Project Description

Historically, damaged joints (primarily knees) in athletes have been treated by one of two methods: either arthroscopic “clean up” surgery, or total joint replacement. However, many people do not get sufficient relief from a “scope clean up” and are not appropriate candidates for a “total joint.” Total joint replacement provides excellent relief from painful arthritis, but surgery is extensive, and has its limitations. For example, total joints have a limited life-span (10-20 years), and high-impact sports are not recommended on a traditional total joint. Regular athletic use can shorten the expected longevity of a traditional total joint, so this may not be an ideal solution for younger, active or athletic people. In addition, a total knee replacement involves sacrificing all the internal ligaments, as well as quite a bit of bone: cutting off the end of the femur, back of the patella and top of the tibia. This is a highly invasive procedure that limits any future options should the prosthesis wear out or come loose.

Alternatively, the field of Joint Resurfacing is a new approach that offers very attractive and exciting alternatives for active adults with joint damage and pain. This approach focuses exclusively on resurfacing or replacing only the damaged parts of the joint, while preserving and retaining all the healthy bone and tissue. It leaves the joint feeling and working more normally. The patient retains an improved sense of balance and position, allowing a return to all sorts of athletics, and activities which would otherwise be painful or impossible.

There are different forms of joint resurfacing, and these may be combined with each other as well as some cartilage restoration techniques. The least invasive method is an “inlay.” Inlay resurfacing is very much like replacing damaged tiles on a tile floor. Rather than ripping out the whole floor to repair a broken or damaged tile (the cartilage) the local area can be resurfaced with an implant specifically contoured to that region of the joint. Inlay implants come in a variety of shapes and sizes. While these implants are very useful, they are limited in terms of what kind of deformities they can repair. Once the joint becomes crooked or deformed, we typically resort to using an “onlay” resurfacing implant. Onlay implants cover the ends of the damaged joint, allowing a normal angle and position to be reestablished while providing a new, smooth surface. Like inlay implants, onlays come in a variety of shapes and sizes.

Even with these modern methods, however, when all three parts of the knee are deformed and the knee is limited in motion, a modern total knee replacement may be necessary and can be an excellent alternative. Unlike traditional procedures, a modern total knee replacement now utilizes digital information technology to precisely pre-plan the procedure. Using this technology, the entire limb is digitized and a preoperative plan is developed to create guides for precise cutting and sizing. In addition, modern materials used for today’s total joint replacements allow many athletes to return to activities such as skiing, hiking, biking, tennis, equestrian, and other limited impact sports.

What Some of Our Joint Resurfacing Patients Say.

Knee Resurfacing of a marathon runnerDr. Phil Davidson – You said to stop in and see you about my knees after ski season. My knees are great and I have had no problems, so I don’t feel the need to take up any of your time. I skied a personal record 90 days this season, sometimes as many as 8 and 9 days in a row when we were having continuous deep powder. I can’t remember ever skiing without any pain before, but certainly it had to be over 30 years ago. I always carried Ibuprofen but never even thought about taking a single pill. We had so many deep powder days this year and being able to ski them with total enthusiasm made me feel like a little kid again. There were things I hoped for last spring when you operated on me, but I guess the way they turned out was even better than my highest hopes. I can’t thank you enough for giving me my knees back. I guess you know I think you walk on water, so keep up all your great work!

Salt Lake City, UT
(Active Hiker, Skier and Professor – 1 year following bilateral knee resurfacing)

B.C., Active Hiker, Skier and Professor - 1 year following bilateral knee resurfacing
I just wanted to drop an email and let you know how I am progressing with my bilateral knee resurfacing’s. Actually, I am doing very well!! Since about Thanksgiving my right knee has been pretty much recovered and now I guess I can say I got the results as I am doing what I want to do, within limits of course. My day-to-day activities have minimal, if any pain, although I do get the usual stiffness after sitting but it is very short lived once I am moving! And I am able to train 5-6 days a week! For the last two weeks I have been doing Kickboxing – it is awesome and is exactly the challenge and activity that I need. Three days a week is the actual cardio kickboxing and the other three are strength training with bands. Once I get in better shape I hope to supplement a couple days a week with biking and rollerblading – and to be able to do those with minimal if any pain is a most joyous thing!! And I’m sure once I lose some weight and get stronger I will feel all-around even better!

I realized that sometime this month, three years ago, we started this process to get me on the road to health and heart health! While that seems like a long time I am happy to say that I am where I wanted to be and I will make the most of this recovery and process!! Thanks again for all your perseverance, patience and vision.

I am sure you are enjoying your new practice in Park City and I do hope all is going well.

Thanks again!
Sincerely, Nancy
(Bilateral Knee Resurfacings)

Nancy, Bilateral Knee Resurfacings

Joint Resurfacing Presentations and Lectures Presented by Dr. Phil Davidson.

Dr. Davidson explains Joint Resurfacing of the Knee.