If arthritis is discovered early enough, before the shock-absorbing articular cartilage has been worn away down to the bone, then it may be possible to get the articular cartilage to repair or to slow the arthritic process down, so that the patient does not require a joint replacement. This is especially so in cases where:
a) The cartilage wear is very localised to a small area when various techniques can deliver articular cartilage repair.
b) The leg is bent (either bandy or knock kneed) which results in one side of the joint taking excess weight. Partially dividing and plating the femur or tibia in correct alignment can redistribute the weight taken by the joint to allow the worn articular cartilage to heal. This is called an osteotomy. Patients go home the day after surgery using crutches, without a brace and can be back to a sedentary job in about 3-4 weeks.
c) Excess looseness and instability in a knee, due to ligament damage, will also cause the articular cartilage to wear prematurely. Stabilising the knee by ligament reconstruction can effectively halt or slow down the arthritic process.
Knee replacements are best deferred until patients are in their 60s and these techniques or a combination of them are very useful in halting or slowing arthritis until the patient is of an appropriate age to consider joint replacement.