Knee joint preservation – Why and How?

 

What is Knee Joint Preservation?

Knee joint preservation is all about keeping the knee working well without needing a replacement. This involves different ways to care for the knee joint, helping doctors fix knee problems while keeping the knee’s natural parts. It is mainly used for people with damage to the knee’s cartilage.

Cartilage injury can lead to arthritis and often causes knee pain. The severity of knee problems can be different for each person. Injuries or normal aging can damage the cartilage, causing pain, stiffness, and trouble moving. Since cartilage doesn’t heal on its own, doctors often need to repair it surgically. Fixing the cartilage can reduce pain, improve how the knee works, and sometimes prevent arthritis from developing.

Knee joint preservation vs. replacement

Knee Joint Preservation: Indications for Knee Joint Preservation

– Damage to articular cartilage

– Early stages of arthritis

– Traumatic injuries with repairable cartilage

– Pain, stiffness, or limited motion with intact joint structure

– Desire to maintain natural knee structure

– Younger patients with active lifestyles

– Good overall joint stability and alignment

Knee Joint Replacement: Indications for Knee Replacement

– Severe arthritis

– Extensive damage to knee joint

– Persistent pain that doesn’t respond to other treatments

– Significant loss of function and mobility

– Failure of previous knee surgeries

– Advanced age with deteriorated joint

– Chronic knee problems affecting quality of life

Techniques of Knee Joint Preservation

Physical Therapy: Exercises and therapies to strengthen the muscles around the knee, improve flexibility, and reduce pain.

Weight Management: Maintaining a healthy weight to reduce stress on the knee joints.

Low-Impact Exercises: Activities like swimming, cycling, and walking that keep the knee active without putting too much strain on it.

Orthotic Devices: Using knee braces or orthotic inserts to support the knee and improve alignment.

Medications: Anti-inflammatory drugs or pain relievers to manage symptoms and reduce inflammation.

Injections: Corticosteroid or hyaluronic acid injections to reduce inflammation and provide lubrication.

Arthroscopic Surgery: Minimally invasive surgery to clean out or repair damaged cartilage and remove loose fragments.

Cartilage Restoration Techniques: Procedures like microfracture, autologous chondrocyte implantation (ACI), or osteochondral autograft transfer system (OATS) to stimulate cartilage growth.

Platelet-Rich Plasma (PRP) Therapy: Injection of concentrated platelets from the patient’s own blood to promote healing and reduce pain.

Stem Cell Therapy: Using stem cells to regenerate damaged cartilage and improve knee function.

Realignment Surgery (Osteotomy): Surgery to correct knee alignment and shift weight away from the damaged part of the knee.

Surgical Procedures for Knee Joint Preservation

Arthroscopic Debridement: Minimally invasive surgery to remove damaged tissue, smooth rough surfaces, and clean out debris from inside the knee joint.

Microfracture: A procedure where small holes are made in the bone beneath the damaged cartilage to stimulate the growth of new cartilage.

Autologous Chondrocyte Implantation (ACI): Transplanting healthy cartilage cells from the patient’s own body to repair damaged areas of cartilage.

Osteochondral Autograft Transfer System (OATS): Transferring healthy cartilage and bone plugs from a non-weight-bearing area to replace damaged cartilage in the knee.

Osteochondral Allograft Transplantation: Transplanting cartilage and bone tissue from a donor to replace damaged areas in the knee joint.

High Tibial Osteotomy (HTO): A surgical procedure to realign the bones of the knee joint to shift weight away from damaged areas of the joint.

Meniscal Repair or Transplantation: Repairing torn meniscus tissue or replacing damaged meniscus with donor tissue to improve knee function.

Postoperative Rehabilitation After Knee Joint Preservation

After having knee joint preservation surgery, it’s important to follow a structured program to help you recover well and get your knee working again. Here’s what the recovery process usually looks like:

Phase 1: Right After Surgery (0–2 weeks)

• Managing Pain: Using medicine and ice packs to help with pain and swelling.
• Staying Safe: Using crutches or a walker to keep weight off the operated knee.
• Moving Gently: Doing easy exercises to keep the knee moving and prevent stiffness.
• Taking Care of the Wound: Keeping the cut from surgery clean and dry to avoid infections.

Phase 2: Early Recovery (2–6 weeks)

• Getting Stronger: Gradually putting more weight on the knee as it feels better.
• Building Muscle: Starting light exercises to make the muscles around the knee stronger.
• Balancing Act: Doing exercises to improve balance and know where your knee is in space.
• Keeping Flexible: Doing more stretches to make the knee more flexible.

Phase 3: Midway Through Recovery (6–12 weeks)

• Getting Even Stronger: Doing harder exercises to make the knee muscles even stronger.
• Practicing Real-Life Moves: Doing exercises that help with everyday things like walking and climbing stairs.
• Working Out the Heart: Starting exercises like biking or swimming to help your heart stay healthy.
• Moving the Joint: Doing stretches and drills to make sure the knee moves well.

Phase 4: Almost Back to Normal (12 weeks and beyond)

• Getting Ready for Sports: Slowly starting to do sports activities again, with guidance.
• Jumping and Moving Fast: Doing exercises to help with jumping and quick movements.
• Following a Plan: Following a plan made by a therapist or doctor to get back into sports safely.
• Keeping It Up: Continuing to exercise regularly, strengthen muscles, and stretch to keep the knee healthy and prevent more injuries.

Is knee joint preservation surgery safe? Are there any risks?

Knee joint preservation surgery is usually safe, but like any surgery, it has risks. Here are some possible risks:

• Infection: Sometimes, the surgery site can get infected, needing antibiotics or more treatment.
• Bleeding: There might be too much bleeding during or after surgery, needing help to stop it.
• Blood Clots: Clots in the legs or lungs can happen after surgery, especially if someone has certain risks.
• Nerve or Blood Vessel Damage: Surgery could hurt nerves or blood vessels around the knee, causing numbness, tingling, or less blood flow.
• Stiffness: The knee might feel stiff or hard to move after surgery, needing more exercises to help.
• Pain: Even with surgery, some people might still have pain or feel uncomfortable in the knee.
• Allergic Reactions: Sometimes, people can have allergies to the anesthesia or medicine used during surgery, but it’s rare.
• Surgery Not Working: In some cases, the surgery might not fix the problem like it should, needing more treatment or different options.

Why Knee Joint Preservation is Important

Why should we care about keeping our knees healthy? Healthy knees can prevent problems like arthritis and injuries. Good knee health means we can move better and enjoy life more, even as we get older. Taking care of our knees now can save us from pain later.

How do you pick a place for knee joint preservation surgery?

Choosing the right place for knee joint preservation surgery is super important to make sure you get good care and a successful outcome. Here’s what to think about when choosing a place:

1. Specialization and Experience: Find a place that’s really good at orthopedic surgery, especially knee joint preservation. Look for experienced surgeons who know a lot about the specific surgery you need.

2. High-Tech Stuff: Pick a place with fancy technology and equipment for the surgery. This includes cool machines for imaging, tools for less invasive surgeries, and maybe even robots to help out.

3. Reputation and Success: Check out what other people say about the place. Look for reviews from patients and see how well their surgeries turned out.

4. Teamwork: Choose a place where lots of different experts work together. You want a team of doctors, therapists, nurses, and other pros who can all help you get better.

5. Rehab Help: Make sure the place has good rehab services to help you recover after surgery. This might include physical therapy or other programs to get you back on your feet.

6. Money Stuff: Check if the place takes your insurance and ask about how much the surgery will cost you. Think about if the care you’ll get is worth the cost.

7. Location: Think about where the place is and how easy it is for you to get there. You want a place that’s not too far from home and easy to reach for appointments and check-ups.