Knee Preservation
What are the Treatment Options of Knee Preservation?
Preserving knee function and delaying or avoiding total knee replacement surgery is a priority for patients with early-stage knee arthritis or specific structural abnormalities. Knee preservation techniques aim to address underlying pathology, restore joint mechanics, and alleviate pain while preserving the native joint. This page provides an overview of advanced knee preservation options, including High Tibial Osteotomy (HTO), Distal Femur Osteotomy (DFO), Cartilage Transplantation, and Meniscal Allograft Transplantation.
- Procedure: HTO involves surgically realigning the knee joint by cutting and repositioning the upper portion of the tibia (shinbone). This redistributes weight-bearing forces away from the damaged or arthritic part of the knee, reducing pain and delaying the need for joint replacement.
- Indications:
- Early to mid-stage unicompartmental knee osteoarthritis, typically affecting the medial compartment.
- Varus malalignment (bow-legged deformity) contributing to increased medial compartment loading.
- Advantages:
- Preserves native joint anatomy and function.
- Delays or avoids the need for total knee replacement in younger, active patients.
- Potential for cartilage preservation and regeneration in unloaded areas of the knee.
- Considerations:
- Requires careful patient selection and assessment of ligamentous stability.
- Longer recovery time compared to some other knee procedures.
- May not be suitable for patients with advanced arthritis or multi-compartmental involvement.
- Procedure: DFO involves realigning the knee joint by cutting and repositioning the lower portion of the femur (thighbone). This alters the weight-bearing axis of the knee, redistributing forces and relieving pressure on damaged or arthritic areas.
- Indications:
- Early to mid-stage knee arthritis with varus or valgus malalignment.
- Correction of patellofemoral instability or maltracking.
- Advantages:
- Corrects malalignment and restores joint biomechanics.
- Preserves native joint surfaces and articular cartilage.
- May delay or prevent the progression of knee arthritis.
- Considerations:
- Complex surgical technique requiring precise planning and execution.
- Prolonged recovery and rehabilitation compared to some other knee procedures.
- Risk of complications, including delayed healing or nonunion of the osteotomy site.
- Procedure: Cartilage transplantation involves the implantation of healthy cartilage tissue into areas of cartilage damage or defects within the knee joint. Techniques include autologous chondrocyte implantation (ACI), osteochondral autograft transfer (OATS), and matrix-induced autologous chondrocyte implantation (MACI).
- Indications:
- Focal cartilage defects or lesions in young, active patients.
- Preservation of native joint surfaces and delay of arthritis progression.
- Advantages:
- Restores articular surface integrity and function.
- Promotes cartilage regeneration and repair.
- Offers potential long-term pain relief and improved joint function.
- Considerations:
- Requires two-stage surgeries in some cases (e.g., ACI, MACI).
- Limited efficacy in patients with widespread or diffuse cartilage damage.
- Rehabilitation is crucial for optimal outcomes and cartilage integration.
- Procedure: Meniscal allograft transplantation involves the surgical implantation of a donor meniscus into a knee with deficient or absent meniscal tissue. This procedure aims to restore knee stability, distribute load, and prevent cartilage degeneration.
- Indications:
- Symptomatic meniscal deficiency following meniscectomy or trauma.
- Preservation of knee function and prevention of osteoarthritis progression.
- Advantages:
- Restores meniscal function and biomechanics.
- Delays or prevents degenerative changes in the knee joint.
- Improves pain, stability, and function in appropriately selected patients.
- Considerations:
- Limited availability of suitable donor tissue.
- Surgical complexity and longer recovery compared to some other knee procedures.
- Rehabilitation is essential for optimizing outcomes and graft integration.
Why choose Dr. Christian Cruz?
Preserving knee function is essential for maintaining an active lifestyle. Dr. Christian Cruz specializes in knee preservation strategies, offering expert care in Alexandria, Arlington, and Lanham. Schedule an appointment to learn how we can help protect your knee health and mobility.
At a Glance
Dr. Christian Cruz
- Fellowship trained in Sports Medicine and Shoulder Surgery
- Expertise in complex knee and shoulder reconstruction
- Assistant Professor of Orthopaedic Surgery at Uniformed Services University School of Health Sciences
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