Knee Surgery Options

Arthroscopy
Arthroscopy is not helpful if you are suffering from severe arthritis. However, in patients with minimal arthritis, the meniscus within the knee joint can become damaged. The damaged tissue can lead to swelling and pain. You may think you have arthritis when you actually have a meniscus tear. In some cases, your surgeon may recommend a procedure called arthroscopy. Arthroscopy uses tiny instruments inserted into the joint through incisions that are about 1/8 inch long. Using tiny instruments, damaged tissue can be repaired or removed. This may provide relief from both pain and swelling while possibly slowing the development of arthritis.

Total Knee Replacement (Resurfacing Damaged Cartilage)
Your orthopedic surgeon may recommend total joint replacement if you have significant arthritis, and when non-operative treatments do not adequately relieve pain and restore joint function. The term “replacement” implies that a surgeon removes the entire joint during surgery, when in fact, a surgeon actually resurfaces the damaged cartilage found at the ends of the bones in your joint. Think of it as “cartilage resurfacing surgery.”

Knee replacement implants, typically made from a metal alloy and polyethylene (plastic) are used to resurface the joint. Total knee replacement resurfaces the end of the femur (thighbone), the top of the tibia (shinbone) and sometimes the back of the patella (kneecap). The implants are designed to restore function and eliminate as much discomfort as possible while allowing the patient to return to a more active lifestyle. Newer, less invasive surgical procedures allow rehabilitation and walking to begin the day of or day after surgery. Knee replacement patients usually stay in the hospital for two to three days. Therapy that begins in the hospital will normally continue after discharge for at least two to six weeks.

Total knee joint replacement has been extremely successful in helping patients with arthritis return to their normal activities while also relieving their discomfort.

Unicompartmental Knee Replacement
The knee is composed of three separate compartments. The term “uni” means one. Osteoarthritis sometimes develops in only one compartment of the knee, while the other two compartments are undamaged. Patients who have osteoarthritis in only one compartment may be candidates for a unicompartmental knee replacement.

The advantage of a unicompartmental knee is that the resurfacing occurs only with the damaged portion of the knee, preserving the undamaged cartilage. With this procedure, you may have a smaller incision, a quicker recovery and less bone removal. Many patients are not good candidates for unicompartmental surgery. Your surgeon will determine if a unicompartmental knee replacement is appropriate for you.

Cartilage Saving Operations
There are some operations that are designed to save the cartilage. They are usually only successful when arthritis is localized to a small area and in younger patients.

Microfracture Arthroplasty
Using an arthroscope, small holes are drilled into the exposed bone in an attempt to encourage the cartilage to grow. This has met with some success when the area is not large. The cartilage that grows will not be as strong as the original cartilage. Six weeks of crutches with minimal weight on your leg may be required.

Cartilage Transplantation
Cartilage can be transplanted from your own cartilage or from a donor to an exposed area of bone. Prolonged non-weight bearing may be required while healing occurs. This procedure is reserved for younger patients with small defects and is not recommended for people with significant arthritis.

Growing Cartilage
Cartilage cells can be harvested during an arthroscopic procedure and then grown in a lab for later transplantation. These cells are then implanted. Prolonged non-weight bearing may be required while healing occurs. This procedure is reserved for younger patients with small defects and is not recommended for people with significant arthritis.

Osteotomy
A bowlegged or knock-kneed deformity can cause increased pressure on one side of the knee. Osteotomy is a technique that attempts to change the angle of the shinbone by either removing or adding a small wedge of bone. The procedure attempts to restore a more natural alignment to the leg, relieving pain and restoring function. It does require a long period of healing and may not effectively relieve all the discomfort. It is used primarily in young, active people who may not be ideal candidates for joint replacement surgery.

Patient Education information provided by Biomet, Inc. - Advanced Science for Real Living™