The knee is made up of three bones, the femur, tibia, and patella. The knee is divided into three compartments, called the medial (inside), lateral (outside), and anterior (front). The bones are joined by a complex series of tendons, ligaments, and muscles. Inside the knee, there are two types of cartilage. Lining the bones is articular cartilage, the white shiny structure that you see when you break open a chicken joint. In between the femur and tibia are two shock absorbers that are kidney shaped. This structure is called a meniscus, and there is one on the inside and one on the outside. A structurally healthy knee has intact cartilage that is strong enough to provide body support and enable smooth joint movement. Likewise, the menisci allow for smooth, gliding motion and cushion the impact of walking.
When the knee becomes damaged, pain and inhibited joint movement are common results. An injury can result from a single traumatic event or infection, as well as general wear-and-tear over time. Likewise, while knee damage may impact the entire joint area, it can also be specific to a single compartment. Based on specific symptoms and case severity, Dr. Harwin will diagnose the type and level of treatment needed for successful recovery.
Knee resurfacing may be recommended when the damage present encompasses only one section of the knee, rather than all three. During this procedure, the deteriorated joint surface is removed, preserving as much of the natural bone as possible. As healthy regrowth is the goal, this approach is recommended for younger patients who exhibit lower amounts of generalized wear-and-tear. In some cases, individuals undergoing a knee resurfacing operation may become candidates for a full replacement later in life.
There are two primary types of knee resurfacing procedure: unicompartmental and patellofemoral. While the unicompartmental approach involves treatment of the femur and tibia on the inside and outside, a patellofemoral operation focuses on correcting damage beneath the patella on the end of the thighbone.
While knee damage can result from a range of activities and injury types, there are some commonplace signs that surgical intervention may be needed. If any of the following symptoms are present, orthopaedic evaluation and examination may be considered:
Upon initial analysis, Dr. Harwin will recommend an approach to comprehensive examination and diagnosis. Typical components include the taking of a condition history, as well as the use of strength and range of motion tests, x-rays and possibly an MRI.
Prior to the completion of a knee resurfacing operation, Dr. Harwin will recommend a plan for post-op recovery and care. In some cases, alterations to work or home environments may be suggested to avoid risks for re-injury or unnecessary strain.
Immediately following surgery, elevating the knee and applying ice will lower the levels of swelling and discomfort. Likewise, precautions should be taken to keep the incision areas clean. Although the risks associated with knee resurfacing procedures are few, notify Dr. Harwin’s team immediately if any of the following symptoms arise:
To support ongoing recovery and the return of healthy knee function, it will be important to adhere to Dr. Harwin’s prescribed regimen of post-op therapy, while completing regular orthopaedic follow-ups.
Dr. Harwin is dedicated to providing the least invasive treatment possible, allowing for faster patient recoveries and the restoration of active lifestyles. To schedule an appointment, contact his office in Manhattan at 212-861-9800, or the Bronx at 718-655-2400.
By Dr. Steven Harwin