“I’m Not Ready for Knee Replacement”
Osteoarthritis, the most common form of arthritis, is one of the most common causes of knee pain. A healthy knee has cartilage and lubricating joint fluid, called synovial fluid, to protect and cushion the bones, allowing the knee to bend and move. In knees with Osteoarthritis, the cartilage protecting the ends of the bones gradually deteriorates, and the joint fluid loses its shock-absorbing qualities. Bones may to rub against each other, causing pain, stiffness, and loss of movement in the joint.
Many patients who have knee osteoarthritis and have tried diet, exercise and over-the-counter-pain medication, but still have issues, may think surgery is the next step. If you feel you’re not ready for knee replacement, there are numerous, less invasive options to consider.
Traditional total knee replacement involves a 7-8 inch incision over the knee, a hospital stay of 3-5 days, and a recovery period lasting 1-3 months, during which the patient walks with a walker or cane. These minimally invasive procedures offer reduced pain, improved motion, and lower recovery time.
Viscosupplementation is an injection into the knee joint with a gel-like substance call hyaluronic acid, one of the naturally occurring lubricants in a healthy knee. Synvisc-One™ is made from a natural substance that lubricates and cushions to relieve pain and improve the knee joint’s natural shock absorbing abilities.
Gel injection is a simple outpatient procedure that takes only a few minutes and can provide up to six months of osteoarthritis knee pain relief with just one injection. Because injections are made directly into the knee, there are none of the serious side effects found with many pain and NSAID medications.
Osteoarthritis often causes more damage to the cartilage on one side of the knee than the other. This asymmetry causes the leg bones to become misaligned, which can put even more stress on the already damaged joint. Tibial Osteotomy is a surgical procedure that cuts away bone to shift a person’s body weight from the damaged area of the knee toward the healthy side. The procedure allows many patients to delay total knee replacement surgery for up to 10 years.
Cartilage Regeneration Procedures
Microfracture is a common surgical procedure recommended for some patients with damage to knee joint cartilage, and on the underside of the kneecap. The goal of microfracture is to stimulate new cartilage growth, prevent or slow further damage to the cartilage, and reduce symptoms of osteoarthritis. The surface layer of bone is hard and lacks good blood flow. Penetrating this hard layer by creating small holes in the bone allows the deeper, more vascular bone to access the surface layer. This deeper bone has more blood supply, making the cells better able to get to the surface layer and stimulate cartilage growth.
OsteoArticular Transfer System, also known as OATS, is a surgical procedure that replaces damaged cartilage in the knee with healthy cartilage from another area of the joint. OATS is ideal for patients with small areas of cartilage damage than can be easily repaired with a graft.
Carticel™ is a biologic product used to repair articular cartilage injuries in the knees of adults who have not responded to prior arthroscopic or other repair procedures. The treatment uses the patient’s own cultured cells to form new hyaline-like cartilage in the knee following a surgical procedure called ACI. Carticel™ is the name of the cells grown from the samples (or biopsy) taken from the knee. When implanted into a knee cartilage injury, the cells form new hyaline-like cartilage with properties similar to normal cartilage.
BioCartilage™ is a biologic product consisting of allograft micronized cartilage also used to repair articular cartilage defects in the knee. It serves as a scaffold over a microfractured defect providing a tissue network that can potentially stimulate cartilage regrowth and improve the degree and quality of tissue healing within a the damaged knee.
Partial Knee Replacement
Unicompartmental Knee Arthroplasty (UKA), also known as partial knee replacement, is ideal for patients with osteoarthritis that is localized to just one part of the knee. Minimally invasive UKA is a surgical procedure that allows a partial knee replacement to be inserted through an incision about 3 inches in length, with minimal damage to the muscles and tendons around the knee. Only the side of the knee that is having problems is replaced. The small incision and minimally invasive nature of UKA allows surgeons to perform the procedure on an outpatient basis.
Only your surgeon can help you decide what treatment is best for your knee osteoarthritis or other condition. Talk to orthopaedic surgeons Dr. Lex Kenerly and Dr. Matt Valosen and the staff at the Bone & Joint Institute of South Georgia about the best treatment for your condition.