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Joint Preservation: Restoration Rather Than Replacement

If you have chronic hip or knee pain, you may think joint replacement surgery is your only treatment option. The good news is — there are less invasive procedures that can help many people relieve their pain and maintain their mobility as they age, says James R. Ross, M.D. [1], an orthopedic surgeon with Baptist Health Orthopedic Care [2].


James R. Ross, M.D., an orthopedic surgeon with Baptist Health Orthopedic Care.

“Total joint replacement surgery is generally performed to treat late-stage osteoarthritis after conservative treatments have failed,” explained Dr. Ross. “While joint replacement may be the best choice for some people, innovative joint preservation procedures are helping others, especially younger patients, prolong the life of their hip or knee joint.”

Preserving the Hip Joint

Dr. Ross performs advanced arthroscopic procedures and open hip preservation surgery to resolve bone impingement and repair or reconstruct soft tissues that have been torn or otherwise compromised. Femoroacetabular impingement (FAI), which occurs when the femoral head (ball of the hip) pinches up against the acetabulum (cup of the hip), is just one of the hip conditions he treats. FAI is thought to be a precursor to osteoarthritis because it leads to lesions of the labrum and/or articular cartilage.

Using 3D reconstruction and technologically advanced software for pre-operative planning and guidance during surgery, Dr. Ross precisely repairs damaged tissue and corrects the abnormal shape of the hip joint. This protocol, he says, minimizes complications, pain and the need for a hip replacement later in life.

Preserving the Knee Joint

Similar to the anatomy of the impingement that causes cartilage problems in the hip, mechanical alignment problems in the knee can cause isolated cartilage defects, says Dr. Ross. An osteotomy procedure can halt this uneven deterioration of knee cartilage. The procedure, which is most commonly performed on active people under age 60, involves removing or adding a wedge of bone to the tibia (shinbone) or femur (thighbone) to help shift body weight off the damaged portion of the knee joint and prolong its life span. Osteotomy is often performed in combination with a cartilage restoration procedure to address the gap in cartilage and bony exposure.

Dr. Ross also specializes in cartilage replacement techniques to treat patients who have good bone structure but suffer with cartilage-only defects. Matrix-induced autologous chondrocyte implantation, or MACI, is just one of the innovative techniques Dr. Ross employs to restore cartilage and preserve the knee joint.

Performing Cartilage Restoration

The MACI procedure is comprised of two steps. First, Dr. Ross harvests cartilage cells from the patient’s knee. These cells are sent to a laboratory where, over the course of four to six weeks, they grow into additional cartilage. The second part of the procedure involves implanting the new cartilage back into the patient’s knee, where it will mature and fill in the defect.

“Prevention is the best medicine,” Dr. Ross explained. “Rebuilding the patient’s cartilage will keep the cushion between the bones intact, which can reduce the risk of developing osteoarthritis and requiring joint replacement surgery in the future.”

Assessing Your Options

So how do you know if you are a candidate for a joint preservation procedure? In general, you should see an orthopedic specialist if your joint pain limits your activities and/or you have recurring episodes of the same pain over several weeks or months. Orthopedic surgeons at Baptist Health Orthopedic Care will determine the best treatment methods to reduce your pain, restore your mobility and prolong the life of your hip and knee joints.

To learn more, please visit BaptistHealth.net/OrthoCare [2] or call 833-556-6764.