Knee Surgery and Preservation

Experiencing persistent knee pain or sustaining a traumatic knee injury, especially if you’re an active adult, can be frustrating and leave you wondering what treatment options may be available. At The Ohio State University Wexner Medical Center in Columbus, Ohio, our orthopedic and sports medicine knee experts have various surgical and nonsurgical methods to treat troublesome knee condition symptoms. Many of our treatments are on the leading edge of technology and technique, allowing our knee specialists to offer a breadth of treatments not available at most other hospitals.

With a focus on preservation and restoration of the knee joint, we’re able to help many people avoid a knee replacement (arthroplasty) or at the very least, delay one. If you’re an active adult looking for choices in your knee care, the Ohio State Wexner Medical Center knee experts can provide many services and get you back to enjoying life as quickly as possible.

What is knee preservation?

Knee preservation is a group of surgical treatments that aim to maintain the native tissues, structure and function of the knee. It includes, more or less, any knee procedure besides joint replacement, which removes the damaged joint and replaces it with artificial materials.

Usually, knee preservation treats people in the early stages of arthritis, particularly those who are younger than 60 and want to lead a more physically active life. At the Ohio State Wexner Medical Center, we have many knee surgeons who specialize in these restorative procedures, including meniscus repair, cartilage restoration or osteotomy.

While knee preservation can be a great option for many people, we do know others will be better candidates for a partial or total knee replacement, especially as they get older.

Nonsurgical treatments for knee pain and injuries

For most people with knee pain, treatment will begin with nonsurgical methods. There are a variety of conservative treatment options that can be a suitable alternative for surgery in the short term or indefinitely.

Those include:

Physical therapy and rehabilitation

Our physical therapists who specialize in sports medicine physical therapy use a variety of strengthening, flexibility and mobility techniques to help people alleviate knee pain or recover from a knee injury.

Sports orthobiologics

Orthobiologics, a type of regenerative medicine, provides a large dose of anti-inflammatory proteins that attempt to treat your injury through your body’s natural healing process. We offer a number of orthobiologics options, such as platelet-rich plasma (PRP), microfragmented adipose tissue (MFAT) and bone marrow concentrate (BMC).

Dry needling, or intramuscular manual therapy

Dry needling therapy is an alternative pain-relief technique that involves the insertion of a small, solid filament (needle) into a tight muscle’s site of spasm and pain, also known as a trigger point. By doing so, the muscle relaxes, and blood flow increases into the area, alleviating pain and improving motion.

Injection therapy

Injections may be used to reduce joint pain and inflammation associated with knee injuries like cartilage tears, degenerative meniscus issues and arthritis-related issues. There are two main types of injections: steroid injections and natural joint fluid treatment (hyaluronic acid injections).

Lifestyle modification

Depending upon the type of knee problem you have, we may suggest lifestyle changes, such as weight loss, to help reduce the pain and stress on your knees. Your exercise prescription might include low- or no-impact exercises, such as swimming or biking and avoiding activities with running.

Surgical treatments for knee pain and injuries

Our experts recommend exhausting other treatment options before deciding on surgery. When there is great discomfort or you desire to get back to your sport, and other methods haven’t produced the desired results, surgery can diminish pain and improve function. Our surgical options, besides joint replacement, include:

ACL reconstruction surgery

ACL reconstruction surgery repairs a torn anterior cruciate ligament (ACL). During reconstruction, a new ligament is built from a graft that is provided from either a donor or from the patient themself. Surgery is often performed four to six weeks after a torn ACL.

Arthroscopy

Arthroscopy involves inserting a telescopic device fitted with a camera into the affected knee area. Your physician will make the appropriate repairs, removing inflamed soft tissue, loose bone or cartilage. Depending on the extent of the repair, the procedure usually takes less than an hour.

Cartilage restoration

Knee cartilage restoration, also called cartilage repair or cartilage regeneration, is a procedure to repair damaged tissue near your knee. Cartilage covers the ends of the bone in your knee to form the knee joint. We can repair it by replacing it with donor tissue or man-made material or by stimulating growth through innovative methods.

Microfracture surgery

Knee microfracture surgery repairs significant acute damage to small areas of knee cartilage. An arthroscope is inserted into an incision made in the knee. Small holes (microfractures) are made in the bone near the damaged cartilage. Cells from your bones are released through the microfractures and will create new fibrocartilage.

Medial implantable shock absorber (MISHA)

The MISHA (medial implantable shock absorber) knee device is a minimally invasive surgical option for patients experiencing pain due to mild or moderate arthritic changes. The device is placed below the skin outside the knee joint and reduces pain by removing pressure from the medial (inner) side of the knee.

Meniscus surgery

The meniscus is padding between the tibia (shinbone) and femur (thighbone) that can tear as a result of an injury and is a common complication in ACL tears. Depending on the type of tear, the meniscus may be repaired through surgery. Surgical removal of the torn section (partial meniscectomy) or the entire meniscus (total meniscectomy), in severe cases, may be necessary.

Kneecap dislocation surgery

Initial patella (kneecap) dislocations can often be corrected by wearing a brace for a few weeks and following up with physical therapy. In repeat cases where ligament damage occurs, medial patella femoral ligament (MPFL) reconstruction may be necessary. MPFL reconstruction rebuilds the ligament, using a graft from the femur to the kneecap to help prevent further dislocations.

Osteotomy

A knee osteotomy is a surgical procedure where part of a bone in your lower leg is cut to shift the positioning of the knee and realign the knee joint and bones. This changes the point where you bear weight on your knee, relieving pain and instability caused by arthritis or chronic ligament injury.