Joint Preservation

Joint preservation is a vital approach that aims to delay or prevent joint replacement surgery through non-surgical or surgical means. It offers several advantages, including a reduced risk of complications associated with implant surgery and infection.

The core objective of joint preservation is to restore normal, pain-free function to joints like the knee, hip, and shoulder. This is achieved through a tailored approach that includes various treatment options such as activity adjustments, physical therapy, medications, injections, and occasionally surgery.

Every patient is unique, and their joint preservation strategy is customized based on factors like age, activity level, expectations, and the extent of joint dysfunction.

Joint preservation is a proactive and patient-centered approach that prioritizes maintaining joint health and function, ultimately enhancing the quality of life without the need for immediate joint replacement surgery.

hip resurfacing
  • The point where two or more bones meet and connect via cartilage is known as a joint. The body's major joints are the hips, knees, shoulders, elbows, and ankles.
  • A damaged joint may be unable to move completely and can be very painful. This can prevent you from doing your regular activities or restrict it, mainly if the pain is persistent or chronic.
  • The joint should be preserved for as long as possible, regardless of the cause. This is especially valid if the patient is a young, physically active individual.
  • A joint may get damaged suddenly or gradually over time. Joint damage may result from an injury to the joint cartilage, trauma-induced bone dislocation, normal wear and tear of the joints, degenerative diseases like arthritis, or inherited abnormalities in the joint. Sports activities also push a joint's range of motion to its absolute limit. A wound impairs the joint's ability to function.
  • A damaged joint is surgically removed (completely or partially) and replaced with a prosthesis in a joint replacement. However, the prostheses are typically very prone to wear and tear and eventually need replacement, especially in young, active patients or athletes.

Elbow Preservation

The elbow is a complex joint that bridges the upper arm and forearm, featuring two critical joints: the humeroulnar joint (allowing arm bending) and the radiocapitellar joint (permitting forearm rotation). The joint's stability is ensured by a robust network of ligaments, muscles, and tendons.Elbow injuries frequently result from overuse, leading to symptoms such as pain, joint instability, restricted range of motion, and occasionally joint locking. Proper care and treatment are crucial for maintaining elbow health and function.

elbow preservation
shoulder anatomy

Shoulder Joint Preservation

The shoulder joint stands as one of the body's most intricate joints, linking the upper arm bone (humerus) to the shoulder blade (scapula). This remarkable joint offers an extensive range of motion in the arm, granting essential mobility. However, this impressive mobility comes at the cost of stability, making the shoulder joint susceptible to injuries and instability due to its complexity.

Hand & Wrist Preservation

The hand and wrist are a marvel of multiple small joints, facilitating intricate tasks like grasping objects, writing, or tying shoelaces. Given the daily wear and tear these essential tools endure, it's not unexpected that pain can arise, often due to overuse conditions like trigger finger or carpal tunnel syndrome. Additionally, sudden injuries are frequent in these delicate yet vital structures. Proper care and timely treatment are key to preserving their function.

hand wrist preservation
hip joint preservation

Hip Joint Preservation

The hip joint stands as one of the most vital joints in the human body. It bears the weight of the body and is essential for maintaining balance. This pivotal joint connects the thigh bone to the pelvis, boasting a ball-and-socket design that combines remarkable strength and flexibility. This construction allows for the extensive range of motion necessary for everyday activities, underscoring the hip's importance in our daily lives.

Knee Joint Preservation

The knee joint, the largest in the human body, serves as the vital connection between the lower leg and thigh. It shoulders the responsibility of supporting the body's weight in both horizontal and vertical directions. The knee's complexity arises from its composition of essential components, including bones, cartilage, ligaments, and tendons, rendering it susceptible to a range of injuries due to its critical role in our daily lives.

foot ankle anatomy

Foot & Ankle Joint Preservation

The foot and ankle form an intricate system comprising 31 bones, 33 joints, and over a hundred muscles, tendons, and ligaments. These remarkable structures serve as the foundation of our mobility, offering support, balance, and shock absorption during activities like standing, walking, and running. Their intricate design ensures our ability to move with grace and stability.


Joint preservation surgery covers a number of treatments that are an alternative option to joint replacement surgery. The aim of joint preservation surgery is to restore functionality to a joint so that it does not have to be replaced, or to delay the need to replace a joint. Joint preservation can be achieved through osteotomies (cuts to the bone) to allow the realignment of the joint.

Treatment options address two important issues biomechanics and biology.

The biomechanics includes knee realignment and ligament reconstructions of the knee. Correction of misalignment improves biomechanics by correcting bowing or knocked knee deformities of the knee and this reduces loads on certain parts of the knee joint reducing pain. The biological forms of treatment are cartilage repair techniques that include Autologous Chondrocyte Implantation (ACI) and osteochondral allograft transplant (OATS).

With the ACI procedure, cartilage cells are harvested from a non-weight bearing area of the knee and grown in a laboratory, and then implanted in the area of the cartilage defect/injury.

With the OATS procedure, autograft cartilage is used and it is obtained from the patient themselves from the non-weight bearing part of the articular cartilage. The allograft can be shaped to fit the cartilage defect and is pressed fit into place.

Ortho-biologics like bone marrow aspiration concentrate(BMAC) and platelet-rich plasma(PRP) are also viable options in the treatment of cartilage defects.

Joint preservation is usually required to address the problems caused by osteoarthritis. Although joint preservation cannot cure arthritis, it can help to relieve pain and discomfort. This form of treatment would be offered to those where non-surgical options have failed. Joint preservation is also more successful in patients who only experience joint pain in certain areas of the joint and the joint as a whole.

During the osteotomy procedure, two small incisions are made, through which a camera is passed to allow the surgeon to assess the damage. An incision is made above the tibia so that the bone can be cut, to allow the realignment of the knee so that the patient’s weight is transferred to the healthier side of the knee joint. The procedure takes up to two hours.

All surgical procedures have risks, including infection, blood clots, and nerve damage. However, the risks associated with joint preservation surgery are significantly lower than the risks of joint replacement surgery.

  • Minimally invasive (mostly performed using the arthroscopic "keyhole" technique)
  • Minimal scarring and bleeding
  • Shorter hospital stays and quicker recovery
  • Reduces or prevents future joint cartilage damage
  • Relieves joint pain
  • Enhances or restores joint function
  • Extends the life of the joint
  • Postpones or prevents joint replacement surgery
  • Restores productivity and quality of life


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