PARTIAL KNEE REPLACEMENT
Anyone who has arthritis of the knee knows how painful it can be. While medication can help, major surgery is often the only way to get complete relief. Now, there's another option.
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Last summer, a severe case of arthritis in his knee made it impossible for Ed Schultz to put on his shoes. A scan of his knee confirmed the problem.
Ed Schultz
Has arthritis
"There was no cartilage at all, no cushioning of any kind between the bones, and so when I'd walk, it was a mortar and pestle grinding away at each other."
Until recently, fixing the problem would have meant total knee replacement. Because only part of Ed's knee was affected, Doctor Michael Bronson recommended a far less invasive option - a partial knee replacement.
Michael Bronson, M.D.
Orthopedic Surgeon
Lenox Hill Hospital
New York, NY
"In a unicompartmental replacement, what we're doing is just resurfacing that area which is worn out."
A metal runner and small plastic disc replace the worn cartlidge, providing a new cushion between the bones.
The 45 minute procedure requires a much smaller incision than a total knee replacement, has less blood loss, and a faster recovery.
Michael Bronson, M.D.
"Whereas in total knee replacement, we talk about recovery being 3 to 6 months. In these operations, we're talking about weeks."
Even more encouraging is that the improvement lasts.
Michael Bronson, M.D.
"And the data that are just coming back after 10 years, shows that 95 percent of patients are still functioning as they did in the beginning, which is an excellent long-term prognosis."
Ed Schultz
"I really have, I believe, virtually full mobility with the knee."
If he's like the others, it will continue.
Doctor Bronson recommends partial knee surgery for anyone over 50, and if a total knee replacement is needed later, he says it's easier to do.
OSTEOARTHRITIS: Osteoarthritis is a progressive, degenerative process that results in the joint surface wearing out. The joint surface eventually erodes away, exposing the underlying bone. This loss can be painful with weight bearing. The normal knee is a complex joint made of three separate areas used together to walk and perform other daily activities. Knee osteoarthritis most commonly develops in one area while sparing the others.
Conventional surgery for arthritis in the knee is total knee replacement. An alternative is being performed for a large group of patients whose arthritis involves only a segment of the knee rather than the entire knee. This is called unicompartmental arthritis.
UNICONDYLAR KNEE REPLACEMENT: A new minimally invasive technique called unicondylar knee replacement is helping the 30 percent to 40 percent of patients with unicompartmental arthritis. The technique replaces only the affected segment of the knee. A metal runner and small plastic disc replace the worn cartilage, providing a new cushion between the bones. The procedure lasts 45 minutes. Though originally developed in the 1970s, the technique has been improved as a result of advances in materials and technique.
AFTER SURGERY: The procedure now involves smaller incisions, shorter operating time and faster recovery. Patients are usually able to walk the day of the procedure, can return home within 24 hours, and can resume pain-free functioning within weeks. Recovery from total knee replacement can take months. Michael Bronson, M.D., from Lenox Hill Hospital in New York, says, "I have seen excellent results and great patient satisfaction with this surgery. Around the country, 95 percent of the patients who have undergone this procedure are functioning well even after 10 years. In addition, this method preserves more normal bone relative to other methods. This allows patients to more easily undergo additional knee surgery in the future."
CANDIDATES FOR THE PROCEDURE: Dr. Bronson recommends the procedure for adults ages 50 and over. Symptoms of knee arthritis include:
pain standing or walking short distances
pain changing position such as sitting to standing
persistent knee swelling
knee locking or giving out
failure to respond to medical treatment
Knee X-rays can help establish if the procedure is needed. The X-ray must show complete loss of joint cartilage in one weight bearing area.
Michael Bronson, M.D.
Lenox Hill Hospital
(212) 734-2646
sagasports@aol.com
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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