Knee replacement surgery is intended to relieve pain and immobility due to degenerative arthritic conditions such as osteoarthritis and rheumatoid arthritis. It may also be performed in cases of severe ligament tears or congenital joint malformations. Total knee replacement is a major operation requiring a three to seven day stay in the hospital and four to five months of physical therapy after the procedure. Patients considering the operation should ask their physicians about alternatives to total knee replacement before deciding on a plan.
Specialized Braces
According to the Joint Replacement Institute, specialized braces may be helpful in some cases of knee arthritis. These braces transfer weight from an area of the knee where the cartilage is worn to an area of the knee where the cartilage is stronger. The braces also help to keep the knee from slipping out of its correct anatomical position. For these braces to be successful, patients must have some area of the knee where cartilage is still present. Also, wearing the brace should cause less discomfort than the pain from the arthritis. Anyone considering a total knee replacement should ask his doctor if wearing a brace is an appropriate option.
Arthroscopy
According to Surgery.com, arthroscopy is the most common alternative to total knee replacement. Arthroscopy is a minor surgical procedure in which a surgeon inserts an arthroscope into the knee through a tiny incision and views the knee on a video screen. WIth arthroscopy, a surgeon can smooth and trim away worn cartilage and the lining of the knee. This causes a decrease in pain and inflammation at the joint. Arthroscopy is appropriate for patients with mild to moderate arthritis; effects of the procedure deteriorate over time, however.
Cartilage Transplantation
The Joint Replacement Institute reports that cartilage transplantation is another alternative to a total knee replacement. During a cartilage transplant, portions of knee bone with healthy cartilage are transplanted to portions of knee bone where cartilage has been damaged. Cartilage transplantation works best in patients whose cartilage damage is localized. Patients who suffer from conditions such as rheumatoid arthritis and osteoarthritis are usually not good candidates for this procedure because cartilage damage in those conditions is typically widespread throughout the joint.
Osteotomy
MayoClinic.com reports that a knee osteotomy may be an alternative to a total knee replacement if damage to the knee is in just one area of the joint. A knee osteotomy is a procedure in which a surgeon removes or adds a wedge of bone to the tibia or the femur. By adding or removing the piece of bone, the surgeon is able to shift body weight off of the damaged portion of the knee joint. Knee osteotomies are performed on patients younger than age of 55 who are considered too young to have a total knee replacement. The procedure requires a one to two day stay in the hospital and may take up to eight weeks for the bone to fully heal.
Knee Fusion
Knee fusion, or arthrodesis, may be performed in cases in which the risk of total knee replacement failure is high. According to the Joint Replacement Institute, arthrodesis is a procedure in which the ends of the femur and the tibia are cut flat and then secured together with pins, plates or screws. After a couple of months, the ends of the bones grow together. The leg is fused straight and can no longer bend. Patients who undergo knee fusion walk with a limp but are no longer in pain.
