Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A total knee replacement is a surgical
procedure whereby the diseased knee joint is replaced with artificial
material. The knee is a hinge joint which provides motion at the
point where the thigh meets the lower leg. The thighbone (or
femur) abuts the large bone of the lower leg (tibia) at the knee
joint. During a total knee replacement, the end of the femur bone
is removed and replaced with a metal shell. The end of the lower
leg bone (tibia) is also removed and replaced with a channeled
plastic piece with a metal stem. Depending on the condition of
the kneecap portion of the knee joint, a plastic "button"
may also be added under the kneecap surface. The artificial components of a total knee replacement are referred to as the prosthesis.
The posterior cruciate ligament is a tissue that normally stabilizes each side of the knee joint so that the lower leg cannot slide backward in relation to the thighbone. In total knee replacement surgery, this ligament is either retained, sacrificed, or substituted by a polyethylene post. Each of these various designs of total knee replacement has its
own particular benefits and risks.