David Cheong, MD – Lateral Total Knee Replacement

My name is Dr. David Chong. I’m an orthopedic surgeon who specializes in joint reconstruction of hips and knees. Arthritis is a progressive degenerative condition where your cartilage in your knee is slowly being worn away.

Arthritis is progressive, so it doesn’t go away. It oftentimes afflicts patients with pain, stiffness, swelling, and sometimes even deformity of their joints. When conservative measures fail to help, some patients have to consider joint replacement surgery, specifically in the instance of knees, a total knee replacement.

A total knee replacement is one of the most commonly performed surgeries in orthopedics with a very high success rate and patient satisfaction. It is done in a way traditionally that requires an incision on the front of the knee. That incision has to cut some of the quadriceps muscle in order to allow the surgeon exposure to the joint.

It is during that exposure where the arthritic bone edges are removed and replaced with metal and plastic, commonly known as polyethylene. It is that surgical procedure which has many benefits. However, a lateral approach, a muscle sparing approach, I believe has many more additional benefits.

These include a faster return of strength and confidence, lower pain after the surgery, and improved functional outcomes in terms of sensations about the knee and activities such as kneeling. The beauty of the lateral approach to total knee replacement is fairly simple. By not cutting muscle, which is normally done in a traditional approach, that muscle does not have to endure the recovery time and process.

And so you’re going to get a faster return to function and a faster return to the activities that you want to do. Normally, after a traditional surgical approach in knee replacement surgery, I explain to patients it’s about eight to ten weeks to get back to a routine. You may not be completely recovered and still making progress, but that timetable was fairly consistent.

What I have seen in my own patients and just recently in performing and making this approach a standard part of my practice, is that time to recovery, that time to a routine, is cut by two to three weeks. And so by week number six or seven, they’re getting back into a rhythm. The patients who will benefit from a lateral approach to a total knee replacement are the same patients who would benefit from a traditional total knee replacement.

So it’s typically the patients who have tried and failed the conservative strategies for end stage arthritis. They can be young, they can be elderly, they can be athletic, they can just want to be more comfortable and do the things that they want to do. As of today, I am currently the only orthopedic surgeon in the Bay Area performing a lateral subvastus total knee replacement.

I really do believe that my team and I are dedicated to patient care and want to see my patients do the best, recover the fastest, and get the most out of their decisions to pursue surgical management for their arthritis.