KNEE ARTHROPLASTY

There is no maximum weight, but all the general complications associated with knee replacement surgery are increased: wound healing problems, infection, re-operation, etc. Therefore, it is best to lose weight before surgery. However, the surgeons at the Clinic regularly perform joint replacements on overweight patients. With their experience, expertise, minimally invasive instruments, and special implants, we can optimize obese patient’s care. We use prostheses with cementless fixation, which have been shown to be more durable in obese patients (see our results with cementless prostheses).

There is no age limit for knee replacement surgery. However, your overall health must be good enough for the surgery to proceed without major medical problems. Before surgery, a detailed medical evaluation is performed by our qualified medical team at Duval clinic. Patients over the age of 80 can have surgery at the clinic. Importantly, the Duval clinic is the only private orthopaedic clinic in Canada to offer hospitalization for more that 24 hours after surgery, providing a save environment for recovery. No need to be transferred to the hotel after surgery! Moreover, with our post-operative ERAS protocol, recovery after surgery is made much easier. 

Yes, robotic assisted knee replacement surgery is now available in Canada. We are proud to announce that on Monday, February 1, 2021, we successfully performed our first two total knee replacements with a surgical robot. The addition of the ROSA robot to our palette of technological tools is another key to ensuring that each of our patients receives impeccable care. The ROSA Knee System is a tool that accompanies the surgeon during a knee replacement operation and allows him to perform the surgery with superior precision. Click this link to see it in action.  Dr. Massé, a specialist practicing at the Duval Clinic, has extensive expertise in robotics. He reminds his patients that “the robotic tool is not there to replace the surgeon, who remains in control of the operation, but rather to transmit information that will allow him to make better decisions and perform gestures with greater precision.» While robotic instruments are an important development in technology and medicine, Dr. Massé says, “the experience and dexterity of the clinic’s surgeons remain the most important elements in a procedure.»
Clinique Duval has always made sure to offer the latest technological tools to ensure an optimal level of care and precision. “The various studies on this subject currently point to a simpler and faster recovery with less postoperative pain,” says Dr. Massé. “Satisfaction levels appear to be higher in patients who have undergone surgery with a robotic device.»

Please listen to Dr. Massé explaining the personalized knee replacement principles and demonstrating the ROSA robot precision here.

Dr. Kiss, in action, using the ROSA robot during a total knee replacement performed at Duval clinic.

Personalized Surgery

Robotic assistance allows the surgeon to accurately reproduce the anatomy of your knee. In this article, Dr. Massé describes the personalized technique he developed with Dr. Vendittoli. Click here to read the article.

Knee arthroplasty is a highly effective procedure, even though it is affected by significant rates of residual symptoms. Unsatisfactory clinical outcomes may be due to the neglect of each individual’s unique joint anatomy and kinematics. The precision and accuracy of implantation has improved dramatically with the use of technological tools (e.g., computer-assisted or robotic surgery). This has allowed the development of a more personalized philosophy of reconstruction of the knee joint.

The Clinic’s surgeons are international leaders in the application of the personalized anatomical/kinematic alignment technique. This technique aims to reproduce the patient’s native anatomy and physiological joint laxity, thus improving knee prosthesis kinematics and functional results (see this article for more information). One of our surgeons, Dr. Pascal-André Vendittoli, is the president and founder of the Personalized Arthroplasty Society.

Personalized Surgery

Robotic assistance allows the surgeon to accurately reproduce the anatomy of your knee. In this article, Dr. Massé describes the personalized technique he developed with Dr. Vendittoli. Click here to read the article.

Knee joint replacement is an effective surgery with a high rate of satisfaction. Most operated patients see their pain greatly reduced and can resume many activities they had to give up since the onset of their disease. Patients must be aware that the full benefit of surgery will often not be achieved until 6 to 12 months after the operation, although after 2 to 3 months, their activity level can already be greatly increased.

 It is important to know that the operated knee rarely feels like a natural knee. The surfaces of the prosthesis are in contact with one another may therefore produce noise. The range of motion of your knee will be reduced compared to a healthy knee.

There are some permanent restrictions following knee joint replacement such as difficulty squatting and kneeling. In addition, it is preferable to avoid heavy work requiring lifting loads of more than 25 kg or climbing ladders and scaffolding. Sports with sudden jumps or stops are not recommended after surgery.

Thanks to our enhanced recovery protocol, post-operative pain should be well controlled and acceptable. Back in your private room, you can eat a full meal and drink whenever you feel like. You will get up for the first time 3-4 hours after the surgery with the assistance of the nurse and physiotherapist. The physiotherapist will help to improve the range of motion of your knee, start muscle strengthening exercises, and start walking.

Once the surgery is over, your prosthesis is firmly anchored to your body. Until you are stable and safe to walk, the use of a walker or cane is recommended (usually 1-4 weeks). Follow the recommendations given by your physiotherapist.

From day one, you will need to follow the exercise program that you will learn before your surgery. You will then do these exercises at home to walk properly and resume your household and sports activities.

We use skin glue to close the incision. This will help reduce discharge from the wound after surgery. You can take a shower starting from the first day since the dressing is well adhered to your skin.

Your stay at the Clinic will last 1 to 2 days. When you leave, an appointment will be made for you to see your surgeon approximately 4 to 8 weeks after the surgery. You will be given the required prescriptions for your medications, necessary equipment, as well as a requisition for x-rays.

The Duval Clinic is the only private clinic in Canada to offer individual convalescence rooms should your condition require a short stay. The length of stay varies from one patient to another between 1 and 2 days. However, the advancement of operative techniques, optimization of postoperative pain control, better organization of home care, as well as effective multidisciplinary collaboration have made it possible to offer you the possibility to spend less than 24 hours in the clinic after your surgery and have an organized and safe discharge. Your surgeon and attending team will inform you if you are eligible for this accelerated recovery protocol (day surgery).

• 1-2 weeks after your surgery you can start using a stationary bike.
• 3 to 4 weeks after surgery, you can return to the pool for some water walking or gentle swimming. It is important that the wound is well sealed;
• During the first 3 months, you should avoid regular and intense sports;
• From 3 to 5 months after your surgery (depending on your condition), you can do social dancing, skating, skiing, hiking, bowling, golfing.
• It is generally not recommended to practice activities with repeated impacts and pivots such as: jumping, jogging, volleyball, soccer, basketball, mogul skiing, aerobic dance, contact field hockey, yoga, karate, etc. Talk to your surgeon at the Clinic for recommendations specific to your condition.

To learn more, please read this article.