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Dr. Buechel presenting post-operative x-rays of a patient after total knee replacement

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)

Posted on behalf of Robotic Joint Center

737 Park Avenue 1C
New York, NY 10021

Phone: (212) 308-3089

FAX: (646) 844-1396

Email:

Mon – Fri: 9 AM – 6 PM

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