What is Meant by Joint Preservation?
As the name suggests, Joint Preservation implies the use of treatment methods and techniques which are aimed towards ‘preserving and maintaining the structure and function of a joint’ without having to remove or replace part or parts of a joint.
The goal of joint preservation methods is to restore the function of an injured or affected joint, thereby preventing or postponing a potential joint replacement procedure.
Joint preservation is also called ‘Cartilage Restoration’, as cartilage is an integral component of any joint, and restoring joint cartilage plays a paramount role in preserving the structure and function of any joint. Joint preservation involves the use of certain surgical techniques, orthobiologics, or both.
Joint preservation as a procedure is most commonly employed in the preservation of the knee joint.
Surgical Techniques Utilised for Joint Preservation
1. Corrective Osteotomy
Any abnormal alignment of the knee (like a bow-leg or a knock-knee deformity) causes unequal weight transmission across the knee, and consequently subjects the joint cartilage to excessive wear and tear.
Corrective osteotomy involves correcting any abnormal alignment of the limb. It requires cutting through a bone and correcting the deformity. It is most commonly done for deformities around the knee.
2. Cartilage Restoration Procedures
Procedures like cartilage transplantation (OATS procedure/mosaicplasty), autologous cartilage implantation (ACI), or bone marrow stimulation (BMS) techniques are aimed at repairing or restoring the joint cartilage.
3. Repair / Reconstruction of Ligaments of the Knee
Ligaments are important for stability of the knee, and a stable knee is important for protecting the cartilage lining the joint surfaces. Repair or reconstruction helps restore stability and preserve cartilage function.
4. Repair of Meniscal Tears in the Knee
Menisci act as ‘shock absorbers’ of the knee, thereby protecting the knee cartilage from undue and uneven loading. Repairing the torn meniscus helps prevent damage to the knee cartilage.
What is Meant by Orthobiologics?
Orthobiologics is also known as Regenerative Medicine.
This refers to methods or interventions which help to repair, augment, or regenerate new tissues inside a damaged or injured joint. These methods are an amalgamation of biological concepts and tissue engineering principles.
It involves using either biological products (one’s own body cells or cell-derived materials), or synthetic products (bio-active materials) which are delivered inside the joint via an injection.
Common Orthobiologic Therapies
Platelet Rich Plasma (PRP)
Bone Marrow Aspiration Concentrate (BMAC)
Fat cells or fat cell-derived materials (MSC, SVF)
Visco-supplementation (high molecular weight Hyaluronic Acid - HA)
Choosing the Best Treatment Option
The modality of treatment that will be best suited for a given patient is decided upon after:
- Detailed consideration of the patient’s symptoms
- Review of patient’s X-rays/scans
- Assessment of the functional needs of the patient
Preserving joint function in any given patient involves choosing the most appropriate surgical procedure, a combination of procedures, the most appropriate Orthobiologic option, or both.
Dr Korday, with his vast experience of treating patients with a variety of knee disorders, will guide you to choose the best possible solution to your problem.