Advanced Knee Arthritis: You may not need a Total Knee Replacement!
Post by Dr. Jonathan R. Mallen
Osteoarthritis of the knee is one of the most common musculoskeletal issues affecting the adult population. Close to 30 million people are affected by osteoarthritis, and the knee is one of the most common joints involved. There are many advances in treatment for osteoarthritis of the knee, both conservative and surgical, if necessary. Conservative treatment is always the first option and preferred course for patients with osteoarthritis. Exercise programs, therapy programs, weight loss, and lifestyle changes are frequently helpful. There are also topical medicated creams and rubs that help to relieve symptoms. Sometimes nutritional supplements, over the counter and prescription medications can also be used, but these need to be used with care to avoid potential side effects and interactions with other medications. There are different types of injections that are also helpful – cortisone injections as well as lubricating injection.
Despite these treatment options, unfortunately, osteoarthritis may still progress and get worse over time. When conservative treatment options are no longer effective and providing meaningful relief of symptoms, knee replacement surgery may be an option. Knee replacements come in different shapes and sizes, and can be tailored to a patient’s individual anatomy and degree of arthritis, instead of a “one size fits all” approach.
A very attractive option for some patients may be a partial knee replacement instead of a total knee replacement. For a patient who has arthritis that is limited to only part of the knee – the inner aspect or the area under the kneecap are examples – partial knee replacement is a less invasive approach that serves to resurface only the involved areas. Instead of removing and replacing bone across the full surface of the femur (thigh bone) and tibia (shin bone), a much smaller amount of bone is removed. This can be done through a much smaller incision, with less blood loss, and typically less pain and a quicker recovery. A partial knee replacement also preserves the knee’s internal ligaments whereas a total knee replacement will remove ligaments from inside the knee – this may result in a more natural “feel” and movement to the knee. No knee replacement lasts forever, and studies show partial knee replacements can last 10-15 years. Because more bone is preserved, conversion of a partial knee replacement to a total knee replacement is a much less invasive procedure and technically easier than a revision or “redo” total knee replacement. Most patients are able to return to a very high level of activity after partial knee replacement, including playing recreational sports such as tennis, golf, swimming, cycling, and hiking.
Is a partial knee replacement an option for you? To make this determination requires a proper evaluation, review of medical history and diagnostic tests such as x-rays/MRI. Schedule an appointment to explore your options and to find out what may be a good choice for you to maintain an active healthy lifestyle!