Joint Preservation

Joint Preservation

Core Decompression of the Hip and Stem Cell Therapy

For young patients with osteonecrosis, core decompression is an alternative to total hip replacement. The procedure involves drilling being done into the dead bone tissue. Drilling has many benefits: it reduces swelling, allows better flow of blood, and inhibits further damage to the bones. For patients suffering from osteonecrosis, core decompression is a preferred mode of treatment. The success of the procedure is dependent on how much of the bone has already suffered damage, which part of the bone has been damaged, the amount of weight, the stress the joint is subjected to, etc. An MRI done ahead of the surgery will tell the surgeon exactly which bone tissue needs removal. This removal will stimulate the production of healthy bone tissue.

The bone marrow that is present inside the bones contains stem cells. These stem cells can change into bone cells when they are injected into the body. This stem cell therapy is used along with core decompression for a better surgical outcome.

High Tibial Osteotomy

A high tibial osteotomy is typically recommended for younger patients suffering from arthritis of knee, to prevent the need for a total knee replacement. When only a part of the knee has suffered damage and not the entire knee, this procedure would be a good choice. During the procedure, a wedge is made in the upper part of the tibia. This helps to remove the weight from the damaged tissue and shift it to healthier tissue. This procedure serves to delay the need for a total knee replacement by at least 10 years.

An x-ray will be done before the surgery to ensure that osteotomy is the right choice and to determine the plan for the surgery. Performed under general or spinal anaesthesia, the surgery will last for around 2 hours. Hospitalization of two to three days may be required. Walking aids should be used after surgery so that the knee is protected from stress. Physiotherapy after surgery is a must and should be performed diligently for best results.

Osteochondral Autograft Transfer System (OATS)

The knee joints in our body are covered by cartilage. The purpose of the cartilage is to ensure that the joint movement is smooth and free from friction. Sometimes this cartilage can suffer injury because of high-impact activity. The patient will experience pain, inflammation, and inability to move the joint freely. To address this, healthy cartilage from the part of the knee that doesn’t bear much weight replaces the damaged cartilage. Performed as an arthroscopic surgery, it is minimally invasive. The surgeon removes the damaged cartilage and replaces it with the new one.

Before surgery, smoking should be avoided and the surgeon kept informed about all the drugs the patient is on. If the patient has an infection or fever close to surgery, the surgeon should be apprised. Talk to the surgeon about your doubts and get them clarified. The surgery will be done under general or spinal anaesthesia. The rehabilitation after surgery is very important and the surgeon and his team will guide the patient through it.

Bone Marrow Aspirate Concentrate (BMAC)

BMAC injections are helpful in providing pain relief from osteoarthritis. The injections contain stem cells that are harvested from the patient’s own bone marrow. When injected into the part that has been affected by osteoarthritis, the patient gets sufficient pain relief.

The procedure takes around an hour to an hour and a half and is performed under local anaesthesia. The stem cells are first harvested from the patient’s pelvis. It is processed and then injected back into the damaged area that is then covered in bandages. There may be some pain after the procedure. The doctor will guide the patient on managing it. It is to be noted that some painkillers are not allowed after this procedure. Pain relief after the procedure will take around 6 weeks. The pain relief will last for quite some time, and there usually is no need to repeat the procedure at short intervals. BMAC is not recommended for patients suffering from cancer, tuberculosis, radiotherapy, etc. The patient should communicate any condition they may be suffering from to the doctor so that the doctor can take an informed decision about giving the injection.

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