Joint Preserving Surgery
In early cases of osteoarthritis, we usually try to preserve the joint. These procedures are largely termed ‘joint preserving surgery’, as we try to avoid replacing the knee with an artificial joint. Mild cases may be amenable to cartilage repair. The most commonly done procedure is microfracture, where small holes are drilled into the bone to stimulate healing of the cartilage. This procedure is often augmented with the addition of collagen, hyaluronic acid or bone marrow aspirate concentrate (BMAC) over the repair site, to improve the success rates.
Where possible, a torn and non-functioning meniscus (shock absorber) is repaired.
Underlying bony malalignment may be necessary to protect the knee from further wear and tear.
In some painful joints which aren’t repairable, subchondroplasty may help to reduce the bone pain of osteoarthritis and hence improve the knee function.
Subchondroplasty involves injecting a bone substitute into the painful, damaged parts of the bone around an arthritic joint. With improvements in pain, this procedure can help some patients avoid a total knee replacement.
Partial (unicompartmental) knee replacement
A partial knee replacement may help if only one compartment of the knee is worn out. This is a smaller operation than a total knee replacement and has a faster recovery time.
Total knee replacement
In severe osteoarthritis, a total knee replacement will remove all the damaged bone and cartilage in the joint and replace it with an artificial joint that is made out of metal and plastic.