There is a lot of information floating around out there about knee surgery and chronic knee pain. It can be hard to know what your symptoms are saying about whether you have arthritis or an injury, which can make it even harder to know what types of treatments are right for you at any given time. Below, our clinical adivsor in orthopedics and sports medicine, Dr. Sugalski answers some of our patients most common questions.
The timing of a knee replacement is based on a patient’s symptoms, not their x-ray. When the symptoms have progressed to where they are significantly
inhibiting their activities of daily living then it is time to consider a knee replacement. Typically if someone has pain that wakes them up at night, they
can not go up and down stairs, and have difficulty walking more than one block or around a grocery store, I recommend surgery. We try to delay surgery until someone has reached the age of 60, because data has shown that individuals who undergo knee replacement surgery under the age of 60 are more likely to require the replacement to be revised later on.
Select patients with arthritis limited to one side of the knee can achieve results with a partial knee replacement equal to that of a total knee
replacement. However, it is generally believed that partial knee replacments do not last as long as total knee replacements. There are at least two reasons for this. First, partial knee replacements can wear out or become loose sooner than total knee replacements. Second, patients, who’ve had a partial knee replacement, can develop arthritis on the side of the knee that was not replaced, requiring the partial knee replacement to be revised to a total knee replacement.
Microfracture is a surgical technique that stimulates regrowth of cartilage in joints by making small holes in the bone. The small holes allow the blood from the bone marrow to reach the injured joint surface and regrow cartilage. The new cartilage (fibrocartilage) is not as good as the original cartilage (hyaline cartilage), but it can certainly be a big improvement. This technique generally does not work in patients with arthritis, patients with large amounts of cartilage loss, or cartilage loss on both the femur and the tibia (kissing lesions). Microfracture works best in younger patients with small isolated cartilage injuries.