Osteoarthritis patients below 40 years of age need not go in for knee replacement surgeries as simpler procedures like “cartilage regeneration surgeries” are available, says Dr Shubhang Aggarwal, Senior Joint Replacement Surgeon and Director, NHS Hospital, Jalandhar.
Osteoarthritis in young people may be caused by surgical removal of an injured meniscus, a C-shaped cartilage in the knee, or injury to the articular cartilage (chondro) and the bone under it, or insufficiency of the ligament. This disturbs the alignment of the knee by placing abnormal stresses on the cartilage of the affected compartment, thus causing pain and difficulty in walking.
The knee replacement might prove to be an overkill and can do more harm than good, he warns.
Asked what these procedures and how are those done, Dr Aggarwal says these technically demanding procedures like cartilage regeneration surgeries are done with the help of keyhole made into the joint and cartilage harvested and grown in the lab.
These procedures, he said, can manage early degenerative changes that happen only in half of the tissue, to start with mostly the inner side. If treated on time these cartilages can be like natural cartilage growing there and can avoid knee replacement surgery, he adds.
“The need for knee replacement surgery in young arthritic patients who have degenerative changes in one compartment of the knee joint is over emphasized,” say experts.
Even though we do robotic surgery which gives a perfect alignment and ensure that the implants which are put in, last up to 30 years, it is advisable that in very young patients especially with osteoarthritis alternate methods of treatment even if their surgery should be considered, the orthosurgeon says.
It would be better to preserve and save natural cartilage than go for knee replacement surgery.
However, in patients who are more than 40 years of age, severe osteoarthritis can be successfully treated with robotic assisted knee replacement surgery.
These implants with robotic technology can last up to 30 years in the knee and 40 years in the hip, says a surgeon who has super specialised in shoulder and knee implant surgeries.
Quality of life is the main thing. But pulling along with pain and swelling and medication and doctors’ visits throughout life just for insisting on not changing the joint is also not correct.
“In severe arthritis or destruction of the knee in younger patients especially with rheumatoid arthritis, joint replacement is fairly successful and can give Quality of life for a number of years but they must be prepared for a revision surgery at a later date,” adds Dr Aggarwal.