Spare the Knee, Stop the Pain

Do you have knee pain? For many patients, knee pain does not have to equal total joint replacement. Sharp-affiliated orthopedic surgeon and knee specialist, Dr. V. Franklin Sechriest II, offers his patients several other joint-sparing surgical options. He uses the "4 Rs" to help patients understand all the available treatments.

"This is a simple concept I use to explain the wide variety of joint sparing surgical options for any knee problem," says Dr. Sechriest. "No matter how much medicine and technology advance, there remain four basic surgical tactics to treat a knee problem."

Remove: This type of procedure is the least invasive. Using a small camera (i.e., arthroscope) allows doctors to evaluate the cause of a patient's knee pain and to remove any damaged tissue. This technique also allows the surgeon to determine what further treatment a patient needs. Patients with knee pain related to a torn meniscus or cartilage injury may greatly benefit from the remove technique. Total recovery time ranges from two to six weeks after arthroscopic surgery.

Realign: Some patients experience knee pain because their joint is not properly aligned. Improper alignment may contribute to poor joint function and pain. In these cases, joint realignment may be the best treatment option. Physical examination and X-rays are used to diagnose the problem. To restore proper alignment, a surgeon may manipulate the bone, or they may release or tighten soft tissues.

"This surgical option may have a longer recovery time because it takes a while for the tissue to heal," says Dr. Sechriest. "Patients typically require aggressive and prolonged physical therapy after this type of procedure. However, the benefit may be great."

Realignment of the knee can decrease pain and prevent further damage to the joint.

Repair: Some patients with knee pain may benefit from repair of diseased or damaged cartilage. Cartilage transplant can improve and/or restore normal joint function. With this procedure, cartilage defects are repaired using tissue borrowed from other areas of the patient's own knee, or from a donor. Dr. Sechriest emphasizes that cartilage repair may be ideal for younger patients who aren't yet ready for total knee replacement. The recovery time varies based on what area of the knee that you are having repaired.

Resurface: The resurface option refers to partial knee replacement surgery. The knee has three parts: femur, patella and tibia. In a total knee replacement, all three parts are replaced and knee ligament(s) are removed. With a partial knee replacement, only one or two of the parts are resurfaced and ligaments are spared.

Dr. Sechriest explains, "Compared to total knee replacement, partial resurfacing of the knee typically means less surgery, less risk, less pain, a shorter recovery time, and a more natural feeling knee."

Patients are able to use their newly resurfaced knee right after surgery.

According to Dr. Sechriest, this procedure can have excellent clinical results and durability. The ideal patient for the resurface option is an active younger person with arthritis who isn't yet ready for a total knee replacement, or an elderly patient who may not be able to tolerate the major stress of a total knee replacement.

When patients are considering knee surgery, it is important to remember that there are few absolute rules to dictate which of the 4 Rs might be best. For this reason, Dr. Sechriest works with each patient to diagnose their knee problem, learn about their lifestyle and to understand their expectations before recommending a surgery.

"Some patients may benefit from one, two, or even three of the 4Rs. It's very individualized care — every patient deserves that," he says. "Patients are empowered, because they have options."

To learn more about joint sparing procedures, call 858-278-8300.