Dr Manuj Wadhwa
manuj.wadhwa@gmail.com
Knee pain is no longer a fate reserved for old age. With modern lifestyles increasing joint strain, more people in their 30s and 40s are facing premature cartilage damage.
While timely intervention through weight management and proper exercise remains the first line of defence, a revolutionary field of treatment is now offering hope to those whose damage has progressed: Knee Preservation.
The goal of preservation is to maximize the life of the patient’s natural joint, moving beyond simple pain management to actively promote healing, correct mechanics, and delay or entirely avoid a Total Knee Replacement (TKR).
As per Dr. Manuj Wadhwa, Chairman Elite Orthopaedics, modern medicine provides several advanced options when conservative treatments like physiotherapy and basic injections no longer suffice. These methods are designed to be deployed before the damage becomes severe enough to warrant a complete joint replacement.
Pillar 1: The Healing Power of Orthobiologics
Orthobiologics are at the forefront of non-surgical knee preservation. This branch of regenerative medicine uses a patient’s own tissues-blood, bone marrow, or fat-to stimulate the body’s innate healing response.
Platelet-Rich Plasma (PRP) and GFC: PRP involves drawing a small sample of the patient’s blood, processing it to concentrate the platelets, and injecting the resulting solution into the damaged joint. Platelets release powerful Growth Factors, which can significantly reduce pain, decrease chronic inflammation, and stimulate natural tissue repair. Growth Factor Concentrate (GFC) is a specialized, purified variety of this treatment. PRP is often most effective for patients with mild to moderate arthritis and minor tendon or ligament injuries.
Stem Cell Therapy: This cutting-edge approach uses a patient’s own adult stem cells, typically harvested from bone marrow (Bone Marrow Aspirate Concentrate) or fat tissue (Adipose tissue). When injected into the knee, these cells work to modulate inflammation and possess the ability to promote the stabilization and regeneration of damaged articular cartilage. Stem cell therapy offers a minimally invasive alternative that can help patients with progressive osteoarthritis delay or entirely bypass a major surgery.
Pillar 2: Surgical Realignment (Knee Osteotomy)
For younger, active patients whose arthritis is confined to just one side of the knee (unicompartmental disease), a procedure called Knee Osteotomy offers a powerful surgical preservation option.
An osteotomy, such as a High Tibial Osteotomy (HTO), is a precise surgery that involves cutting and reshaping the bone-typically the tibia (shinbone). The goal is not to replace the joint, but to realign the leg, correcting any bowing or knocking, and shifting the body’s weight away from the damaged, worn-out side and onto the healthier compartment of the knee.
This procedure relieves pain and, crucially, preserves the natural joint, allowing the patient to return to a fully active lifestyle, often including high-impact activities not typically recommended after a TKR. A successful osteotomy can prolong the life of the native knee joint and delay the need for a total replacement by 10 to 15 years or more.
From harnessing the body’s own healing cells to surgically correcting mechanical flaws, the options available today mean that severe knee pain is no longer a guaranteed march toward TKR. By listening to your body, seeking expert consultation early, and exploring these advanced preservation techniques, you can make an informed choice to save your knee and keep moving for a lifetime.
The author is Chairman & Executive Director ELITE Institutes of Orthopaedics & Joint Replacement, Chandigarh President Elect- Indian Arthroplasty Association (IAA)
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