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Joint Replacement

When it comes to injured, damaged, or arthritic joints, our top priority is restoring your mobility, eliminating your joint pain, and getting you back to the activities you enjoy. We offer the most current joint replacement techniques and technologies available, including:

  • Ankle replacement
  • Minimally invasive surgery of the hip and knee
  • Direct anterior and mini-posterior minimally invasive and muscle sparing approaches for hip replacement
  • Hand joint replacement
  • Minimally invasive partial knee replacement and total knee replacement using patient-specific cutting guides for custom knee implants
  • Computer-assisted navigation for total knee replacement

At POA, our surgeons use their skills coupled with the latest in multimodal pain management and accelerated, rapid recovery techniques to replace our patient’s joint with the highest level of accuracy and least amount of pain, with two goals in mind: shorter recovery times and quality outcomes.

From our one-on-one preoperative education and postoperative patient care plans to our state-of-the-art outpatient surgery center at Deer Pointe, our entire team is committed to providing our patients with the same high quality care found at the most respected academic centers right here at home.

POA is also proud to be part of the joint center at Nanticoke Memorial Hospital in Seaford, Delaware offering our southern Delaware total joint patients a concierge, private room and the demonstrated skill and expertise of our team of surgeons.

We Are Here For You

Our team of talented surgeons will work closely with you and your primary care physician to develop a highly personalized plan for your total or partial joint replacement. For many patients, joint replacement surgery is the last option for eliminating chronic pain, but it can also be the first step toward an active, pain-free life.

Ankle Replacement

Ankle arthritis can be a severely debilitating ailment, making walking unbearable or even impossible. Most ankle arthritis is different from knee and hip arthritis because, it typically affects younger patients and is often related to previous trauma. Ankle replacement is a fast-growing and highly successful solution for patients with chronic, incapacitating ankle pain from advanced arthritis. It is performed by a select few surgeons who are trained in complex foot and ankle reconstruction. Ankle replacement surgery may allow you to walk with a near-normal gait and say goodbye to pain medication for good. It also allows you to keep the remaining motion in your ankle joint or even improve on your existing motion, while sparing adjacent joints in the hindfoot.

During ankle replacement surgery, we remove the damaged joint and implant a prosthetic joint between your lower leg and ankle bones. Dr. Mandel uses state-of-the-art technology and cutting-edge implant materials and design. He is one of very few surgeons in the country trained on the newest ankle replacement system, the Zimmer Trabecular Metal Total Ankle Replacement. This system is bone sparing, uses a highly crossed-linked polyethylene, has Trabecular MetalTM components to allow for bone ingrowth, and uses curved cuts and implants for a natural contour and refinishing to the existing anatomy. Any joint asymmetry and deformity will be corrected at the time of surgery.

Our foot and ankle surgeon will review your medical history and perform a thorough evaluation to determine if ankle replacement surgery is the best option for you. Patients must have healthy soft tissues, normal blood flow to the lower leg, intact sensation, and a fair range of motion. Patients must also follow a post-op protocol in order to prevent any adverse post-op events.

Click here for more product information on the implant and technique.

Hand Joint Replacement

Arthritis can wreak havoc on the joints in your hands. Your hand, an intricate system of joints, is your lifeline – and when its mobility is compromised by chronic pain, even the simplest tasks can become unbearable. At POA, you will have access to the premier hand specialist in the region, who can perform complex, highly specialized joint replacement surgery to get your fingers, knuckles, and wrist moving in sync once again. Hand joint replacement surgery at POA can reduce joint pain, restore your hand’s mobility, improve your hand’s appearance and greatly increase your overall hand function.

Your hand is made up of knuckle joints, finger joints and your wrist joint. During joint replacement in the hand, one or more of these damaged joints will be removed and replaced with state-of-the-art prosthetic joints. Many wrist and hand joint replacement surgeries can be performed on an outpatient basis, reducing your time in the hospital and getting you back to your normal routine quickly.

Our hand surgeon and his team will review your medical history and perform a thorough evaluation to determine if hand replacement surgery is right for you.

Hip Replacement

The hip, a ball-and-socket joint, is one of the most important parts of your body when it comes to getting around. It allows you to walk, twist, get in and out of your car, climb stairs and simply bend down to tie your shoe. When your hip can’t move like it used to, your daily life can be severely affected. Hip replacement surgery at POA is designed to relieve your pain, improve mobility, and increase your strength and coordination.

During total hip replacement, our surgeon will replace the ball at the upper end of your femur, or thigh bone, with a prosthesis made of state-of-the-art materials. The socket in your pelvic bone will be resurfaced as well. Damaged cartilage will be replaced, and your new joint will be locked into place in the precise location to restore your natural anatomy, ensuring that it moves normally. Your surgeon will choose the approach to the hip that best provides a long-lasting, stable joint that gets you back on your feet as quickly as possible. This can be done equally well from the front, side, or back of the hip.

Our team will review your medical history and perform a thorough evaluation to determine if hip replacement surgery is right for you. When needed, we will help you evaluate which type of implant and most up-to-date surgical technique is right for you, including:

  • The direct anterior minimally invasive, muscle sparing approach
  • The mini-posterior minimally invasive, muscle sparing approach
  • The posterior approach
  • A variety of traditional surgical approaches for more complex cases and hip revision surgery

Knee Replacement

The knee is the largest joint in your body. It is also a key player in nearly all of your everyday activities. So if your knees are debilitated from arthritis or injury, chances are your daily activities are severely limited. Total knee replacement at POA is designed to get you moving again, eliminate your pain, and improve your overall quality of life.

During total knee replacement, your surgeon will resurface your damaged knee and implant prosthesis. Your surrounding muscles and ligaments play a huge part in helping to support your new knee. Our team of orthopaedic surgeons perform many different types of knee replacement, including:

  • Unicompartmental: medial, lateral and patellofemoral
  • Posterior cruciate ligament (PCL) substituting
  • Posterior cruciate ligament (PCL) retaining
  • Patient-specific instrumented (PSI) partial and total knee replacement for added accuracy and customization
  • Rotating platform
  • Constrained hinge
  • Computer navigated knee replacement for added accuracy of within 1 millimeter or 1 degree on cutsAt POA, your doctor will work with you to choose the right design, fixation method and materials depending on the amount of bone loss, your surrounding ligaments, and other personal health factors. We use today’s most proven minimally invasive and computer-assisted technology to cut down your recovery time and improve the accuracy of your knee replacement surgery.

Kinematic/Anatomic Knee Alignment
Kinematic, or anatomic as we call it, alignment in knee replacement simply means putting the replacement parts back so that its mimics the patient’s natural alignment before the arthritic process began.

For the past 40 years, the majority of surgeons have replaced knees with a process called mechanical alignment, which has a goal of aligning the center of the hip, knee and ankle. Unfortunately, this only restores a patient’s natural anatomy about two percent of the time. This means that in the majority of patients the ligaments that stabilize the knee no longer work at the length that was originally intended. They either end up too tight on one side and too loose on the other side, or the surgeon has to loosen the ligaments on one side of the knee in an attempt to “balance” the knee. In reality, what is happening is the surgeon is changing the way that the patient’s knee works. This may explain why up to 20 percent of knee replacement patients across America are not satisfied with their new knee.

Anatomic alignment recreates each patient’s individual anatomy and does not require releasing ligaments that stabilize the knee. Instead, the bone is cut in such a way that the ligaments are allowed to function normally without altering their length or tension on either side of the knee. This creates a more natural feel to the knee, a quicker recovery and a happier patient. POA surgeons use imageless computer-assisted navigation, which allows guided and personalized surgery and helps them execute the surgical plan with truly amazing precision. Our goal is to bring this technology and technique to surgeons across America, improving patient outcomes everywhere.

Why is this so important? Because lower leg alignment and patterns of arthritis vary widely from person to person, and a few degrees of variation in implant placement can lead to more successful outcomes and longer implant lifespans.

The benefits:

  • A more natural feeling knee
  • Preservation of the correct joint line height and orientation, as well as a replaced knee that has the same appearance as the uninvolved knee
  • Quicker recovery times and return to normal activities
  • A greater range of motion

Our technique to create anatomic alignment allows for intraoperative planning adjustments and ensures that each patient has the knee positioned optimally to allow the ligaments to function normally.

Our orthopaedic specialists will review your medical history and perform a thorough evaluation to determine if kinematic knee alignment is right for you.

Shoulder Replacement

Shoulders are complicated. As the most mobile joint in your body, the shoulder works with a vast network of cartilage, bones, muscles, and ligaments to bear the brunt of your hard work. As an intricate body part, the list of possible shoulder ailments is extensive, from osteoarthritis to rotator cuff injuries. And when your shoulder is in pain, your whole body can feel it, too.

The good news is that your shoulder is in excellent hands at POA. Our surgeons have the most experience in total shoulder replacements in the area and were the first in the region to offer reverse total shoulder replacement.

During shoulder replacement surgery, your surgeon will replace or cap the damaged portion of your upper arm and shoulder bone with a state-of-the-art prosthesis. We use the most current technology to get precise and accurate results with the least amount of pain and shortest recovery time possible.

Reverse Shoulder Replacement
Reverse shoulder replacement is an option for patients with major rotator cuff tears and chronic shoulder arthritis. POA is one of a select group of U.S. practices whose surgeons are highly experienced in this newer, complex shoulder procedure. During the procedure, your surgeons will reverse your shoulder’s mechanics by inserting a highly specialized implant. In short, the ball-and-socket shoulder becomes a socket-and-ball shoulder. The results can be astonishing – bringing movement back to seriously injured shoulders, eliminating pain and greatly improving shoulder mobility.

Reverse shoulder replacement is not right for everyone, but in some cases it’s exactly what is needed. Our shoulder surgeons will review your medical history and perform a thorough evaluation to determine if shoulder replacement surgery is right for you.

At POA we offer a wide range of options to best meet your needs, including:

  • Total joint replacement
  • Partial knee replacement
  • Revisions of previously replaced joints that have worn out
  • Prosthetic joints made from the best materials with proven track records
  • 3-D image guided surgery and kinematic knee alignment
  • Multimodal pain control, including Exparel, to decrease postoperative pain

Explore our Frequently Asked Questions or our Patient Resources to learn more about joint replacement.

American Academy of Orthopaedic Surgeons

At POA we offer a wide range of options to best meet your needs, including:

  • Total joint replacement
  • Partial knee replacement
  • Revisions of previously replaced joints that have worn out
  • Prosthetic joints made from the best materials with proven track records
  • 3-D guided surgery and kinematic knee alignment
  • PRP therapy to decrease blood loss and improve recovery time
  • Multimodal pain control, including Exparel, to decrease postoperative pain

Explore our Frequently Asked Questions or our Patient Resources to learn more about joint replacement.

American Academy of Orthopaedic Surgeons

 

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