2.7 million people in the U.S. were living with an artificial knee, according to a study conducted in 2010 (1). Since more than 600,000 people a year undergo surgery for a total knee replacement (2), that total has significantly increased and does not include other types of knee repair surgeries.
The Agency for Healthcare Research and Quality estimates that “by 2030, about 11 million Americans will have either a hip or knee replacement, making it one of the nation’s most common elective surgical procedures.”
The American Academy of Orthopaedic Surgeons states that “more than 90% of people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living.” However, like any other surgery, it carries significant risks and recovery time. What if there was a better way to repair your knee, with less risk and much shorter recovery time?
Knee Cartilage Basics
Cartilage in your knee is a type of hyaline cartilage called articular cartilage. It is a rubbery tissue that cushions the joint and reduces friction between the bones when you move your knee. It is very tough, elastic, and springy which allows your knee to move smoothly and to absorb shock, up to 20 times your body weight. However, cartilage does not have a blood supply, so it has a limited ability to heal and takes far longer to heal when damaged than other types of tissue in your body.
Cartilage in your knee may be damaged through a heavy impact, such as a sports injury, bad fall, or car accident. Wear and tear may cause inflammation and breakdown of cartilage. Damaged knee cartilage can cause severe pain, swelling, stiffness, and loss of function. Since cartilage does not repair itself well, injuries and damage will often require medical treatment.
Minor damage may only require conservative treatment such as non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, or steroid injections. These treatments do not actually repair the joint. NSAIDs and steroid reduce inflammation and pain while giving the cartilage time to heal, and physical therapy strengthens the muscles around the joint to support it and reduce pressure on the damaged cartilage. When conservative treatment will not work, conventional medicine will recommend surgery.
Knee Replacement Surgery
There are two common reasons that people need knee surgery. The first is to repair a torn ligament or meniscus. The second is to replace a knee joint with cartilage that has degenerated or worn down, usually as a result of osteoarthritis or rheumatoid arthritis.
Your knee has four main ligaments, the lateral collateral ligament, posterior cruciate ligament, anterior cruciate ligament (ACL), and medial collateral ligament (MCL). When any of these are torn, they are usually treated with surgery, which can require 8 weeks to 6 months for a full recovery.
The lateral meniscus and medial meniscus are disc-shaped pieces of cartilage that provide a cushion between the bones. Sometimes tears in the meniscus can be treated without surgery, but surgery is usually recommended if the tear is large, or on the inner part of the meniscus. You are usually fully recovered within 8 weeks.
While most surgeries to repair a torn meniscus or ligament in the knee are successful, unfortunately, the injury and surgery to repair it usually have long term repercussions. You are more likely to develop osteoarthritis in a joint which has previously had surgery to repair a damaged ligament or tendon. In fact, one study found that “Neither conservative therapy nor the current surgical reconstruction techniques have been successful in eliminating or slowing the progression of osteoarthritis following ligament injury” (3).
What is Osteoarthritis?
Osteoarthritis (OA) is a degenerative disease in which the articular cartilage of a joint wears down. When this happens, the bones rub against each other, causing swelling, pain, and loss of function. Eventually, the bone, tendons, ligaments, muscles and synovial lining can also be damaged. OA is different from rheumatoid arthritis, which is a chronic inflammatory autoimmune disorder that affects the lining of your joints and can damage many other parts of your body.
Many factors lead to the development of osteoarthritis. Prior damage and aging are common causes. However, “metabolic factors such as hyperglycemia, dyslipidemia, and obesity affect articular tissues and may initiate or exacerbate the OA” (