Description:
Kevin R. Stone, M.D., talks about the benefits of Biologic Knee Reconstruction
and Replacement experienced by patients at The Stone Clinic. 5.0
minutes/5MB |
|
The topic today is biologic knee reconstruction and replacement. Most
people have heard of artificial knee replacement, which is when the knee
is arthritic, which means the articular cartilage surfaces have worn down
to bone and bone spurs are present, the joint space is narrow, and a person
complains of pain, limited ability to walk, usually loss of range of motion.
These afflictions of the knee, when they become bad enough, limit people’s
enjoyment in life and ability to do activities.
Artificial knee replacement
has been a pretty successful method of treating older people who have lost
their joint cartilage. Artificial knee replacement with the new designs
that permit plateau rotation, excellent motion, and return to sports have
a number of great features to them; however, they are also limited in their
life span in that the survival of the artificial joint is usually at about
90% in 15 – 20 years. Many of our patients are young and in their
40s, 50s, and 60s, and have 40 or 50 more years of playing sports and being
active to go. If they underwent an artificial joint replacement they might
have to undergo more than one in their later life and we know that the
first joint replacement tends to be the best and therefore we like to do
everything possible to rebuild the knee joint with biologic tissues rather
than artificial tissues to help delay the time in which artificial joint
replacement is necessary.
Rebuilding the joint with biologic tissues means
replacing the knee joints meniscus cartilage, the fibrous tissue in the
joint that provides shock absorption and stability, re-growing the joint
articular cartilage, the white shiny surface that covers the ends of the
bone, sometimes re-building the ligaments of the joint and sometimes realigning
the joint to depending on the findings. By restoring the meniscus shock
absorber, and smoothing and re-growing the arthritic articular cartilage,
many people can gain significant pain relief and improved function and
delay the time in which joint replacement is necessary for decades. Additionally,
when we replace the joint with biologic tissues we permit our patients
to go back to full sports since there is no artificial material to wear
out. This ability to return to running or impact sports without concern
for damaging the artificial material has permitted many of our patients
to return to a very active lifestyle. Additionally, biologic knee joint
reconstruction and replacement can be done as an outpatient arthroscopic
procedure, therefore limiting the risk to the patient, time in the hospital,
the cost, and the time for recovery.
Many patients ask us if they are too
old or too arthritic, if their joint space is too narrow, or if their legs
are too bowed to undergo biologic joint reconstruction. Often they have
been told they couldn’t have those procedures because of the degree
of arthritis. We have found, however, that people with fairly significant
or severe arthritis can benefit from cleaning up the joint and replacing
the meniscus shock absorber and smoothing down the arthritic surfaces despite
what the x-ray looks like, thus we have been encouraged by people whose
joints looked fairly arthritic and their response to biologic joint replacement
has been quite gratifying, delaying the time in which joint arthroplasty
has been required.
We have published our data on the results on the components
of biologic knee joint reconstruction in the Journal
of Arthroscopy under
the terms “Meniscus Transplantation for the Arthritic Knee and Articular
Cartilage Paste Grafting for the Arthritic Knee,” with long-term
follow-ups over 12 years. We now have experience with patients going out
more than 15 years with meniscus or articular cartilage replacement. These
patients have found return to sports and return to activities to be a very
gratifying component of biologic knee joint reconstruction.
The Stone Clinic in San Francisco concentrates on returning injured people
to their active lives, fitter, faster, and stronger than they were before.
The Stone Clinic includes Dr. Kevin Stone, physician and surgeon, a staff
of physical therapists, and an x-ray and MRI facility. Our specialties
include the treatment of joint injuries and arthritis with leading edge
surgical and rehabilitation techniques. Elite athletes and everyday people
alike come to The Stone Clinic from around the world for the best in orthopaedic
care. The Stone Clinic is located at 3727 Buchanan St., San Francisco,
CA 94123. For more information, please call us at (415) 563-3110 or visit
us at www.stoneclinic.com.
|
