G2 Orthopedics and Sports Medicine performs knee replacement in Richmond, VA for patients affected by knee arthritis when non-surgical and alternative treatments fail.
As a fellowship trained expert in knees, Dr. Goradia has performed thousands of knee operations. He will review non-surgical treatment options including alternative treatments for arthritis with you and only recommend partial or total knee replacement if absolutely needed. He also offers (if recommended by Dr. Goradia) an outpatient knee replacement surgery where patients can be safely discharge home the same day as surgery, without being admitted to a hospital.
With Outpatient Replacement Surgery patients now have the option (if recommended by Dr. Vic Goradia) for the same-day replacement surgery. The entire process can be completed at the hospital or surgery center and patients can be safely discharged (the same day) home to recover in the comforts of their own home.
Total Knee Replacement
When arthritis is present in two or more of the compartments, a total knee replacement can be performed. During surgery the damaged, arthritic cartilage is removed and the bone is prepared for the knee replacement device.
- The femoral or thighbone piece fits over the bone like a “glove”.
- The tibial or shin bone piece sits on the bone with small stem that helps to hold it in the bone.
- A small kneecap button is attached to the back of the kneecap after removing the arthritis.
Partial Knee Replacement
There are 3 different compartments in the knee joint. If someone has arthritis in just one of these, they may be eligible for a partial knee replacement.
Knee Replacement Technology
The OARA Score:
Each patient is closely evaluated by Dr. Vic Goradia, prior to surgery using the Outpatient Arthroplasty (i.e. replacement) Assessment Score, also known as OARA Score to determine if they are a candidate.
- This assessment was developed by Dr. Meneghini from Indiana to identify patients that would have lower risk factors for outpatient joint replacement.
- A series of questions are asked regarding the patients’ health
- A score is calculated to determine if patient is a low, medium or high risk
- The results are reviewed with the patient
Each patient will also receive regular communication and instructions from Dr. Goradia through the outpatient communication system: MotionIQ. Through these communications they’ll receive instructions regularly before and after surgery. They’ll also receive videos from Dr. Goradia, and the information about their recovery will be sent directly to Dr. Goradia so he can monitor the recovery progress closely.
Minimally Invasive Knee Replacement in Richmond VAUsing the KneeAlign® handheld computer the size of a smartphone, we are able to perform a more accurate partial and total knee replacement. This device uses GPS technology similar to what is used rockets, missiles and cars.
Normal Knee Alignment
Rod Inserted in Bone
One key to a successful result after knee replacement is to restore the normal alignment of the leg. The alignment should create a straight line from the hip through the knee to the ankle.
The standard way surgeons achieve this is by inserting a rod into the middle of the bone. After surgery this can result in more bleeding from the bone which can affect recovery.
The KneeAlign computer gives more accurate alignment without insertion of a rod making it less invasive with less blood loss.
Adjusting Alignment with Computer
Knee Replacement Devices
There are numerous manufacturers of knee replacement implants. Most surgeons select a particular knee replacement based on ease of use, past experience and some patient specific factors. Our surgeons have used devices from:
- DePuy Johnson and Johnson
Pain After Knee Replacement
There have been tremendous advances in the management of pain after knee replacement surgery. The process begins before the operation with what is known as preemptive analgesia. This means that we attempt to block the pain before the knee replacement surgery begins. This is done by giving the patient a variety of medications that will block different types of pain. Examples of this may include:
- Spinal anesthesia which numbs the legs and prevents grogginess from general anesthesia.
- Femoral nerve block which reduces pain around the knee and lasts for up to 12-16 hours.
- Non-steroidal medications that reduce pain from inflammation.
- Additional Medication which reduces nerve related pain.
For Outpatients Pain Management:
- The Anesthesiologist will give you a nerve block prior to surgery to numb your leg. This will last 12-24 hours after surgery and will help reduce your discomfort
- Tylenol or acetaminophen will be recommended for you to take 4 times per day if you are not allergic to it. This may not seem like much, but it does help with some baseline pain control.
- You may be prescribed an anti-inflammatory medication for pain and swelling.
- Applying ice to the knee can also reduce pain and swelling
- You may be prescribed medication to take at night for nerve related pain and it can also help your fall asleep
- Finally, you will be prescribed a stronger medication for more severe pain
Going Home After Knee Replacement Surgery and Beyond
Most patients will go home one night after a partial knee replacement and two nights are a total knee replacement.
- Home physical therapy 3x/week for 2-3 weeks
- Afterwards, outpatient physical therapy 2x/week for 2-3 months
- Most patients use a walker for 1-2 weeks
- Cane up to 4-6 weeks after the walker.
- Patients are allowed to drive when they are able to walk with cane and feel safe to drive.
Patients are safely discharged to recover in the comforts of their own home and Physical Therapy Exercise begin.
- A physical therapist and nurse will visit your home the day after surgery so we can make sure you are progressing well
- Getting the knee fully straight is very important in the first 1-2 weeks after surgery. It is more important than bending the knee
- Squeeze the muscle on the top of your thigh (quadriceps) and try to push the knee downward. This will help regain strength.
- Ankle pump exercises will circulate blood and reduce your risk for a blood clot
Why G2 Orthopedics and Sports Medicine?
We are a small, specialized orthopedic practice in Richmond, VA that provides Advanced Orthopedic Treatment Options, Excellent Results, Personalized Care and Convenient Appointments.
Dr. Vic Goradia is fellowship trained in sports medicine, minimally invasive surgery and knee & shoulder reconstructive surgery. He began practicing in Richmond in 2001 and has extensive experien