|
|
 |
|
 |
Joint preserving surgery of the knee encompasses issues
related to ligament stability, cartilage surfaces, and limb
alignment. Ligament stability issues are best managed by surgeons
who specialize in sports medicine. Management of cartilage
loss in the knee can be addressed in a number of ways. These
include simple "microfracture" techniques where
areas of exposed bone in the joint are treated by making small
cracks in the exposed bone surface to encourge cartilage to
grow back onto the surface. Autogenous chondrocyte transplantation
is another method that attempts to restore cartilage surfaces.
This involves taking a sample of cartilage from the patient,
growing cartilage cells in the laboratory, and reimplanting
the cells into the knee. While this technique shows some promise,
most cartilage defects in the knee are not well suited to
this treatment. This technique is best applied to "pot-hole"
type defects rather than more diffuse patterns of cartlage
loss which are much more common. A third technique called
mosaicplasty can also used for cartilage defects. This method
involves taking plugs of normal cartilage with its underlying
bone from a less-stressed area of the knee and tranplanting
it into the worn area. Again, none of these techniques is
as ideal as we would like them to be in terms of reliability
and long-term results.
Many knees wear out on the inner side in association with
a bowing deformity of the leg. This is because bowing of the
leg results in excessive stresses being transferred to the
inner part of the knee. If identified before too much damage
had taken place, these knees can be treated by realigning
the limb to remove the bowing deformity. Realignment of a
limb is called osteotomy. There are many ways to do this.
Issues related to this are described in the published manuscripts
below:
|
|
 |
| |
|
