If you find yourself dealing with frequent or chronic knee pain caused from an improperly healed meniscal tear, osteoarthritis, or other condition, you may be wondering whether a partial or total knee replacement is the right option for you. However, many orthopedic surgeons are reluctant to perform this operation on younger patients, as these artificial joints will need to be periodically replaced. If you're under age 50 and aren't sure your knee will be able to make it to age 60 (the age at which most surgeons are willing to perform a knee replacement), do you have any other options? Read on for some treatments that may be able to extend the amount of time you have until a need for knee replacement surgery.
Meniscal or cartilage transplant
If the source of your knee pain is a damaged meniscus, or if your meniscus was partially or completely removed after being damaged during your younger years, you may benefit from a meniscal transplant. On the other hand, if the cartilage in your knee is degraded from osteoarthritis or another injury, you may be able to regain your range of motion and ease your knee pain by undergoing a cartilage transplant.
Both these transplants make use of cadaver bone and tissue, so can help avoid the risk of periodic replacements inherent with most types of artificial knee joints. And because there is relatively little bone marrow or other living tissue in the transplanted material, you won't need to take immunosuppressant anti-rejection drugs.
When you undergo a meniscus transplant, the orthopedic surgeon will make several small incisions around your knee to remove your current meniscus and take out a small slice of bone from your femur. The cadaver meniscus will then be inserted into an incision in the back of your knee. This cadaver meniscus is still attached to a small piece of bone, and the cadaver bone will be placed in the groove created by the small slice of your femur that was removed. This "anchor" will help facilitate the healing and integration of the new meniscus.
If you're having a cartilage transplant instead, the doctor will drill several small holes into your existing cartilage and implant cadaver cartilage into these spaces. Cadaver cartilage will also be used to "fill in" any areas of your knee where the current cartilage levels are too low. This process will help trigger cartilage growth, and although cartilage has very minimal blood flow, your body's own cartilage will eventually fuse with the cadaver cartilage to form a healthy cushion around your knee joint.
Another option for the treatment of chronic pain caused by osteoarthritis of the knee is a series of hyaluronan injections. This fluid is naturally present in your knee, and helps lubricate your knee's inner structures to facilitate movement -- much like engine oil helps lubricate your vehicle and prevent friction damage. These injections may be ideal for patients who have been afflicted with osteoarthritis at a relatively young age and have already tried other methods, like pain relievers and rest.
Although this hyaluronan will eventually be metabolized by your body and won't last forever, you should be able to get a few months of relief from a brief series of injections, without needing to resort to more extensive surgery. This can also be a way to minimize your knee pain while waiting to age enough to have a partial or total knee replacement performed. If you find that this treatment significantly improves your quality of life and range of knee movement, you may opt to have it performed every few months to maintain a pain-free lifestyle.