Joint Preservation Surgery

Joint preservation surgery consists of many different procedures to address individual problems with the knee. Joint preservation surgery aims to improve knee symptoms and function and avoid joint replacements in appropriate patients. Joint preservation surgery aims to treat damage to cartilage, tears of the meniscus, and realign bone to preserve the original knee. Most of these techniques are used together to address the knee injuries as a whole.

Cartilage Surgery
The knee cartilage cushions the knee and allows it to move with minimal friction. Damage to cartilage is usually permanent and does not heal spontaneously.
Cartilage surgery aims to restore near normal cartilage and hence preserve the function of the knee. Early cartilage surgery options have had limited success in regenerating normal cartilage.

Fortunately, modern developments and techniques now increase the chances of regenerating normal cartilage via minimally invasive procedures. Restoring normal cartilage helps to reduce pain and restore knee function.

Dr Lee employs the latest approved techniques to help repair and restore damaged cartilage.

Meniscus Surgery
Injuries to the meniscus (or shock-absorber) of the knee often do not heal well. A torn or non-functional meniscus can give rise to knee pain and predispose one to early arthritis. Traditional surgical techniques have had some success with repairing the torn meniscus. However, many tears still fail and eventually require excision, thus predisposing the knee to arthritis.

Modern meniscal repair techniques improve the success rates of meniscal repairs, including repairs for complex tears. In some extreme tears where the meniscus is not salvageable, a meniscus transplant may restore the shock-absorber function to the knee. Such transplants, however, carry significant risk and may not be suitable for all patients.

Dr Bernard Lee strongly believes in repairing and preserving the meniscus. By safeguarding the meniscus, one can preserve the knee.

Joint Realignment
Occasionally, a malaligned leg or joint may predispose the knee to rapid wear and tear and early arthritis. In such cases where surgery to repair a torn meniscus or damaged cartilage have been performed, a limb or joint realignment operation may be required to protect the repair from re-injury, and to prolong the longevity of the knee. Such surgery can also help reduce symptoms of pain and knee dysfunction.

Dr Lee employs a comprehensive assessment and global treatment plan to improve the outcomes of joint preservation surgery.

Subchondroplasty
Subchondroplasty is a new procedure that can significantly reduce pain and improve function in some patients with arthritic knees. This has been shown to help 70% of patients avoid a total knee replacement for at least two years.

By preventing a knee replacement, one can avoid the inherent problems associated with an artificial joint, including wear and tear, infection, loosening and the need for revision surgery. Preserving the original knee also allows the patient to maintain more of his or her previous lifestyle activities, which may have had to be sacrificed if the knee had been replaced.

Dr Bernard Lee is one of three pioneers of this procedure in Singapore when it was first launched.

References:

1) Collagen Augmentation Improves the Quality of Cartilage Repair After Microfracture in Patients Undergoing High Tibial Osteotomy: A Randomized Controlled Trial,
http://journals.sagepub.com/doi/full/10.1177/0363546517691942