Joint Replacement Surgery what does it mean?

In an Arthritic joint, the joint surfaces are damaged which leads to friction & pain while movement. This friction & unevenness needs to be overcome to have a pain-free joint. In Joint replacement the natural lining of the joint is recapped /replaced with artificial lining which is made up of various materials Like Cobalt Chrome, Ultra High Molecular Weight Poly Ethylene (UHMWPE), Ceramic, Titanium etc depending upon the region (knee/hip, etc) & type of material used.

What is Joint Preservation surgery?

Joint preservation means preserving the damaged surface instead of replacing it. The most common way to achieve this is to offload the joint by changing the alignment of the leg such that a load of the body passes through the normal non-arthritic portion of the joint due to which the arthritic portion is no more in contact while the weight-bearing activities & becomes pain-free

How is the alignment of the leg changed?

Special X-rays called the scalogram are done where the entire leg x-ray is done from the hip to the ankle of both sides in one single film. Once this calibrated x-ray is done then various measurements are done digitally to check for the location of the maximum deformity (bowing) of the leg & accordingly it is corrected via an osteotomy

What is an Osteotomy?

Osteotomy is the procedure where we cut a bone to realign it in a direction such that the joint above or below it gets offloaded & mostly becomes parallel to the ground & normal joint mechanics are restored. Most commonly done osteotomy in adults is for early knee arthritis & is called a High Tibial Osteotomy (HTO)

What is HTO?

High tibial osteotomy is done in the Tibia (Leg Bone) to realign the bone as such the weight of the body passes through the normal side of the joint most commonly it is the outer side of the knee which is normal & inner side of the knee joint is damaged as shown in the x-ray above after the surgery inner worn out portion opens up

Which surgery should I undergo for my damage knee/knees?

This decision depends upon the age of the individual, extent of involvement of the knee, quality of bones, and overall health of the person. Though newer designs & materials in Knee replacement surgery have increased the lifespan of the implants, in younger individuals with single compartment arthritis HTO type joint preservation surgery gives a second chance to keep the native joint intact which can be replaced as the age progresses