Total knee Replacement OVERVIEW
When knee arthritis or injury limits your daily activities in Nashville or Franklin, Tennessee, total knee replacement surgery offers renewed mobility and freedom from chronic pain. As a fellowship-trained orthopedic surgeon and Mako robotic surgery specialist serving Williamson County, Dr. Cory Calendine explains that knee replacement surgery is actually a precise cartilage replacement procedure rather than replacing the entire knee joint. During total knee replacement in Nashville, the damaged cartilage surfaces are carefully removed and replaced with advanced metal alloy components on the femur and tibia, with medical-grade plastic positioned between them to create smooth joint movement. The kneecap's undersurface may also receive a plastic replacement when necessary. This minimally invasive knee surgery approach, often utilizing robotic-assisted technology, creates a new cushioning system that significantly reduces arthritis pain while restoring function. Patients throughout the Greater Nashville and Franklin areas experience dramatic pain relief and progressive improvement in range of motion, allowing them to return to the activities they love without the daily burden of joint pain limiting their quality of life.
The journey toward knee replacement surgery in Franklin, TN begins with a comprehensive evaluation by Dr. Calendine, Chief of Orthopaedic Surgery at Williamson Medical Center and founding partner of the Bone and Joint Institute of Tennessee. During your initial consultation at our Nashville area practice, Dr. Calendine will review your medical history, perform a detailed physical examination, and analyze X-rays of your knee joint. Even when patients experience significant pain and X-rays reveal advanced arthritis, conservative treatment options are typically explored first, including targeted weight management, specialized exercise programs, anti-inflammatory medications, therapeutic joint injections, and supportive bracing. If these non-surgical treatments fail to provide adequate symptom relief, total knee replacement surgery may be recommended. As robotic joint replacement surgery represents a major surgical decision, Dr. Calendine encourages thoughtful discussions between patients, their families, and our experienced surgical team. The decision to proceed with knee replacement in Nashville ultimately rests with each patient and is based on how arthritis pain and disability impact their quality of life and ability to participate in meaningful daily activities, work, exercise, and sleep comfortably. Ideal candidates for total knee replacement are those whose symptoms prevent them from enjoying activities that matter most to them in the vibrant Nashville and Franklin communities.
description of total knee replacement
A knee replacement (also called knee arthroplasty) might be more accurately termed a knee "resurfacing" because only the surface of the bones are actually replaced. There are four basic steps to a knee replacement procedure.
1. Prepare the bone. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
2. Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or "press-fit" into the bone.
3. Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. Some surgeons do not resurface the patella, depending upon the case.
4. Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.
Anesthesia
Patients undergoing total knee replacement surgery in Nashville and Franklin, Tennessee typically arrive at Williamson Medical Center on the morning of their procedure. Upon admission, you will meet with Dr. Calendine's experienced anesthesia team to discuss the safest and most comfortable anesthesia approach for your knee replacement surgery. The anesthesia specialists will evaluate your medical history and current health status to recommend the optimal pain management strategy. Common anesthesia options for total knee replacement include general anesthesia, where you sleep comfortably throughout the robotic knee surgery, or regional anesthesia techniques such as spinal, epidural, or peripheral nerve blocks that numb the surgical area while you remain awake and alert. Your anesthesia team at our Nashville area surgical center will work closely with you to determine which anesthesia method best suits your medical needs, personal preferences, and overall comfort level for your knee replacement procedure.
While general anesthesia remains a safe and effective option for knee replacement surgery in Franklin, TN, many orthopedic surgeons and anesthesiologists prefer regional anesthesia techniques for total knee replacement procedures. Clinical research demonstrates that regional anesthesia options, including spinal anesthesia, epidural anesthesia, and specialized peripheral nerve blocks, can significantly reduce post-operative complications while enhancing your recovery experience. Patients who receive regional anesthesia for their knee replacement surgery often experience less post-operative pain, reduced nausea, and require fewer narcotic pain medications during their recovery period. Advanced peripheral nerve blocks have become increasingly popular for total knee replacement, particularly the adductor canal block, which provides excellent pain control for knee surgery while preserving important muscle strength needed for early mobilization and physical therapy. Dr. Calendine and the anesthesia team at Williamson Medical Center will discuss these innovative pain management options with you during your pre-operative consultation, ensuring you understand the anesthesia plan and post-operative pain control strategy tailored specifically for your total knee replacement surgery in the Nashville metropolitan area.
Are all knee replacement implants the same?
The orthopedic implant industry has developed numerous innovative technologies designed to enhance total knee replacement surgery outcomes for patients in Nashville, Franklin, and throughout Tennessee. With manufacturers increasingly marketing these advanced implant designs directly to patients, Dr. Calendine recognizes that many individuals considering knee replacement surgery in the Nashville area have questions about which implant type offers the best results. As a fellowship-trained orthopedic surgeon and Chief of Orthopaedic Surgery at Williamson Medical Center, Dr. Calendine emphasizes an important evidence-based message: while various manufacturers may claim superior design advantages, comprehensive registry data from thousands of total knee replacement procedures demonstrates no clear outcome differences between most modern implant designs. Large-scale clinical studies tracking knee replacement surgery results show that surgeon expertise, patient selection, and surgical technique often matter more than specific implant brand or design features. During your consultation for total knee replacement in Franklin, TN, Dr. Calendine will discuss which proven implant design best suits your individual anatomy and lifestyle needs.
Gender-Specific Knee Replacement Implants: These specialized implants acknowledge the anatomical differences between men's and women's knee structures, offering modified designs that better accommodate average gender-based variations in knee anatomy. Most leading manufacturers have incorporated similar anatomical modifications into their current knee replacement systems, providing Dr. Calendine with expanded sizing options to achieve optimal fit and function for each patient's unique anatomy. This personalized approach to total knee replacement surgery in Nashville helps recreate natural knee movement and stability.
Rotating Platform vs. Fixed Bearing Knee Implants: The rotating platform design features a plastic bearing component that rotates independently on its metal base, while fixed bearing implants lock the plastic component securely to the metal tray. When rotating platform technology was initially developed for knee replacement surgery, theoretical advantages included reduced plastic wear, decreased loosening rates, and improved knee mechanics. However, extensive clinical data from five to ten-year follow-up studies of total knee replacement patients shows no significant differences in outcomes between rotating platform and fixed bearing designs. Dr. Calendine selects the most appropriate implant design based on your specific anatomy, activity level, and surgical considerations rather than marketing claims, ensuring you receive the most reliable knee replacement solution for your lifestyle in the Greater Nashville area..
What is subvastus approach knee replacement?
The subvastus approach to knee replacement, also known as muscle sparing knee replacement or SubV knee replacement, represents an advanced surgical technique that preserves the quadriceps muscle during total knee replacement surgery. Unlike traditional medial parapatellar approaches used in conventional knee replacement surgery, the subvastus technique allows Dr. Calendine to access the knee joint by working underneath the vastus medialis muscle without cutting through the quadriceps tendon. This quadriceps sparing approach to total knee replacement in Nashville and Franklin, Tennessee offers patients a less invasive alternative that maintains the structural integrity of the muscles responsible for walking, climbing stairs, and everyday mobility. As a fellowship-trained orthopedic surgeon and Chief of Orthopaedic Surgery at Williamson Medical Center, Dr. Calendine specializes in this muscle sparing knee replacement technique, often combining it with Mako robotic assistance to enhance precision and optimize patient outcomes.
Benefits of Muscle Sparing Knee Replacement SurgeryPatients who undergo subvastus knee replacement surgery in Franklin, TN experience significant advantages compared to traditional knee replacement approaches. The muscle sparing technique preserves the quadriceps tendon entirely, resulting in less muscle damage, reduced post-operative pain, and accelerated recovery timelines. Because the quadriceps muscles remain intact during SubV knee replacement, patients typically require fewer assistive devices like walkers or canes and demonstrate improved early mobility following surgery. This quadriceps sparing approach leads to better long-term functional outcomes, with many patients in the Greater Nashville area reporting faster return to work, recreational activities, and normal daily living. The subvastus technique is particularly beneficial for active adults who want to resume sports, travel, or demanding physical activities as quickly as possible after their total knee replacement surgery.
Combining Subvastus with Robotic Technology Dr. Calendine's approach to muscle sparing knee replacement incorporates cutting-edge Mako robotic technology to further enhance the precision and effectiveness of the subvastus technique. This combination of SubV approach with robotic assisted knee replacement surgery allows for personalized 3D surgical planning, more accurate bone preparation, and optimal implant positioning tailored to each patient's unique anatomy. The integration of robotic guidance with the muscle sparing subvastus approach results in smaller incisions, better soft tissue balance, and more predictable surgical outcomes for patients throughout Middle Tennessee. During your consultation for subvastus knee replacement in Nashville or Franklin, Dr. Calendine will evaluate your candidacy for this advanced muscle sparing technique, considering factors such as your anatomy, activity level, medical history, and surgical goals to determine if SubV robotic knee replacement is the optimal approach for restoring your mobility and quality of life.
Source:
American Academy of Orthopaedic Surgeons, https://orthoinfo.aaos.org/; American Association of Hip and Knee Surgeons, https://hipknee.aahks.org/total-hip-replacement/Cory Calendine, MD is an Orthopedic Surgeon and founding partner of the Bone and Joint Institute of Tennessee at Williamson County Hospital in Franklin, TN. Dr. Calendine is an expert in Joint Replacement, specializing in Hip and Knee Surgery. From diagnosis through treatment, the Orthopedic Surgical experts at the Bone and Joint Institute use the latest techniques and technology to improve care for people with musculoskeletal problems. For more information, please contact our office or schedule your appointment today.
