Speaker: ‘Tried-and-true’ knee cartilage treatments likely to yield best results
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WAIKOLOA, Hawaii — Patients with compromised knee cartilage status and Kellgren-Lawrence grade 2 changes are good candidates for cartilage surgery, but surgeons need to proceed slowly and select the optimal treatment, a speaker said.
“I think with cartilage, the stakes are high. It’s important for us to get it right the first time,” Aaron J. Krych, MD, said at Orthopedics Today Hawaii.
Imaging is a key part of a thorough workup of a patient who is being considered for operative or nonoperative knee cartilage treatment, he said.
“I think [you should] have a nice set of X-rays on all of these patients. I’m often sending them back downstairs for repeat films and studies, and that is OK,” said Krych, who is co-chair in the division of sports medicine and professor at Mayo Clinic Orthopedic Surgery in Rochester, Minnesota.
He encouraged the close study of patients’ MRIs, calling this a valuable tool to assess the knee joint as an organ.
“You’re looking at synovium, the amount of fluid, subchondral bone, the size, location of cartilage, etc. So, take some time and study that on your own,” Krych said.
Once the problem is diagnosed, deciding on the optimal knee cartilage treatment from the many that are now available can be challenging, according to Krych.
“Stick with the tried-and-true options. We have 3 decades of outcomes now on some of these procedures, and I think that’s good and valuable information to share with your patients,” he said, noting that managing patient expectations and the course of postoperative rehabilitation taken are critical to the result.
Based on results in the literature, patients should be told they are not going to have a fully “normal knee” or full resumption of activities after knee articular cartilage treatment, according to Krych.
“Can we improve pain? Can we improve function? Absolutely. But there certainly are limits on all these procedures,” he said.
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Krych AJ. Treatment of knee disorders in 2022: What you need to know: Articular cartilage. Presented at: Orthopedics Today Hawaii. Jan. 9-13, 2022; Waikoloa, Hawaii.
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