Knee Replacement Doesn’t Have to Mean Giving Up an Active Life

For many people, the words “knee replacement” can sound intimidating. The good news is that today’s knee replacement procedures are far more sophisticated—and, in many cases, far less invasive—than many people realize.

Frederick F. Buechel, Jr., M.D., FAAOS, an orthopedic surgeon with Physicians Regional Medical Group, has spent his career helping patients understand their options and get back to the activities they enjoy.

A board-certified orthopedic surgeon, Dr. Buechel is fellowship-trained in adult joint reconstruction through the University of Pennsylvania and specializes in partial knee replacement, total knee replacement and knee arthroscopy. He was also the first surgeon in Southwest Florida to perform robotic-assisted knee surgery, beginning that work in 2009.

His interest in orthopedics began early.

“My father is an orthopedic surgeon and a very well-known joint replacement specialist,” Dr. Buechel explains. “Growing up, I watched him be excited about this and his happiness and joy that he got from this profession ultimately inspired me.”

So when should someone see an orthopedic surgeon about knee pain?

According to Dr. Buechel, worsening pain is an important signal. Swelling following an injury, sharp pain, difficulty walking or pain that does not improve with simple measures such as ice and anti-inflammatory medication are also reasons to seek medical attention.

For many patients, the underlying problem is osteoarthritis—the gradual wearing away of cartilage that normally provides a smooth, protective surface between the bones of the knee. As cartilage deteriorates, pain, swelling, stiffness and reduced range of motion can develop.

But not every damaged knee requires a total replacement.

The knee has three compartments: the medial compartment on the inside, the lateral compartment on the outside and the patellofemoral compartment where the kneecap moves. If arthritis is limited to one compartment, a partial knee replacement may be an option. If the damage involves the entire knee, a total knee replacement may be appropriate.

“The reason why you have a knee replacement in the first place [is] to take away pain and restore function,” Buechel says.

One significant advantage of a partial replacement is that it preserves healthy portions of the knee. When appropriate, the procedure can preserve the knee’s ligaments and other structures that remain healthy.

Total knee replacement, meanwhile, resurfaces all the damaged compartments of the knee. Buechel compares the concept to putting a cap on a tooth rather than replacing the entire tooth.

For patients who qualify for partial knee replacement, the procedure can offer additional benefits, including a generally easier and faster recovery, less pain and improved range of motion.

Technology has also changed the way knee replacement surgery can be performed.

Buechel has extensive experience with robotic-assisted technology. He explains that the system uses CT scan data and computer planning to help create a surgical plan customized to each patient's anatomy. During surgery, additional information about ligament tension and knee movement can be used to make adjustments before the implant is positioned.

“It’s a smarter way of doing joint replacement surgery,” Dr. Buechel explains. “It’s a more customized way to do joint replacement surgery that adapts to each individual’s bone shape and ligament tension.”

Buechel began using the technology at Physicians Regional in 2009 and went on to teach other surgeons, traveling internationally to help launch robotic-assisted programs in countries including Australia, China, Hong Kong, Greece and Italy.

Ultimately, however, technology is only part of the equation.

Buechel says the most rewarding part of his work is seeing patients return to their lives after surgery—traveling, walking on the beach, spending time with family and participating in activities they may have avoided for years because of knee pain.

“This is a quality-of-life operation,” he says. “I’m here to help make you have an active lifestyle again and to live your life again and do the things that are enjoyable to you.”

For Southwest Florida residents considering knee replacement, that combination of experience, technology and a comprehensive medical team is important. Buechel emphasizes that successful joint replacement is never the work of one person alone.

“Physicians Regional’s facilities are fantastic. The people taking care of you are fantastic,” he says. “I can do my part, but I can’t do my part without everybody else.”

Physicians Regional Healthcare System’s three Naples hospitals provide quality care to the Naples and the greater Southwest Florida community with the objective of offering more options and improved access to healthcare for all citizens and visitors.

Three Naples hospitals and more than 800 physicians are recognized within their fields, offering advanced medical care in more than 45 specialties and subspecialties, including programs in 24-hour emergency care, cardiology, vascular disease, digestive diseases, orthopedic care, spine care, neurosurgery, and women's services.

Patients considering knee replacement can begin with an orthopedic evaluation to determine what is actually causing their pain—and whether surgery is even necessary. For those who do need a replacement, understanding the difference between partial and total knee replacement can be an important first step toward making an informed decision.

And perhaps most importantly, a knee replacement should not be viewed simply as an operation.

It can be an opportunity to get back to living.