Greta Hall of Palatine knew she
needed to do something about her knees. After 35 years of short-track
speed skating and countless accidents, she had endured four surgeries
on each knee, including cartilage replacement. At age 66, the typically
active woman's knees were "bone on bone," but "I was putting off
surgery, waiting to see if anything new would come on the market."
Then, after injuring her knee again by simply getting up from a chair,
her physician, Dr. David Trotter, an orthopedic surgeon with the
Alexian Brothers Hospital Network, recommended a UniSpacer knee disc
for her right knee. Now "it's like a new knee to me," Hall said of the
disc, made by Zimmer. "No restrictions, full mobility." So mobile, in
fact, that Hall traveled to Turin, Italy, for the Winter Olympics. At
age 68, she was the only female short-track speed-skating official at
the Games.
A recent Harris Interactive survey released by
DePuy, which also manufactures knee-replacement parts, showed that when
asked about joint replacement, nearly half of surgery candidates, like
Hall, said they were holding off on operations to wait for more
advanced surgical techniques.
On the other hand, research
presented at the American Academy of Orthopaedic Surgeons conference in
Chicago in March indicated that the number of first-time total knee
replacements would jump by 673 percent, to 3.48 million, by the year
2030.
Trotter specializes in the former; specifically,
knee-disc surgery, in which the metallic implant is placed in the inner
compartment of the knee, the area frequently involved with painful
arthritis. Using no screws, cement and a much smaller incision than
total knee replacement, the disc separates raw or rough cartilage, or
bone-on-bone surfaces, from each other.
"Individuals don't feel
the disc; they feel the dramatic relief of pain," he said, emphasizing
that the procedure should be done only on appropriate candidates,
meaning those who have primary, painful arthritis in the inner
compartment of knee. This is determined via a standing knee X-ray,
which shows where cartilage is most abnormal, because of long-term
sports, wear and tear or just natural aging.
The knee disc is
the least invasive alternative form of surgical implant compared with
complete or even partial knee replacement, Trotter said, although it
still requires anesthesia. Patients can resume lower-impact activities
such as doubles tennis, walking and golf with significant reduction of
previous arthritic knee pain.
But not everyone's onboard with
the disc alternative. Libertyville orthopedic surgeon John Mayer said
he prefers complete knee replacement, in which the inside and outside
of the joint, plus the kneecap, are replaced with a metal alloy and a
plastic spacer that provides a gliding surface. He thinks disc
replacement is "not a realistic alternative . . . because the disc
slides around and can pop out of place," he said. Both procedures
require a short hospital stay and six to eight weeks of physical
therapy. Patients experience a 90 percent success rate over 15 years
with full replacement, Mayer said.
Trotter, however, said that
"in some cases [the UniSpacer] will be a bridge to postpone a
replacement for as long as possible/desirable, as replacement longevity
can be highly variable. However, in the right candidates, the discs may
well obviate patients from replacement altogether."
Be sure to discuss all options with your doctor. To find a list of knee surgeons in your area, visit kneereplacement.com.
