Dr Michael Van Manen

Dr Michael Van Manen Board Certified Orthopedic Surgeon. Fellowship trained in Total Joint Reconstruction.

Revision total knee case. The key concepts to revision knee replacement are to balance the flexion and extension gaps eq...
06/13/2026

Revision total knee case.

The key concepts to revision knee replacement are to balance the flexion and extension gaps equally while maintaining the native joint line. This creates normal tension on the supporting ligaments and tendons. This is very challenging as we are dealing with bone loss. This is where the “feel” and the understanding of knee biomechanics and anatomy is paramount.

This patient had bone implant loosening and instability. We removed minimal bone and used augments to recreate her joint line. Anytime you choose to get a knee replacement, unfortunately this can happen. Yes, we can redo failed knee replacements, but they are harder to do and take longer to recover.

It’s paramount patients learn prevention when it comes to extreme knee arthritis. Maintain ideal body weight with diet and exercise. Use PRP in early onset arthritis. New research is on the horizon with peptide therapy. Be realistic with your aging body. Our minds might stay young but our machine does wear out with time.

As orthopedic techniques advance, be mindful that the science of longevity and wellness is also advancing. Longevity and wellness is hard and takes individual discipline. Even if we can save your joint, that does not mean you need to abuse your body. Try and Keep what God gave you.

-Dr V.

“It suck’s getting older”…..I hear it daily.
06/11/2026

“It suck’s getting older”…..I hear it daily.

It works. Been using it in patients for over 9 years.
06/11/2026

It works. Been using it in patients for over 9 years.

After a decade of orthopedic research, confirmation bias creates dogma and trends. It’s human nature to latch onto the “...
05/16/2026

After a decade of orthopedic research, confirmation bias creates dogma and trends. It’s human nature to latch onto the “NEW.” Scientists and doctors must fight this and stay current with long term research and must importantly, that every patient’s story is different that requires careful analysis. This is a great paper discussing the approaches to total hip replacement. The surgical approach is not the most important factor. Surgeons market the “NEW” because they treat health care as a business.

Primary Total Knee case. Some primary total knee replacements require increased stabilization. This was a robotically as...
05/16/2026

Primary Total Knee case.

Some primary total knee replacements require increased stabilization. This was a robotically assisted total knee in a patient that also had an MCL tear. He was a younger patient. There are knee replacement designs that increase stability if there is an associated ligament issue. We elected to use a semi constrained design and not a fully constrained design due to his younger age. We added stems (long rods that go into the femoral and tibia canals). He is three years out with no pain. Decision making on surgical implants is unique to every patient and their pathology.

-Dr V.

You must weight train. I hear it all the time….”I walk everyday for exercise .”
05/15/2026

You must weight train. I hear it all the time….”I walk everyday for exercise .”

Periprosthetic fracture case. These can be very devastating injuries. There is a zone between normal biological bone and...
05/07/2026

Periprosthetic fracture case.

These can be very devastating injuries. There is a zone between normal biological bone and the metal implant that can increase the chance of fracture. If you get a total joint, please exercise caution when doing activities that could result in trauma. Stay as physically fit as possible, and learn to practice fall precautions. Of course life happens and your local orthopedic surgeon is on call.

This was a case done a while back. The patient fell off a ladder and fractured their femur around the femoral stem implant. It required removal of implant, cabling the fracture and re-inserting a longer more stable stem. Very hard recovery for this patient. Very challenging case.

-Dr V.

Strong evidence shows increased precision with robotic assisted total hip replacement.
05/02/2026

Strong evidence shows increased precision with robotic assisted total hip replacement.

Trauma case. This is a 75 year old patient who suffered a insufficiency fracture of the femur just by walking. Her femur...
04/28/2026

Trauma case.

This is a 75 year old patient who suffered a insufficiency fracture of the femur just by walking. Her femur bone fractured without any trauma.
She suffered a pathological fracture due to prolonged use of a Bisphosphinate medication for osteoporosis. This inhibits normal bone remodeling that can create very brittle bone that can fracture. If you have been taking Bisphosphinate medication for over 5 years for osteoporosis, be aware of thigh pain that could be due to this medication. Seek follow up with your primary care or an orthopedic surgeon.

-Dr V.

Trauma case for the upcoming trauma season. Be careful. This was an ankle fracture suffered by a high energy twisting i...
04/21/2026

Trauma case for the upcoming trauma season. Be careful.

This was an ankle fracture suffered by a high energy twisting injury. The injury occurred when a rancher got his foot caught in the stirrup when he fell off his horse. There were multiple fractures of the tibia and the fibula. The one image shows the ankle was very unstable. This required surgery with multiple surgical approaches and multiple plates and screws to address each fracture fragment as to restore his ankle anatomy. Unfortunately, his ankle will never be the same. But he ended up getting back on his horse after 6 months of healing and rehab.

Trauma happens. But please exercise caution when deciding to push limits this summer.

-Dr V.

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1655 Quail Lake Loop
Colorado Springs, CO
80906

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