the knee. Injuries can vary in severity, ranging from a minor sprain to a complete tear or rupture of the ligament. Less serious injuries are frequently treatable with physical therapy alone, while a torn ligament will usually require surgery, as a completely torn ligament cannot repair or reattach itself.

During surgery, the ACL is replaced with quadrupled semi-tendinosus/gracilis tendons located on the side of the knee. A synthetic screw or anchoring device is utilized to fasten the replacement ligament to the femur. This is placed under arthroscopic control. The tibial end of the graft is usually anchored to the bone by a metal staple or screw. In addition, a screw is placed next to the graft within the tibial tunnel that has been drilled in the bone. This screw, known as a bio-absorbable interference screw, pushes the graft firmly against the inside of the bone tunnel to assist in the healing process. The screw is made of a material that gradually dissolves after the healing process is complete, and is eventually replaced by bone.

With proper care, most patients can expect a full recovery from an injured ACL. Patients are able to walk on a surgically treated ACL immediately following surgery, although knee bracing is required. Patients who undergo Arthroscopic ACL Reconstruction surgery, are likely to return to previous levels of athletic activity with proper rehabilitation and physical therapy.

Dr. Evangelista has a special interest and expertise in the treatment of ACL injuries.

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