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What is Joint Preservation Surgery?

Joint preservation surgery is an orthopedic procedure performed to repair and preserve a deteriorating joint causing pain. 

A joint is a point in our body where two or more bones meet and connect through a fibrous tissue called cartilage. Major joints of the body include the hips, knees, shoulders, elbows, and ankles. 

Joint preservation surgery typically involves:

  • Correcting the anatomic abnormalities of the joint
  • Restoring the normal joint motion without replacement
  • Maintaining cartilage and bone health of the joint 

While the procedure can be used for any joint in the body, it is most commonly performed to the knee, shoulder or hip joints. 

Significance

Damage to a joint can prevent a full range of the joint’s movement and cause a lot of pain. This can stop or limit you from performing daily activities, especially if the pain is recurring or chronic. Joint replacement is a surgery in which the damaged joint is removed (partially or totally) and replaced with a prosthesis.

However, most of the time especially in young active patients or athletes, the prostheses are highly prone to wear-and-tear, and will eventually require repeat surgery. In such cases, preserving the joint with surgery can help prevent deterioration of the joint or delay the onset of certain degenerative conditions like osteoarthritis affecting the joint. This will allow the patient to resume normal activities without further damaging the joint.

Causes of Joint Pain

You can damage a joint suddenly or it may happen gradually over time. The causes of joint pain can be:

  • Injury to the joint cartilage
  • Bone dislocation due to trauma
  • Natural wear and tear of the joint
  • Degenerative diseases such as arthritis 
  • Inherited abnormalities in the joint

Whatever the cause, the joint should be preserved as long as possible. This is particularly true if the patient is a younger, active person.

Indications for Joint Preservation Surgery

Although joint pain is common in both adolescents and adults, the surgery is best suitable for patients who are in their early teen years to middle ages.

You can be a potential candidate for a joint preservation procedure if you experience any of the following:

  • Cartilage deformity in the joint
  • Inability to do daily activities
  • Increasing and constant joint pain
  • Joint pain following an arthroscopy procedure
  • Pain after previous joint replacement

Preparation

Your surgeon will discuss the necessary protocol to be followed before the surgery. 

Joint Preservation Surgery

The joint preservation surgery can be all arthroscopic, all open or a conjunction of the two techniques. However, arthroscopy alone method is most frequently employed for joint preservation.

Arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which a device called an arthroscope is inserted into the affected joint to check for any damage and repair it simultaneously. This procedure is performed through very small incisions and is used to treat various joint conditions.

A joint preservation surgery typically involves repair of only a part or two of the joint. The spectrum of the surgery includes:

  • Cartilage repair or restoration 
  • Bone altering or realignment 
  • Transplantation or implantation
  • Joint resurfacing or reconstruction 
  • Partial joint replacement

Joint preservation surgery will vary based on the requirement of the patient. The surgeon will discuss and choose the best option depending on the joint affected, type of injury or disorder, severity of the condition and age of the patient.

After Surgery Protocol

Following the surgery, an individualized physical therapy program may be recommended until normal mobility returns to the affected joint.

Benefits of Joint Preservation Surgery

  • Avoids joint cartilage damage in future
  • Eliminates or reduces joint pain
  • Improves or restores joint function 
  • Prevents or minimize further joint degeneration 
  • Increases the life span of the joint 
  • Delays or avoids joint replacement surgery 
  • Restores productivity and quality of life
  • Reduces long-term costs of health care

Contraindications

Joint preservation surgery is not recommended for patients with severe arthritis (inflammation of the joint).

  • American Orthopaedic Society for Sports Medicine
  • Arthroscopic Association of North America
  • posna
  • prism
  • Connecticut Childrens