‘Joint preserving knee surgery works well on young’

Doctors say that old age-related osteoarthritis was formerly believed to be inevitable due to everyday wear and tear. However, recent research suggests that in young and middle-aged adults, the condition may be related to metabolic changes in cartilage after knee injury. The knee is the most frequently impacted joint when it comes to osteoarthritis, one of the top 10 global diseases as recognised by the WHO.

When conservative osteoarthritis treatment fails, total knee replacement (TKR) is the best option for an elderly patient. Dr Bharani Kumar Dayanandam, Consultant Trauma, Joint Replacement and Arthroscopic Surgeon at Apollo Hospitals, Ayanambakkam, says that evidence from recent research demonstrates prosthesis survival above 90 per cent at 15 years for total knee arthroplasty in the senior population.

However, the procedure fail more frequently in younger patients. He says that meniscus and anterior cruciate ligament injuries are the most frequent types of knee damage among the young. One of the best options available for young patients is Joint Preserving Surgery - meniscus repair and meniscus replacement surgery. In a knee without a meniscus or ACL, the likelihood of getting osteoarthritis is more.

The goal of meniscus repair is to attempt to shield the surfaces of the joints from potential future wear and tear arthritis. To repair the torn meniscus, the procedure requires inserting sutures or specialised fixation devices.

“The majority of repairs can be made arthroscopically (via a small hole in the knee), but for severe tears and tears in specific locations, a small incision may be required to tie the sutures. Because the meniscal repair needs to be shielded from excessive stresses while it heals, post-operative rehabilitation takes longer than it would after a typical knee arthroscopy. Meniscal replacement procedures may provide a better solution over Meniscal repair surgery for patients who lose meniscus volume at a young age,” adds Dr Bharani.

Patients who completely lose their meniscus may be eligible for a meniscal transplant. These two techniques are both effective. There is strong evidence that these surgeries, which have lengthier recovery times, do indeed alleviate symptoms.