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Joint Preservation versus Joint Replacement

Joint preservation is the reshaping of the natural bones of the joint using advanced arthroscopic techniques.  This surgery may also include bone and cartilage grafting, or microfracturing.  Soft-tissue procedures in joint preservation of the shoulder may include a rotator cuff repair; in joint preservation of the hip, a labral repair for femoroacetabular impingement, FAI; and in joint preservation of the knee, a meniscal repair.  In select patients, the inside of the bone may require evaluation and treatment endoscopically as well.  The goal of joint preservation surgery is to improve how the natural bones work together by removing and/or repairing the abnormal tissues that destroy the cartilage, either from within the joint or from within the bone, or both.

Joint replacement is the removal of the entire joint and its replacement with an artificial device, called an implant.  During knee replacement, the bottom part of the thighbone is replaced with a smooth piece of metal and the top part of the leg bone is replaced with a metal tray.  Plastic is inserted between the two pieces of metal and an artificial joint is made.  An easy way to understand knee replacement is to consider it a very extensive cleaning process of the joint.  The joint is cleaned so extensively that a lot of bone is removed.  Because so much bone is removed during surgery an implant is required.  We as orthopaedic surgeons know that bone removed during surgery cannot be replaced; therefore, some patients may undergo a “partial joint replacement” if the arthritis is only in part of the joint.  In the case of the hip, a partial hip replacement may be called a “surface replacement.”  It is important to know that these partial types of replacements are not true joint preservation procedures, but rather “bone preserving” procedures that require some form of metal and/or plastic in order for the joint to work after surgery.  Common product names for total and partial replacement products are the NexGen Total Knee by Zimmer, the Triathlon Total Knee by Stryker, the Optetrak Logic Total Knee by Exactech, the Oxford Partial Knee by Biomet, the Birmingham Hip Surface Replacement by Smith & Nephew, and the Corail Total Hip by DePuy.

At JPIK we only offer joint preservation.  Additionally, we educate our patients about their disease and why they should keep their joints if possible.  We emphasize the importance of recognizing the early symptoms of arthritis and any contributing factors.   More than 500,000 joints are replaced each year in our country, with many more patients in chronic pain having arthritis not bad enough for a replacement.  Some of these patients may only be waiting until they can no longer tolerate their symptoms or the joint is completely worn out, bone-on-bone.  While joint replacements are safe and effective and can be performed by many orthopaedic surgeons, e.g. in the Kansas area, Kansas City Orthopaedic Institute, KCOI; Carondelet Orthopaedic Surgeons, C-ORTHO; Kansas City Bone and Joint Clinic, KCBJ; or Dickson Diveley Midwest Orthopaedic Clinic, DD-CLINIC, joint preservation is our goal and we encourage patients to make an appointment with us to discuss their chronic pain and disease to determine if joint preservation is an option for them.  While there are numerous choices for replacement, there is only one choice for preservation.

The below graph helps many of our patients understand where joint preservation fits in the continuum of care and the importance of seeking treatment early for chronic joint pain.

Am I a Candidate for Joint Preservation?

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Joint Preservation Institute of Kansas, LLC
8101 W. 135th Street  •  Overland Park, Kansas 66223  •  913-491-3999