What Dr. Buechel Does to Improve your Partial Knee Outcomes

Knee Positioner for Exposure and safety

• Dr. Buechel uses a Specialized Padded leg holder designed to support your leg safely during the partial knee procedure (IMP Leg Holder)

Infection control

• Dr. Buechel wears a Joint Replacement Space Suit with lighted helmet for optimal visualization and protection
• Adhesive Drapes are used to seal skin during surgery
• Antibiotics are in the Bone Cement
• Antibiotics are given to you in your IV
• Preoperative and postoperative Nutritional Supplementation is recommended to optimize your healing and immune system

Muscle avoiding incision

• Dr. Buechel precisely draws the anatomy for optimal incision size and position
• 2-3-inch skin incision is used for most medial partial knee procedures
• Avoiding Muscle allows for faster return to activity during the recovery process

Blood Loss Control

• The medicine Tranexamic Acid is given intravenously to reduce blood lossLocal Anesthetic with Epinephrine is injected into the incisions to reduce bleeding
• Meticulous bleeding control during the exposure minimizes blood loss
• No Tourniquet is needed to control bleeding, which also reduces blood clot risk
• Orthobiologics Application into joint and would closure reduces bleeding
• Proper knee positioning and use of the leg positioner during surgery reduces blood loss.

Anesthesia

• A multimodal approach to your pain control provides an optimal recovery
• Spinal Anesthesia is recommended, General Anesthesia is good if needed.
• Regional pain block #1: I-PACK Block
• Regional pain block #2: Adductor Canal Block
• Periarticular Local Block: Marcaine, Ketorolac, Morphine

Blood Clot Reduction

• No Tourniquet is used which is the biggest reducer of risk
• No instruments in the canals of the bones to cause emboli
• Spinal Anesthesia reduces blood clot risk
• Walking within hours of the surgery reduces clot risk
• Aspirin 81mg once or twice a day for 3-4 weeks
• Efficient surgical process reduces risk
• A compression sports sleeve is used after surgery for 4-6 weeks

Suture Choices

• Micro-barbed sutures
• Avoids knot abscesses
• Antibacterial material lowers infection risk
• Provides a Watertight closure

Skin Adhesives

• Dermabond Skin Adhesive seals the skin edges
• Allows Showering the Day after surgery
• Provides a Barrier to Infection
• Provides better scar appearance
• Removes easily at 3 weeks

Skin Dressings

• Silicone Boarder Dressings are used
• Reduces skin irritation
• Waterproof for showering
• Remain on for 5-7 days
• Anti-bacterial
• Protects the skin glue from clothing rubbing it off

Cold Therapy Wrap / Cooling Devices

• Wear continuously as tolerated after surgery
• Reduces swelling
• Reduces pain
• Reduce medication requirements
• Improve motion
• Commonly used for 4-6 weeks daily to optimize swelling reduction early

Compression Sleeve

• We provide a Reparel Compression Knee Sleeve after surgery
• These Reduce swelling
• Provides comfort/support
• Improves blood flow
• Used for 4-6 weeks to optimize recovery

Medications

• Decadron IV Pre-incision & Post Op given in Operating room (Steroid to reduce inflammation)
• Aspirin 81mg once or twice a day for 3-4 weeks (Reduce Blood Clot risk)(Pain reducer)
• Acetaminophen (Pain and Inflammation reduction post op) as needed
• Ibuprofen (Pain and Inflammation reduction post op) as needed
• Hydrocodone (Moderate pain reduction medication, if needed)

Instruments/Tissue Safety

• Dr. Buechel is very gentle with tissue handling to minimize tissue harm and optimize wound healing.
• Dr. Buechel’s custom partial & total knee instrument sets have tools designed specifically for these procedures and are used to minimize tissue harm and optimize efficiency.
• Dr. Buechel uses the precision robotic-arm assisted knee installation system by Stryker called “Mako Partial Knee” and “Mako Total Knee”.
• Dr. Buechel is an expert user of, and Stryker certified international instructor for the Robotic Mako Knee and Hip Replacement Systems.

Physical Therapy

• We provide a comprehensive post op therapy program for home and your therapist
• Gentle therapy starts the day of surgery
• Physical Therapy is a guide that is designed to eventually return you to a regular exercise program on your own

Nutritional Support

• Protein Supplementation is recommended to enhance wound healing
• Vitamin C: (to enhance wound healing and infection reduction)
• Probiotics: (to support your microbiome to optimize healing and to minimize the negative the effects of the antibiotics on your GI Tract)