Why so few MIS surgeries?

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skigirl

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I am interested that there are so few posts in this part of the forum. Are there really so few folks who use MIS surgery? I think it is awesome and would never consider anything else. When I got back from surgery, I got out of bed walked into the bathroom and used the facilities. then I walked over and changed my clothing--no hospital gown for me. When other people talk about being barely able to get out of bed on the first day, I wonder why they did not opt for MIS.

I know that the surgeon has to be highly trained to do this type of surgery---but, if you use a knee specialist==it seems likely that he would do MIS. My doc is a knee specialist and mostly does MIS---he trains other docs for Stryker, so he is pretty good. (just ask him, he will be glad to tell you how great he is!!!!)

I have a four inch scar that you can barely see---there were no horrible staples in my leg---it gives me the creeps to see them in other legs at pt. No home pt necessary because I could walk perfectly well and went to a pt facility. "Why isn't MIS more popular?
 
I dont know why more Dr's dont do it but there must be a reason. Im glad yours came out so well. But at that same time I dont think it was nice to say that people with knee/hip scars gives you the CREEPS. Do you realized that is everyone on here. ........Good Luck to you and Im glad you are doing so well............)
 
Kelly,
I am happy that you were able to have the MIS but it is not easy in some area's to
find OS that do this. I am really sorry that the larger scars creep's you out. But
I must say that my first knee is now looking like nothing ever happen to it. We do
what we have too with who we have to work with. Now I will always think about
how I had a creepy knee.
 
Have to tell you I have one of the best OS and he never mentioned the MIS. He was the second OS for knees that did the computer alignments in the USA. He taught others

I assume the reason the MIS is not done a lot is because perhaps most OS do not think they are the way to go.

Sorry we creep you out with our knees. But you can barely see the staple marks on my leg and my scar is getting better.
 
I am assuming it has something to do with insurance not covering it. Glad you were lucky enough to have something so much better than almost everyone else. As I lie here suffering for 4 weeks, I guess I feel kind of suprised my stapled incisions are so ghastly to someone. Oh well. I have worked hard to get where I am, MIS or not. I'm not that sensitive, it doesn't bother me really.
 
Kelly, like any surgery even those who have minimally invasive procedures heal differently. Not everyone who has it gets up on their feet and walks around immediately. You were one who did and that's great. But please understand that others may have more difficulty, pain, swelling and other problems following an MIS procedure. After all....you still have your bones sawed, hammered and maniuplated even in MIS. Everyone's body reacts differently to that assault.

I don't know why MIS procedures are not practiced more in the USA. If it is superior, doctors will eventually gravitate toward it in time.

Doctors choose how they close wounds. Some use stitches, others glue, and some use staples. It's not a factor of whether the surgery is MIS or not.

I'm sure you didn't mean to offend anyone on the forum....we ALL are proud of our scars and everything this surgery means to us!
 
Of course I did not mean to offend anyone on the forum. First it is not the scar or the size of the scar that I even notice anymore===especially since i have one of my own to worry about.
It is the staples protruding from the wounds that catch my eye----I would not like to be stapled like a report!! However, when I see them in pt I don't think anything of the PERSON involved in it---simply that I do not want them on me---it is the idea of being stapled that bothers me---not the physical staples in someone else's legs.

And, I know that many of you have extremely reputable surgeons who do not do MIS---I did not give this a lot of thought, obviously, justf posted a thread that was a musing more than anything else.

This fourm has been extremely helpful to me and I have recommended it to many others---I hope that those of you who were offended by a thoughtless remark will have the compassion to forgive me.
 
Kelly,
I think most people know you did not conciously criticize them with your choice of words.
I think it takes a while to be trained in putting in each particular "brand" of knee. My OS uses the Johnson & Johnson Depuy "brand". Some have rotating platforms and some do not. I think even though each brand is similar to the next, there are particular methods to putting them inside the body. If an OS was trained in MIS, that is great, but my OS has not been trained in MIS. I am happy I have the ROM, and can continue on with my life.
Most likely since MIS is relatively new, then new OS will be utilizing this type of surgery if they feel comfortable doing so. They too will have to gain experience with the process. I just don't think I would be comfortable being one of the ones they were practicing on in order to get better at the procedure. I am happy I have an OS with and excellent reputation who does do revisions from other OS botch jobs. We all have to make the decision on what is more important to us; the experience of the OS, MIS, or the brand of the replacement. Priorities are different for all of us regarding our decisions.
 
Hi Kelly. I just wanted to point out, if you have ever seen the operation online, like I have seen 2, the staples are just a drop in the bucket compared to what's done in surgery. I just saw another one yesterday, mostly did it because I have had a lot of pain the last few days, and wanted to be reassured it was because of went through with surgery. I have even had some trouble with my heel. And in the surgery see they wrap some kind of wheel/holder to keep heel in place and now know why my heel is still so bruised because it was manhandled during the surgery.

So in the realm of things the staples really aren't so bad, at least to me. I always had the reassurance they were there when I had my PT and felt like it was responsible for my healing in the best pay possible.

Hopefully in the future, surgery will become easier, and we have all been there to help it advance in the best possible way.

Take care.
 
When I was doing my research on a total knee arthroplasty prior to my first surgery I identified several doctors in the Houston area who were joint replacement specialists and only performed joint replacement surgery. They perform hundreds and hundreds of surgeries per year....all utilize the minimally invasive procedure.

This procedure greatly enhances recovery because there is basically no cutting of the quadraceps muscle. If a doctor is not utilizing this procedure I would assume that it is an issue of skill and technique. The procedure is more difficult with the smaller inscision and requires greater expertise by the doctor. The incision is only 4-6 inches in length....dependent on the size of the prosthesis required (I am 6'4" and my incision was 6 inches).

I find it hard to understand why anyone would opt for a doctor who does not utilize this procedure. If there were no experts in the area where I lived I would find a doctor in another area and have the surgery there.....while it may not be the most convenient approach this is a major surgery and the expertise of the doctor is far more important.


Steve
Spring, Tx.
 
In reading about ways of closing wounds, I came across this statement:
Like Steri-strips, however, tissue glues cannot be used on areas of high moisture. They are also ineffective for use on the knee or elbow joints.

I had staples and laughed at how gross they looked when at 14 days, the PT took off the clear plastic bandage to remove the staples. Removing them didn't hurt at all even though a couple were stuck in and she had to work to get them out. My doc insists that they wait 14 days, and that they use antibiotic ointment on the holes before using the steri-strips. I was going to ask the PT to spray it all with colloidal silver until I learned that. I can't imagine leaving open holes. The ointment did make it difficult to make the strips stick though. But once they were on, they stayed.

I'd told the OS that I didn't care at all what the scar looked like. Who cares? Knees aren't faces and who's looking. But, I'm proud of my scar and several of us were showing off our scars at the pool. Mine is 5".

Minimally invasive helps, I guess, but they're still cutting off your bones. My OS asked at the pre-surgical joint clinic day if I had any concerns. I said, "No, only that you're going to cut my bones off." He laughed and said to think about it as a re-tread. Just resurfacing.

Online they make partials and MIS sound like a piece of cake. I know people who've had totals who've done much better than I. Also, I know that athletes are somehow made differently. Look at George Hincappie riding his bike with a broken collarbone. I could never keep a clear mind and continue a demanding activity after a serious injury.

All in all, I think there are a lot of doctors who aren't quite sure they want to go through all the extra training required for a more difficult procedure. If it turns out MIS is very much better, I'm sure more and more will try it. There are very few around here that do MIS or partials. Time will tell.

Pat
 
Well put Pat 29 my OS does all 3. He does what he thinks is best for the patient. After all he does have the degree as they say.

He told me when he went in he would make the final decision after seeing what was going on. I know he is one of the best and left
that decision up to him. (as it should be) Well I got a TKR not a
PKR (what I thought I was going to get) and not a MIS.

My scar is only about 6 to 6 1/2 inches. I don't think that is bad.
And I don't care. I can walk and my life has just about turned to normal and hey that is what it is all about.
 
I find it hard to understand why anyone would opt for a doctor who does not utilize this procedure. If there were no experts in the area where I lived I would find a doctor in another area and have the surgery there.....while it may not be the most convenient approach this is a major surgery and the expertise of the doctor is far more important.


Steve
Spring, Tx.

Because people need to get their hip or knee fixed and cannot afford to fly around the country to find a Dr to do that particular procedure....Dr's who don't do MIS are expertise as well...
 
I was just remembering, when I came back to my room after my MIS with a Partial....I had my leg wrapped with beige bandages, a machine that squeezed my legs to keep the blood flowing, the circulating ice water machine wrapped around, a catheter, and an IV. I don't think any of that came off until the next a.m., but I can't remember. The last thing I wanted was to get up to go to the bathroom!!! hahaha

A well stuck-together incision! hehehe, couldn't resist.
[Bonesmart.org] Why so few MIS surgeries?


Pat
 
Pat I think Parl are just as painful as a tkr they seem to do the same.....i almost had a parl but he just said i couldnt but as we were talking pretty much sounds the same recovery wise.....so yea the recovery is just as hard..but all in all worth it in the end..............your last part to cute.........
 
Hi Kelly,
Sounds like things are still going well for you ,woot woot.
And you for sure never offended me,,matter of fact,,my staples were awesome. I am betting if you would have seen them,you would have told your surgeon,,hey any chance I could get staples like Clunker had??:hehe:

Keep up the great posts Kelly,,love hearing success stories!

Oh and Pat,,thanks for flashing a little leg around here,lol.
 
There's a big mystique about MIS. It's not at all the same as in knees as it is in hips. For one thing, the hip prostheses are so much smaller than the knee prostheses and you naturally have to have an incision that's big enough to get the implants through! You also need to have room to use the instruments and tools. There again, the difference between the two joints is considerable.

On the other hand, the instruments for a THR are totally different in design. The don't have to be attached to the bone in the same way as in knees and are made with long handles and business ends that simply ream out the bone, not reshape it. You can see the difference between that and the incision required for hip resurfacing which is much more akin to a TKR.

Thus what many people might call a minimally invasive surgery is, in fact, simply a reduced incision. In many cases, the incision is reduced from 12" to about 6" in smaller individuals. The more the fat, the bigger the incision has to be.

Thus, it now being fairly common practice to make reduced incisions, knee surgeons would rarely pass comment on it anymore. On the other hand,
for hip surgeons it's a totally different operation.
 
Kelly girl!!! Ya think ya stuck your foot in your mouth or what? What may skeeve YOU out cosmetically -imho I thinkya went a little overboard! These folks can walk and live life again! Kinda shallow!!! Kinda hurtful!!!!
 
Any knee surgery whether it be tkr pkr or mis is painful and it depends on the person as to how the recovery is.

It makes sense the size of the leg/knee would have a lot to do with the size of the scar. To me being able to get back to life means more than the size of the scar. But I am not vain or shallow, I just wanted to walk again.

There was someone on here that the glue did not hold and they had to go back to the OS.
 
Well Pat and others.....you guys keep on keepin' on!! THAT'S what's TRULY important!!! :thmb:
 
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