One of the newest and most exciting treatment technologies offered in orthopaedics today is knee resurfacing. Knee resurfacing is a true alternative to traditional total knee replacement. Knee resurfacing is performed by replacing only the worn-out, arthritic, compartment(s) of the knee vs. the more traditional knee replacement approach in which the entire knee is replaced. This approach is especially recommended for the younger, more active patient who does not have any cartilage remaining on a portion(s) of their knee. Post-operatively, this approach also offers the potential for the patient to return to a fairly high level of activity.
What is Knee Resurfacing?
For years, this concept could not be realized, primarily because of difficulties in imaging the knee accurately. However, new advances in CT or CAT (computerized tomography) technology now make it possible for implant manufacturers to utilize a simple CT scan of the knee to construct an exact, three-dimensional model of a patient's knee. A CT scan is an X-ray technique that produces images of your body in which internal structures are visualized in cross section rather than the overlapping images typically produced by conventional X-ray exams. After the anatomically correct model is created, the manufacturer can then fabricate the necessary implants required to replace the arthritic area(s) of the knee.
How Does This Procedure Differ From Traditional or Computer-Designed Knee Replacement?
In order to fully appreciate the differences in the resurfacing procedure when compared to other knee replacement approaches, some explanation is in order. Although most computer-generated knee replacements involve a patient to pre-operatively undergo an MRI scan or CT scan of their knee, this concept is different from other computer-designed knee replacements that are currently being advertised. It must be remembered that most manufacturers of knee replacement implants make a left knee and a right knee model in a variety of different sizes. A patient's knee will be cut down to accommodate whichever size of implant most closely approximates their natural knee. All surgeons use cutting guides or "blocks" which are made to facilitate the implantation of the pre-fabricated knee implant, no matter if the replacement is to be a traditional or computed designed procedure. However, in a knee resurfacing procedure, there are no pre-manufactured cutting blocks or implants. The patient's own knee is utilized to make the model on which the patient's custom-made implants are then manufactured, cutting blocks are created and everything is sent to the surgeon to be used at the time of surgery.
What are the Benefits of this Procedure for Patients?
1. Less bone is removed in the procedure. All knee replacements require that a patient's knee be "prepared" to receive the implant, which usually requires significant bone removal and shaping before the implant can be positioned into place. The knee resurfacing manufacturer produces a cutting block, fitting the patient exactly, which is sent to the surgeon to use when making the initial bone cuts. As a result, the implant lies on the surface of the knee bones and essentially replaces the cartilage that has been worn away.
By utilizing custom-made cutting blocks and knee resurfacing implant, the surgeon does not have to remove nearly as much bone to achieve the proper fit and positioning of the implant. Less bone cutting also translates into less pain post-operatively.
2. More surgical options are available if the knee needs to be fully replaced at a later date. Since minimal bone is removed during the knee resurfacing procedure, it is much easier to convert a resurfaced knee to a primary total knee replacement, should the need arise due to complications from arthritis or injury down the road. Also gone is the worry that the patient may require a complex revision should something happen to a conventional knee replacement.
While not for everyone, knee resurfacing is a great alternative to total knee replacement for healthy persons who are younger and want to maintain an active lifestyle.
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