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The human knee is a fragile joint that often has difficulty withstanding the rigors of athletic activity. If you engage in long-term high-impact sports, you may find yourself experiencing knee pain, loss of range of motion, and joint instability. While often a knee replacement will come eventually, you and your orthopedic surgeon, like Jon B. Greenfield MD, may have reasons to want to buy some time with alternative procedures first. Here are five common surgical ways to put off knee replacement.
Knee pain can come from multiple sources, and eradicating even one source can help put off more invasive surgery, like a knee replacement (also known as TKA, total knee arthroplasty). Debridement involves shaving down rough surfaces, like a shredded meniscus, the wedge-shaped cushion between the upper and lower leg bones at the knee joint. Sometimes the meniscus can become so worn, it looks like crab meat, instead of a smooth surface, and filing it down can prevent it catching on connective tissue in the knee.
Lavage is usually done in concert with other knee procedures. It's basically a fancy surgical term for rinsing out the knee. Sometimes bits of calcium form in the knee joint that can float around and cause pain, as well as impede movement. Removing calcified loose bodies with lavage can help restore range of motion and reduce inflammation.
Sometimes the kneecap, also known as the patella, doesn't track correctly and is pulled to the outside of the knee joint, causing uneven wear on the joint and pain. A lateral release can correct this.
In a lateral release procedure, the lateral retinaculum (the tissue to the outside of the knee) is cut slightly to allow it to give. This permits the patella to track more towards the center of the knee and alleviates excess wear and discomfort.
In some patients, the meniscus is so worn down it fails to provide the cushioning it should to the knee. The thigh bone (femur) and shin bone (tibia) rub on each other causing pain and a sort of grinding feel to the knee in motion.
In this case a chondral abrasion can be performed, in which tiny holes are drilled into the bones around the knee. The bones release fluids that fill in the meniscal cavity with a similar spongy substance to act as a substitute.
Hyaluronic Acid Injections
While all of the above procedures are performed as day surgery arthroscopically (with tiny incisions using a little scope to look inside the knee and make changes), hyaluronic acid injections can be done in the doctor's office with no downtime. Hyaluronic acid, or HA, is a natural lubricant found in many joints. When this lubrication is lacking in the knee, hyaluronic acid can sometimes be injected with a needle. This procedure can be repeated several times over the course of a year or two for relief from joint pain.
If your knee is so worn down that it is affecting your quality of life or athletic performance, a TKA is probably in the cards. However, if you are too young or can't take the time off work for this surgery, the alternatives above may buy you years before you have to go under the knife again.Share