Joint-Preserving Surgery
Replacement is not the first step. Before a joint is worn bone on bone, there are ways to save it.
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- PRP is made from
your own blood - Walking with support
within 3 days - Can delay or avoid
a replacement
Which treatment, at which stage
Arthritis is graded from stage 0, the earliest signs, to stage 4, when the joint is worn bone on bone. Which of these fits depends on the stage and on the joint.
-
PRP: treatment from your own blood
Stages 0 to 3. Knee, shoulder and elbow.
-
PFO: straightening the leg without a plate or screw
Stages 1 and 2. Knee, with bowed legs.
-
HTO: straightening a knee bent by wear
Stages 2 and 3. Knee, usually under 60.
-
Joint replacement
Stage 4, when the joint is worn bone on bone.
PRP: treatment from your own blood
A small amount of your blood is taken and the platelet-rich part is separated out. That concentrate is injected into the joint.
- Joints treated
- Knee, shoulder and elbow.
- Stage
- Arthritis from stage 0 to stage 3. That runs from the earliest signs up to a joint that is worn but not yet at the point of needing replacement.
- Made from
- Your own blood. Nothing in it comes from outside your body.
- How many injections
- This depends on your joint and how much treatment it needs. It is decided at your assessment.
- Where it is done
- In the hospital. How long you stay depends on the treatment and on how you recover.
- Insurance
- It depends on your policy. If your mediclaim covers PRP, the claim works like any other treatment here, so bring your policy details.
PFO: straightening the leg without a plate or screw
Proximal fibular osteotomy is a short operation. A 1 to 2 cm piece of the fibula, the thin outer bone of the leg, is removed just below the knee. This moves weight off the worn inner side of the knee and relieves the pressure there. No plate or screw is used.
- Who it is for
- Adults, usually over 40, with painful arthritis only on the inner side of the knee and with bowed legs. It is not used for knock-knees.
- Stage
- Early to moderate arthritis, stages 1 and 2. It does not work well once the joint is worn bone on bone. For stage 3, HTO is the better option.
- Hospital stay
- 1 to 2 days.
- Walking with support
- With a walker or crutches within 24 to 48 hours.
- Walking on your own
- Most patients within 2 to 4 weeks.
- Insurance
- Mediclaim covers PFO. The usual policy rules apply, including the waiting period for arthritis, so check your policy.
HTO: straightening a knee bent by wear
In a high tibial osteotomy, the upper part of the shin bone (tibia) is cut just below the knee and opened into a wedge, which straightens the leg. A plate and screws hold it in place permanently. This moves weight off the worn inner side of the knee, and can delay or avoid a knee replacement.
- Who it is for
- Patients, usually under 60, who want to avoid or delay a knee replacement.
- Stage
- Stages 2 and 3, with arthritis only on the inner side of the knee. The outer side and the kneecap must still be healthy.
- Hospital stay
- 3 to 5 days, for pain control, wound care and the start of physiotherapy.
- Walking with support
- With a walker or crutches within 2 to 3 days, putting only part of your weight on the leg.
- Walking on your own
- After 6 to 8 weeks, once the bone has healed around the plate.
- Insurance
- Mediclaim covers HTO. The usual policy rules apply, including the waiting period for arthritis, so check your policy.
Come and be assessed
Which of these fits depends on the stage and on the joint. Bring what you already have and we will go through it with you.
- Any X-rays or scans you already have
- Your insurance policy details, if you have cover
