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Alternatives to Total Joint Replacement
Alternatives to Total Joint Replacement

Perhaps over-the-counter pain medications no longer ease your knee pain. Maybe the days of hoisting your grandchild on to your shoulders, her favorite perch, are over. And unfortunately, that complaining knee has finally put the kibosh on skiing and running. For many chronic joint pain sufferers, total joint replacement may seem inevitable, but there are other options you may want to consider before committing to a total joint.

Joint preservation can be a smart alternative to completely swapping out old for new. While there are a wide range of options with various levels of invasiveness, anatomic bone-sparing implants have lately become ground zero for innovation.  Solutions like our OVOMotion® with Inlay Glenoid Shoulder Arthroplasty Systems for the treatment of shoulder arthritis and our Patellofemoral PF Wave® Implant for knee arthritis replace only the parts of the joint that are damaged, while conserving much of the native structure. Why is this approach preferable to total joint replacement?

The cons of total joint replacement

The wholesale replacement of a joint — whether it's a knee, shoulder, hip, ankle, or wrist — is a highly invasive procedure that comes with a number of disadvantages. The procedure itself can be lengthy and recovery is often a long haul. The surgeon is removing significant bone, cartilage, ligaments, and tendons and replacing them with an artificial mechanical joint that sometimes feel foreign in the body Some people even discover too late that they’re sensitive to the new joint’s metal. The implant may loosen, feel stiff, or occasionally become infected. In some cases, patients report after total joint replacement that their limited range of motion persists or even worsens. The goal of fixing a joint should be to preserve as much of the native joint structure as possible, similar to how filling a tooth cavity is often preferable over putting a crown on it, which requires removing up to ¾ of the natural tooth.

The pros of joint preservation

Joint preservation procedures that use implants customized to the patient’s joint shape and size do a great job of mimicking their native anatomy. These solutions recreate the native shape of the joint and remove minimal bone, so post-surgery, patients can experience less pain and can regain their active lifestyles more quickly1. Compared to traditional total joint replacement, these joint preservation alternatives take less time and are typically done on an outpatient basis. There is also a lower risk of complications such as fractures near the restored joint with these procedures. Post-op physical therapy to increase flexibility and strength is usually recommended. Clinical studies are confirming that preserving approaches are very successful at reducing pain and improving joint function. One study of the PF Wave Implant for knees showed significant improvement in symptoms and no progress of arthritis at the five-year point.

Are you a good candidate?

Consulting with an orthopedic surgeon is your first step, but you might consider a second opinion, if the first one is that you're not a good candidate for a joint preservation procedure Because joint repair technology is evolving so quickly, different doctors may be familiar with and skilled at different techniques and procedures. You can find a doctor experienced in joint preservation here.

As more of us stay active and healthy in to our later years, joint preservation procedures will become more common and continue to improve. They can help many of us return to hoisting our beloved little ones on to our shoulders, skiing, running, weightlifting and doing all of the other activities we love to do.

1. Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results  comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis. Miniaci, Anthony et al., JSES Open Access, Volume 0, Issue 0

 

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