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OA and Knee Replacements

January 25, 2013

Prosthetics like the preservation implant protect more healthy bone.  Not all procedures are equally invasive, and surgeries like the MAKOplasty may improve function and accelerate recovery.

The most severe cases of knee osteoarthritis are treated with a total knee replacement.  This highly invasive surgery involves removing large portions of bone in order to attach metallic prosthetic substitutes.  The surgery is highly traumatic and requires a lengthy recovery.  This makes a total knee replacement a difficult option for older or infirm patients because slow healing may make full recovery difficult or impossible.  Total knee replacements are also problematic for very young and very healthy people because the implants typically last only 5-10 years.  When the original prosthetic implant is replaced, even more bone must be removed to anchor the new, larger implant.  This means that a 50 year old man with severe knee osteoarthritis who has a total knee replacement can expect more highly traumatic surgeries every 5-10 years for the rest of his life.   As he ages and his healing slows down, the recoveries for each surgery will be longer as well.

Fortunately, a total knee replacement is not the only surgical option, even for the most severe patients.  Osteoarthritis affecting only one side of the knee has been effectively treated with partial knee replacements for many years.  Robotic technology has vast surgical applications, and has recently been employed in a new procedure called a MAKOplasty.  The MAKOplasty uses robotic arms to trim away only the damaged bone, and to create and implant a unique prosthetic that complements the healthy tissue.  This means that healthy, well vascularized bone is not removed, and so there is much less trauma and a faster recovery.

This procedure may not be appropriate for everyone but the MAKOplasty and other partial replacements could be a more conservative surgical treatment.  If your doctor recommends joint replacement surgery, ask about your options.  You may not need a total joint replacement to get the best results.

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