The Vanguard XP Total Knee System is a cruciate retaining design that allows for the posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) to be preserved while incorporating geometry to accomodate and enable the natural function of the ligaments of the knee.

While Total Knee Replacement is, overall, an excellent procedure with great results, a small percentage of patients (usually younger and more active) have described their replaced knees as not feeling "normal" or "natural." Leading experts agree that this is due to removing the ACL, which is done in all Total Knee Replacments, until now.

The Vanguard XP Knee Replacement is designed to retain the ACL (and PCL), while replacing the damaged joint.

Dr. Goldhagen, who has been performing Total Knee Replacements for almost 20 years, has recently received special training to be certified and able to perform the Vanguard XP Total Knee Replacement.


Please ask Dr. Goldhagen if this knee is right for you!




The human body is made of billions of specialized cells that form specific organs like the brain, skin, muscles, tendons, ligaments, joints and bone. Each day these cells go through a degenerative and regenerative process. As older cells die, new cells are formed from stem cells with the unique capability of being able to create multiple types of other cells. However, when tissues are injured, the degenerative process exceeds this regenerative process, resulting in these structures becomming weaker, more painful, and less functional. While there are several types of stem cells, those promoting musculoskeletal healing (tendon, ligament, cartilage, and bone) can be found in bone marrow, which acts as a type of stem cell reservoir. Modern techniques allow us to withdraw stem cells from bone marrow, concentrate them, and then re-inject them into injured or damaged tissues in other areas of the body. We are enhancing the natural repair process of degenerated and injured tendons, ligaments, and arthritic joints - turning the tables on the natural breakdown process that occurs on a daily basis from ageing, overuse, and injury. The stem cells can be injected along with Platelt-Rich Plasma, which is obtained from a patient's blood.


Please ask Dr. Goldhagen if you are a candidate for Stem Cell or PRP treatment!




Traditionally, hospital stays after Total Joint Replacement surgery (Hips and Knees) averaged 2-4 days. Most of this time in the hospital is spent getting post-operative pain under control, usually with Morphine or another narcotic, with a PCA pump (patient-controlled analgesia). This narcotic use often causes intolerable side effects, such as nausea / vomiting, or itching. Also, the longer a patient stays in the hospital, the greater chance they have of getting an infection (since hospitals have a lot of "sick" patients with all sorts of infections).

Recent advances in the prevention and treatment of pain, including nerve blocks, regional anesthesia, and multi-modal pre-operative pain management have allowed patients to stay just one night in the hospital and return home within 24 hours of their surgery (in fact, there is a facility in Altoona, PA, that discharges their knee replacement patients 4 hours after surgery!). Recovering in your own surroundings has been shown to be better physically, emotionally, and psychologically. Additionally, replacing hips through an anterior approach (which have less post-operative pain than the traditional posterior approach) helps make outpatient hip replacemnet surgery possible.

Outpatient joint replacement surgery is definitely not for everyone, but those who have had it done as an outpatient have done extremely well, and prefer it to traditional in-patient hospitalization. Even if you do not have your joint replacement performed as an outpatient, you will still benefit from the newest pain-relief techniques and medications, with the goals being short and long-term pain relief, minimal side effects, and limited potential for dependence on long-term narcotic therapy.


Please ask Dr. Goldhagen if you are a candidate for this type of joint replacement!




Some younger, active patients have severe arthritis affecting only one side of their joint (usually the inside, or medial side). When this pain doesn't respond to medication, therapy, rest, and injections, a partial knee replacement may be indicated. This is not a "temporary fix" until a total joint replacement is indicated, but rather a "permanent" solution to a specific problem. The Oxford Partial Knee Replacement has been shown to have excellent survivorship at 20 + years (meaning that it can last that long, without having to be changed to a total knee replacement). This surgery is also for a select subset of the population. Dr. Goldhagen has been certified for years.


Please ask Dr. Goldhagen if this is the surgery you need!