For athletes, the love of the game is often undercut by the fear that an unexpected injury will bring their careers to a sudden end. Take, for instance, a local college basketball player who twisted his knee and played with pain for the rest of the season without telling anyone how he was feeling. When he finally saw a doctor, the MRI showed a large complex meniscus tear that did not appear to be repairable.
In an attempt to keep him in the game, he underwent arthroscopic surgery that confirmed the meniscus repair could not be carried out, and they removed more than 75% of the damaged tissue. After the surgery, the patient continued to have joint pain and was unable to return to basketball, the worst news an athlete can hear.
Fortunately, the story does not end there. The player next received a meniscus transplant in a joint preservation procedure by CarePoint Health’s Yaser El-Gazzar, MD, but would that be enough to get him back to the game?
Dr. El-Gazzar, Director of Sports Medicine at Christ Hospital, provided answers to questions about joint preservation and how this procedure opens doors for young athletes that joint replacement cannot.
What is joint preservation?
Joint preservation is an ever-growing subspecialty of sports medicine orthopedics focused on preserving the cartilage health of joints. Examples of joint preservation would include cartilage transplants, meniscus transplant, realignment procedures, hip labral repair, and others. However, each one of those techniques is custom tailored for the patient being treated. There is no cookie cutter approach in utilizing joint preservation techniques in treating your patient.
Why is joint preservation a good alternative to total joint replacement, for qualifying patients?
Joint preservation provides another option in the treatment of young athletes to prevent the injured joint from progressing to a level where a total joint replacement is the only solution. It allows the younger athlete to resume activity without further damaging their joint and cartilage.
The ideal candidate for a joint replacement, on the other hand, is older and has a modified activity level. There is a huge difference between the postoperative expectations and activity level of a young soccer player compared to a more senior patient who is playing golf.
What are some of the main benefits to patients for electing joint preservation over total joint replacement?
Total joint replacements have proven to be one of the most successful surgeries ever pioneered by man. In the end, though, it is a man-made creation designed to re-create nature’s anatomy. The occurrence of catastrophic complications are rare, but they do happen including infection, allergic reaction, and early catastrophic failure.
Early catastrophic failure is possible because a joint replacement is a mechanical design relying on the interaction of metal and plastic. Imagine you and I purchase the same car from the same car dealership on the same day. Your car can last 20 years without any issues, while my car can break down after two months. It’s just mechanical failure with no explanation. The same is possible with joint replacement; it has nothing to do with the surgeon, surgical technique, or the implants.
The younger the patient that undergoes a total joint replacement, the more likely that these devastating complications can occur during their lifetime. This means that they will encounter the need for a revision total joint replacement in their lifetime. Joint preservation is not susceptible to this outcome.
How is CarePoint leading efforts in joint preservation?
My experience at CarePoint so far has been amazing. CarePoint’s most notable contribution has been their unrestricted resolve to provide me with the equipment and implants needed to deliver cutting edge joint preservation procedures to the population of Hudson County. They also aid in supplying high quality musculoskeletal imaging and MRI to serve as the diagnostic tool for these conditions and cartilage injuries.
CarePoint also partners with my practice to conduct outreach to the local schools and student athletes in Hudson County. We provide coordinated sports injury care from start to finish including:
- The initial injury on the field
- Expedited ER evaluation
- Orthopedic outpatient follow-up
- Definitive diagnosis and treatment plan
All this is achieved while communicating efficiently with the athletic trainers and coaches at the schools, the athletes themselves, and the families.
As for our college basketball player, joint replacement was not an option for him due to his very young age. Without the meniscus transplant he received, it is likely he would experience accelerated degenerative wear and arthritis in the knee joint over the next few years.
Instead, he underwent joint preservation approximately two years ago. In recent follow-up appointments, he reports that he has had no pain and has been able to return to college level basketball without difficulty. For young athletes in Hudson County, joint preservation at CarePoint could be the difference between returning to the field and hanging up the cleats.