Total knee replacement is the most common joint replacement procedure performed today, with a large majority of patients reporting near or complete relief of their arthritic symptoms after recovering from surgery.

Knee replacement is best described as knee resurfacing, with the end of the femur and the top of the tibia resurfaced with smooth metal and plastic implants. It’s a good option when severe knee arthritis causes daily pain and limitations that non-operative treatments don’t resolve.

While reliable in its effectiveness, there are still a number of factors to consider to ensure the best possible outcome. Below, we look at some difference makers in knee replacement surgery.

Appropriateness

Appropriateness is a leading factor in how effective knee replacement surgery will be. There are many non-operative care options for arthritis patients, and the decision to have knee replacement surgery is most often a “quality of life” choice. Surgery may be appropriate if a patient has tried exercise, medications, physical therapy or bracing and is still experiencing daily pain and limited joint function.

Preparation

While knee replacement surgery may be appropriate for your situation, it can still take a toll on your physical and mental health. For the best possible outcome, preparation for knee replacement surgery should include a prehabilitation or prehab program to help make you stronger going into the procedure.

A prehab program that includes education and strengthening exercises can optimize where you are in your musculoskeletal health and help identify any medical problems that could impact your recovery.

Experience and Volume

It may go without saying, but experience and volume also impact the effectiveness of knee replacement surgery. Evidence suggests that selecting a surgeon who does at least 50 to 100 replacements a year and a hospital that does at least 100 a year improves your chances of an ideal outcome.

Computer-Assisted Knee Replacement

Advancements in surgical techniques and technologies also lead to an increase in patient satisfaction with knee replacement surgery.

Computer-assisted navigation systems allow surgeons to plan surgery on a 3D model of a patient that’s developed from a CT scan. A robotic arm then assists the surgeon in making pre-planned bone cuts that allow for a greater degree of accuracy.

“Because of technology like this, there’s greater awareness of the fact that every knee is slightly different,” says Dr. Joseph Maratt, knee replacement surgeon at Forté. “The solution is to personalize the positioning of implants based on each person’s anatomy.”

Personalized Knee Replacement

A more personalized knee replacement process enhances patient outcomes because it ensures the surgeon removes just the right amount of damaged material during surgery. More of a patient’s soft tissues and bone are preserved, and there is increased accuracy in implant positioning, reducing the risk of complications.

“Personalization ultimately leads to less pain in the post-op period,” says Maratt. “We can’t make a knee replacement painless, but it leads to a more normal feeling knee and a faster recovery.”

Learn More

Wondering what to expect from life after knee replacement surgery? Maratt answers some of the most frequently asked questions and shares some of the benefits of computer-assisted knee replacement surgery.

To learn more about Forte’s joint replacement offerings using the latest techniques and technologies for the best results and fastest recovery, visit forteortho.com or call 317.817.1200.

If you suffer from severe knee arthritis that doesn’t respond to non-operative treatments, you may be considering knee replacement surgery. The procedure is a good option for patients with daily pain and limitations, as it’s reliable at relieving pain and restoring function.

“Modern knee replacement is truly an amazing procedure,” says Dr. Joseph Maratt, knee replacement surgeon at Forté. “The performance of today’s implants is much closer to feeling like your own knee than the implants of the past.”

As you consider your next steps, you may be wondering what to expect from a new knee. Dr. Maratt answers some of the most common questions he receives about life after knee replacement surgery.

Will I be taller after knee replacement surgery?

Knee replacement surgery doesn’t change your height. At most, it can give you a few millimeters. For example, knee arthritis can cause a patient to develop a bowed leg. While knee replacement surgery can correct the bow, it’s unlikely to lead to any noticeable change in the length of your leg.

Will I be able to climb the stairs to my second-story bedroom?

Most patients do not have to change their sleeping arrangements! Whether you plan to have an outpatient surgery or stay overnight, our team will ensure you’re standing, walking and moving around a few hours after surgery. As part of this early recovery process, a physical therapist will help you learn to navigate stairs. You probably won’t want to climb up and down them 10 times a day, but if your goal is to come down in the morning and go up in the evening, you’ll be fine.

Will I be able to kneel on the floor after surgery?

It’s perfectly safe to kneel on the floor after knee replacement surgery. Will you like it? Not necessarily.

There is a desensitizing program I recommend to my patients. For example, you start by kneeling on a mattress for ten minutes a day for a week and then progress to a slightly firmer surface, such as a couch cushion. Over six weeks, you’ll work your way to kneeling on a yoga mat. The last step is to try to kneel on a hard surface, but most patients don’t like it. Most generally, you’ll be able to tolerate kneeling on soft surfaces.

Will I be able to play pickleball again?

Not to worry, you should be able to play pickleball around four months after surgery. We don’t recommend becoming an ultra-marathoner, but you can have a mostly unrestricted return to sports and activities. My best advice is to ease back into physical activity to help prevent a setback due to deconditioning.

Will my new implant set off airport security metal detectors?

Yes, your implant will set off airport security detectors, but you don’t need to worry about obtaining a card or note from your physician before traveling. Simply tell the TSA officer you had a knee replacement prior to your airport screening. Since the TSA has policies and procedures for devices such as pacemakers and implants, they will be able to adjust accordingly, and off you’ll go.

Is there an age limit to have knee replacement surgery? How old is too old?

There is no “too old” for knee replacement surgery. I’ve seen 85-year-old patients in the clinic who don’t have a single thing filled out on their form other than some knee pain. That person sometimes asks, “Should I have surgery now or wait until next year?” It can be tricky, but there’s no reason to wait other than avoiding the standard risks. So, I would say to have surgery when you feel as though you need it.

There also isn’t really a “too young.” I try to get my younger patients to maximize their non-operative options and make some acceptable lifestyle changes before turning to surgery. If you are in your late 40s or 50s, it’s fine, but you’ll probably have a revision at some point in your lifetime. I have done knee replacements on patients in their 20s and 30s, but thankfully, those cases are rare.

Schedule a Consultation

Our hip and knee replacement specialists, Dr. Kevin Condict, Dr. John Hur, Dr. Joseph Maratt and Dr. Lucian Warth perform hundreds of joint replacement surgeries each year using the latest technologies and techniques to get you the best results and fastest recovery. To schedule a consultation, visit forteortho.com or call 317.817.1200.

You can also read more from Dr. Maratt as he shares some of the benefits of computer-assisted knee replacement surgery.

In the mid-90s, a group of more than 27,000 Swedish patients who had knee replacement surgery received a postcard in the mail asking one question: Are you satisfied with the outcome?

When an overwhelming 83% of respondents said “yes,” researchers spent the next two decades focused on the remaining 17%.

“What they found is that these patients say something just feels different,” says Dr. Joseph Maratt, knee replacement surgeon at Forté. “Because of that, there is greater awareness that every knee is slightly different, and one of the best ways to change the outcome for that 17% is to personalize knee replacement based on each person’s anatomy.”

How we personalize knee replacement

At Forté, patients receive computer-assisted knee replacements, which are more personalized than traditional knee replacement surgeries.

The first step is patient-specific surgical planning. A CT scan of your knee is used to create a 3D virtual model of your unique joint. After tracking a series of points around your knee, Maratt guides it through a range of motion to capture how much it will straighten, how far it can bend and how tight the ligaments are.

“What we often see is that if we just decided to put implants in based on the 3D model alone, you’d end up with a knee that feels too tight when you’re trying to bend it,” says Maratt. “Those are the things that, in the past, would make recovery really hard.”

Maratt uses the model to determine the optimal size, placement and alignment of your implant. With help from the computer guidance system, he can optimize where bone cuts should be and where implants will go so that ligaments are ideally tensioned.

“Think of it as a simulation tool that we can use to try different combinations of things and pick the one that makes the most sense before we make a single bone cut,” he says.

The benefits of personalized knee replacement

After adjusting the software, Maratt uses robotic arm technology to help perform the knee replacement. The personalization of the process ensures just the right amount of damaged material is removed, preserving more bone and soft tissues than traditional knee replacement surgery. Robotic instruments also increase the accuracy of your implant’s positioning, reducing the risk of complications.

“It ultimately leads to less pain in the post-op period,” says Maratt. “We can’t make a knee replacement painless, but it leads to a more normal feeling knee and a faster recovery.”

What to expect from the recovery process

With a new implant in place, you’ll begin your journey to strengthen your new joint.

“We will get you up standing, walking and moving around a few hours after surgery,” says Maratt. “A physical therapist will give you a few exercises to do and visit you at home for the first two weeks after you leave the hospital.”

Just as every knee is different, so is every patient’s experience. But Maratt says most patients hit a series of milestones as they participate in physical therapy following computer-assisted knee replacement surgery:

How to know when the time is right

Determining your readiness for knee replacement surgery is a personal decision. While Maratt says he can help you understand when surgery is appropriate for your situation, only you can decide when the time is right.

“My advice is to take note if you’re unhappy with the choices you’re making, such as choosing to sit in your hotel room rather than going sightseeing with your family,” says Maratt.

“When you get to that point, don’t become sedentary,” he says. “Get back to the things in life that you like doing.”

To learn more about Forté’s knee replacement offerings using the latest techniques and technologies for the best results and fastest recovery, visit forteortho.com or call 317.817.1200.

When Tony Sandlin started feeling side and back pain getting in and out of his hot air balloon baskets, he knew something was wrong.

Tony has been a hot air balloon hobbyist for nearly 20 years and 12 years ago, he decided to make Midwest Balloon Rides a full-time gig. He needed to be able to climb in and out and on top of the baskets to work on burners and when he started feeling pain, he called Forté on the recommendation of a friend.

Tony realized the pain he was feeling was actually hip pain, despite never having hip issues before. He met with Dr. Joseph Maratt, who determined that Tony needed his hip replaced.

The process went so smoothly, Tony asked Dr. Maratt if he really did the hip replacement – he was amazed at the lack of pain following the procedure. So when he determined that he needed his other hip replaced, he knew exactly where to go.

“I’ve been telling people, ‘Don’t be afraid of getting the hip done. Don’t wait until you’re 70 years old. You don’t have to – it’s not as bad as you think it’s going to be,’” said Tony.

Thanks to Dr. Maratt and the team at Forté, Tony is back in the sky and feeling better than ever.

Don't let joint pain stand in the way of what you love most. Our team is here to listen to you, and provide a quick diagnosis and personalized treatment plan to help you get back to living a full life. Request an appointment online or by phone at 317.817.1200.

CARMEL, Ind. (January 5, 2023): Forté Sports Medicine and Orthopedics, previously known as Methodist Sports Medicine, announces the election of a new board president and officers, effective as of Jan. 1, 2023. Dr. Jonathan Smerek now serves as president of the medical group, with Dr. Dale Snead serving as vice president and Dr. Joseph Maratt serving as secretary and treasurer.

Smerek, a fellowship-trained orthopedic surgeon specializing in foot and ankle reconstruction, brings vast experience to his new leadership role, including serving as a team physician in which he works as part of a highly collaborative group taking care of athletes. Before being elected president, Smerek served one term as vice president of Forté.

“I’m honored to have been selected to lead Forté and to keep building on all of the great achievements we’ve had during our 40 years of service to the community,” said Smerek. “I firmly believe that, like an athletic team, each member of a medical group contributes to the overall success of the organization. My main priority as president will be working with all team members to grow our practice and build out our centers of excellence in each specialty to continue to be a go-to for orthopedic care in Central Indiana and beyond.”

Smerek succeeds Dr. Mark Ritter, who served as Forté’s president for eight years and continues to serve the medical group as a physician. Ritter, one of three team physicians for the Indianapolis Colts, is a fellowship-trained orthopedic surgeon specializing in orthopedic sports medicine, trauma, and knee and shoulder injuries. During Ritter’s tenure as president, Forté underwent a rebranding process, opened both a new clinic and a new orthopedic specialty hospital in Carmel, advanced its urgent care program, and added two new surgeons, among other successes.

“Dr. Ritter’s support of Forté, its physicians and staff has been steadfast, requiring many hours outside of his patient schedule and family time,” said Marty Rosenberg, CEO of Forté. “We will be forever grateful for his leadership, which not only continued the legacy Forté has established as one of the country’s original sports medicine practices but also built upon it.”

To learn more about Forté Sports Medicine and Orthopedics, its services, and its accomplished team of physicians and staff, visit forteortho.com.

About Forté Sports Medicine and Orthopedics

Forté Sports Medicine and Orthopedics, previously known as Methodist Sports Medicine, is an independent, physician-owned orthopedic practice recognized as one of the region’s most respected orthopedic groups. Founded in 1983 as one of the country’s original sports medicine practices, Forté’s physicians and staff provide comprehensive, specialized sports medicine and orthopedic care to patients of all ages.

Clinical evaluations performed by highly skilled fellowship-trained orthopedic surgeons, combined with advanced surgical techniques and comprehensive non-surgical treatment options, provide patients with exceptional treatment outcomes and a return to active living. Forté provides patients with expert orthopedic care in several sub-specialties, including hand, wrist, elbow and shoulder; foot and ankle; hip and knee; joint replacement and revision; spine care and sports medicine. Forté has been trusted by the Indianapolis Colts as their official team physicians since 1983 and serve as the orthopedic provider for Purdue University, Butler University, Indiana State University and numerous high schools and public safety departments throughout central Indiana.

Forté Sports Medicine and Orthopedics also innovates daily through a separate 501(c)(3), Forté Orthopedic Research Institute, that improves the lives of patients everywhere through advanced clinical research and education.

Dr. Joseph Maratt, joint replacement surgeon with Forté Sports Medicine and Orthopedics, said the Stryker Mako technology combines advanced navigation for preoperative planning with a robotic arm that allows the surgeon to precisely execute the plan.

People’s lifestyles don't come in a one-size-fits-all form, Forté Sports Medicine and Orthopedics physical therapist Monica Schrader explains. For that very reason, when it comes to joint replacement surgery, taking time up-front to understand each patient's circumstances - home set-up, career needs, the level of help required of a designated caregiver and patient goals - is crucial to ensuring the best possible outcome post-surgery.

Prior to joint replacement surgery, every patient at Forté Sports Medicine and Orthopedics receives personalized, one-on-one joint replacement education to help ease their anxieties and prepare them for what to expect when coming home from surgery.

This time is spent ensuring

The principle goal of pre-op joint replacement education is to ensure there is nothing to figure out upon arriving home from surgery, Schrader explains - everything will have been planned, practiced and ready to go. What's more, realistic and appropriate expectations are outlined so patients are aware how and when to safely return to their desired level of activity. "By empowering our patients with knowledge tailored to their own needs," Schrader says, "we optimize the outcome of their joint replacement surgery."  

As a physical therapist, Monica Schrader’s treatment philosophy is simply this: a patient is more complex than just one joint or a single surgery. Experienced in treating a wide variety of patients undergoing different sports medicine and orthopedic surgical procedures, she knows - pre-op or post-op, patient education is best-done one-on-one.

Living with a joint that isn’t functioning like it should and has been causing you pain can be scary. You may wonder if you need a joint replacement, but are grappling with fear of the surgery and not knowing what choice is best. Many people have dealt with this unknown as they try to take on their daily tasks. An occasional pain in the knee is one thing, but chronic, severe pain even when you aren’t moving is another. But, is a joint replacement really the best choice for you?

If you’re facing this type of decision, it’s always important to talk to your doctor. According to Dr. Joseph Maratt, an orthopedic surgeon who specializes in hip and knee replacements, “I tell patients that joint replacement is an elective surgery and that the choice of when to have surgery is entirely up to them.”

Dr. Maratt continues on to explain that these factors should be considered when weighing the pros and cons of joint replacement surgery:

If you find that you have to give up aspects of your life that are important to you because of the pain, it may be time for a joint replacement. No one should have to trade happiness and quality of life because of joint disease. Dr. Maratt explains that most people will know when the time is right for joint replacement, “It’s when you find yourself giving up things that matter to you, missing out on things that matter, or doing it anyway and then suffering for it later – it’s that point when most people know surgery that can help them is the right choice.”

If you find that you’ve tried everything to manage joint pain and aren’t able to have the quality of life that you want, a total joint replacement may be the right option for you.

Learn more about our total joint replacement program.

Our Forté Fast Orthopedic urgent care clinic in Noblesville will close on Monday, June 24th at 11:30 am.

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