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Joint Preservation for Osteoarthritis

Joint Preservation for Osteoarthritis Overview

Osteoarthritis Knee Treatment

Millions of Americans will experience knee osteoarthritis in their lives, a condition that causes pain, swelling and stiffness. Osteoarthritis is a degenerative condition of the joint caused by the deterioration of the articular cartilage, as well as changes in the surrounding soft tissue and subchondral bone. For patients needing an osteoarthritis knee treatment to alleviate pain, a joint preservation for osteoarthritis procedure may be recommended to delay total knee replacement surgery. Dr. Brian Waterman offers various knee replacement alternatives for patients who are not an ideal candidate for total knee replacement or for patients with advanced osteoarthritis.

Knee replacement alternatives specifically designed as an osteoarthritis knee treatment have been performed in recent years in patients who have bone spurs decreasing the knee’s range of motion and localized areas of damage, as well as patients who are not yet indicated for a total knee replacement because of younger age, activity level or degree of arthritis. Typically these procedures are not indicated for older patients (over age 60) or those with more advanced bone on bone degeneration.

The most common knee replacement alternative performed by Dr. Waterman is an arthroscopic approach designed to remove all damaged areas of the joint causing pain and stiffness. This procedure typically requires Dr.Waterman to remove bone spurs, release scar tissue and/or contractures and improve a patient’s range of motion in the knee joint.

Additional osteoarthritis knee treatment techniques are performed by Dr.Waterman and are more specific. Patients must have a thorough physical examination, a series of X-rays and an MRI scan performed to determine if they are a candidate for Microfracture or an OATs procedure. Microfracture involves small holes being made in the defective area’s bony surface to allow the flow of marrow and stem cells. The marrow and stem cells form a clot over the defective area and a covering of fibrocartilage eventually develops. An OATs procedure, either an osteochondral autograft transfer or an osteonchondral allograft transplantation, involves small plugs of healthy cartilage and bones to be transferred to a patient’s damaged area of the knee. The plugs can be harvested from the patient (autograft) or from a donor (allograft). In other cases, an osteotomy may be considered. In osteotomy is used to change the shape (alignment) of the joint to transfer weight from a damaged area of the joint to a more normal area of a joint to reduce pain and symptoms while still allowing for higher levels of activity.

Recovery and Rehabilitation after Joint Preservation for Osteoarthritis

Knee replacement alternatives are highly successful when patients are appropriately selected for the procedure and if patients follow the physical therapy and rehabilitation program prescribed by Dr. Waterman and his team. The physical therapy program will focus on the knee’s range of motion, reactivation of the quadriceps muscle and decreasing post-operative swelling. Dr.Waterman may not recommend an osteoarthritis knee treatment designed for joint preservation if a patient feels they cannot follow the aggressive rehabilitation program.

At a Glance

Dr. Brian Waterman, MD

  • Chief & Fellowship Director, Sports Medicine, Wake Forest
  • Team Physician, Wake Forest University, Chicago White Sox
  • Military affiliation/Decorated military officer and surgeon
  • Learn more

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