Alternatives to Knee Replacement
After an orthopedic doctor examines the conditions following an injured and/or decay knee, he might recommend a knee replacement as the best solution. However, there are other options that you, as a patient, should at least know before you make a final decision. These are:
A surgical telescope (arthroscopic) is placed through these portals into the underlying joint and through additional portals specifically designed instruments can be inserted to perform the procedure. The joint is distended with a saline solution usually through a pump to allow clear unobstructed viewing of the joint.
A fiber optic cable connects a small camera on the arthroscope to the viewing monitor and the surgeon manipulates the instruments while viewing the monitor. This is usually done at an ambulatory surgery center as an outpatient under general or local anesthesia. Regional nerve blocks can
accompany anesthesia to further control postoperative pain.
The most common reason for using arthroscopic surgery in the knee is a torn meniscus (cartilages) in the knee, one medially (inner side) and one laterally (outer side). The meniscus is a very important structure transmitting 50% of the joint load medially and 70% laterally. It iscomprised of fibrocartilage and has a very poor blood supply, its nutrition being received from the joint fluid. Because of this poor blood supply, tears of the meniscus rarely heal on their own and almost always require surgical treatments. The meniscus can tear from a variety of reasons. In the first few decades of life this usually
requires a significant trauma to the knee (i.e., sports injury).
Knee osteotomy is a surgical procedure that may be recommended if you have arthritis damage in just one area of your knee. In knee osteotomy, a surgeon removes or adds a wedge of bone to your upper shinbone (tibia) or lower thighbone (femur). This helps shift your body weight off the damaged portion of your knee joint.
Knee osteotomy is most commonly performed on people who may be considered too young for a total knee replacement. Total knee replacements wear out much more quickly in people under the age of 55 than in people over the age of 70.
Many people who undergo knee osteotomy will eventually need a total knee replacement — usually about 10 to 15 years after the knee osteotomy.
- Specialized Braces
Braces are support systems created to transfer weight load from worn cartilage to a less affected area. Rehabilitative braces assist medial to lateral movements. It also limits extension or flexion of the knee. On the other hand, arthritic braces were created to assist people who suffer from knee arthritis. They help reduce pain and promote stability of the joint. These are the ones that should be used to prevent a surgery.
- Knee Fusion
Also known as Arthrodesis, knee fusion is considered when chances of success in total knee replacement are slim. The operation involves cutting the tibia and femur bones then fusing them together with screws, pins and plates. However, the knee is fused in a straight manner so the patient will not be able to bend the knee and therefore develop a minor limp.
- Cartilage Transplant
Cartilage transplants are done best for knees that are still healthy with the cartilage being the only affected part. Your orthopedic surgeon will transplant a healthy cartilage from a part that does not carry much weight onto a damaged part of the knee. Unfortunately, cartilage transplants are not a good option for rheumatoid arthritis and osteoarthritis which tend to degenerate the articular cartilage.
Like we said at the beginning, these alternatives to knee replacement surgery should only be consider and discuss with your doctor before you take a final action. Please let us know if we can assist you with any questions you may have.
Surgeon’s Advice | Leon Mead MD Orthopedic Doctor | 730 Goodlette Road North, Suite 201 Naples Florida 34102 | Phone: (239) 262-1119