Working WITH nature vs. Imposing man’s will on nature
As a doctor, going through all of the learning about the anatomy and the workings of the human body I am awestruck by the complexity of it all. One can’t possibly begin to understand the workings of nature, but instead have the ultimate respect for it. As a vegetable gardener we learn about the soil and the climate and rainfall, as well as the typical needs of the plants we want to grow. We learn about nature so that we can work with nature. You can’t grow oranges in Tennessee, or grow lettuce in the heat of summer.
The same holds true for orthopedic surgery. In treating broken bones we must know how the body typically heals a bone and then try and create an environment in which the natural forces at play can succeed in healing it. We cannot impose our will on it and force it to heal quickly.
In the case of treating an arthritic knee it is wise to let nature heal early stages of the problem, helping with low impact exercise, weight loss, nutritional supplements, and rest. When non-operative treatment has failed and the cartilage is worn down to bone and a patient is unable to walk through a grocery store without leaning on the shopping cart; then it may be time for the orthopedic surgeon to intervene with joint resurfacing.
How minimally invasive partial knees (MIPKR) work WITH nature
The idea behind MIPKR is very simple. In fact so many of my patients have suggested it to me. When we look at an x-ray that shows that the protective coating of one portion of their knee has worn off, patients ask “why can’t you just put some kind of artificial coating back on where it is worn off?” Makes sense to me. That really is all that is wrong with the knee, the cartilage surface is worn off and it needs a new one. MIPKR is the most successful way to do just that. We simply resurface along the natural contours of the existing bone with a few millimiters of height added, to try and recreate the patients own natura anatomy, before the knee became diseased.
How Total Knee replacement does not make much sense for most patients with one compartment arthritis
A total knee replacement can best be described, and I often hear it described this way, as BRUTAL. The quadriceps muscle is cut to well above the knee, the kneecap is dislocated, the ACL and usually the PCL is removed. Large amounts of bone are sawed off and two thirds of the knee surface which may be in pristine condition is removed and replaced with heavy metal and plastic componentsWhy would anyone want to go through all of this, discarding healthy stabilizing ligaments and lots of good natural joint surface, scarring forever a big muscle?. There are certain situations, such as morbid obesity, in which it may be the only good choice because in these patient their considerable weight is spread out over a larger surface area. For the majority of patients it is complete overkill.