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Interview with RPA Janssen, M.D. on the latest developments in the treatment of knee osteoarthritis. The minimal invasive total knee prosthesis (MIS Knee) is explained. It leads to faster recovery of the patient with a knee prosthesis. The article is published in .info/surgical.
Emergency and elective medical care does not have to interfere with each other. This is proven by the new Orthopaedic Center Máxima. Knee specialist, orthopaedic surgeon RPA Janssen, performs many minimal invasive total knee procedures with the new MIS Knee, a novel technique for total knee arthroplasty surgery. "My patients in Orthopaedic Center Máxima are almost all candidates for this elegant technique".
RPA Janssen had mastered the learning curve just in time for the opening of the new Orthopaedic Center Máxima Eindhoven, The Netherlands. After several years of minimal invasive surgery with unicompartimental knee prostheses, he adapted the technique this last year for use with the larger total knee arthroplasty. The MIS Knee technique is important in the new clinic where short waiting lists, high quality of professional orthopaedic care is combined with friendly service and efficiency of care. Patient can be seen in the outpatient clinic on short notice and surgery, if indicated, may be performed in 3 to 6 weeks time. Patients experiences in the new setting are very positive. "The Orthopaedic Center Máxima is our answer to the ongoing changing politics of health care".
Advantage lies beneath the skin
RPA Janssen is part of a generation who grew up with arthroscopic and less invasive surgical techniques. He is President of the Dutch Arthroscopy Society. He sees himself as "an early adapter", but states that sometimes a more extensive approach is necessary for adequate placement of the prosthesis. "A knee joint is a biomechanical wonder. Spatial orientation in 6 different axes of motion is required in order to fulfill the surgery correctly. If one masters the biomechanical principles of the knee, one can treat the full compass of both osteoarthritic and complex instability problems of the knee. The technique used for placement may vary. It is essential to surgically place the prosthesis in an exact position in relation to the mechanical axis of the leg with a well balanced ligamentous end-result. Minimal invasive surgery is more elegant than an extensive approach. However, one should realize that the prosthesis still needs to be well placed and balanced through a smaller incision. That is where the MIS Knee system comes in. The smaller instruments are designed in such a manner to minimize trauma to the soft tissues around the knee. The latter explains the quicker rehabilitation and gain of knee function in the patients after the surgery. RPA Janssen denotes the MIS Knee instruments as "technically pleasant". However, extensive experience in total knee arthroplast surgery is required to master the technique correctly. In addition to the MIS Knee technique, he makes use of a high flexion total knee arthroplasty in all patients. This prosthesis allows for better flexion of the knee.
No factory work
The opening of the more efficient Orthopaedic Center Máxima has drastically reduced the waiting list for total joint surgery. In addition to the well planned elective surgery, RPA Janssen also treats complex knee problems such as revision arthroplasties, knee trauma cases and multiligamentous instabilities of the knee. "The elective surgery still remains challenging. A complication in an elective case may be just as dramatic". The orthopaedic surgeon views the less invasive surgery of the knee as an excellent technique to help patients faster on their feet after the surgery. In addition, it is a more friendly procedure with less morbidity for the patient. This allows RPA Janssen in Orthopaedic Center Máxima to work according to the highest standards of care, without becoming a factory work place. Orthopaedic Center Máxima (as part of the Máxima Medical Center) is the only hospital in south eastern province of Noord Brabant, to fullfill the highest standard of medical care necessary to be allowed to have an orthopaedic residency program. Less invasive knee surgery has become part of this high standard of care for patient with knee osteoarthritis.
Patient experiences after knee prosthesis may be read in chapter Cases.