C. Michael Kelly, M.D., orthopaedic surgeon with the Alegent Health Orthopaedic Institute.
Find out more about Dr. Kelly
Q: Whole joint replacement for persons with osteoarthritis seems to be a rather radical procedure to treat the absence of cartilage. Is there research being done on "cartilage replacement"? Are there any alternative treatments to whole joint replacement for osteoarthritis? Thank you.
A: Cartilage replacement, or Autologous Chondrocyte Implantation (ACI) allows surgeons to replace cartilage that's been damaged by trauma with the patient's own cartilage cells. This procedure, Carticel, (TM) was developed by a division of the Genzyme Corporation. However, the procedure is not useful for widespread cartilage damage or for the treatment of osteoarthritis.
Read uni-knee article by Dr. Kelly
For many surgical procedures, studies
have shown better outcomes where the procedures are performed more
frequently. Dr. Kelly has performed thousands of joint replacements, which
include hundreds of knee surgeries. More than half of those are
partial knee replacements, or "uni-knee" with a mini incision
which leads to quicker recovery and rehabilitation. Learn more
from Dr. Kelly at a free seminar.
Visit our events calendar and search on keyword "Kelly." |
For end-stage arthritis of the knee joint, patients have traditionally undergone total knee replacement. In this procedure, all cartilage is removed from the knee joint, and a metal and plastic implant is substituted.However, an alternative for whole joint replacement is partial knee replacement, or unicondylar implant, also called unicompartmental knee arthroplasty or uni-knee. The partial knee replacement procedure has generated interest because it entails a smaller incision and faster recovery than traditional total joint replacement surgery. Also called unicompartmental knee replacement, this minimally invasive knee surgery removes only the most damaged areas of cartilage, and replaces these surfaces. Individuals who can benefit from partial knee replacement surgery are: Persons 50 and older who show one or more of the following symptoms may benefit from this procedure:
- Pain while standing
- Pain while walking
- Pain changing position, such as sitting to standing
- Persistent knee swelling
- Giving out or locking of the knee.
- Failure of the knee to respond to medical treatment
Knee X-rays can indicate if the uni procedure may be appropriate. The X-ray must show complete loss of the joint cartilage in one of the two weight-bearing compartments in the knee. See an uni-knee animation here.
