Knee Surgery Options
Dr. Davidson has made it the guiding principle of his practice to offer an ever increasing array of surgical options to restore damaged knees. He is not a proponent of one procedure or device, but rather strives to offer the best possible solution for each patient, on an individualized basis. Historically Orthopedic Surgeons have typically performed arthroscopic debridement (clean up) and when that does not work they offer patients a Total Knee Replacement. There are many situations and circumstances where options between those two extremes are critically beneficial.
Arthroscopic Chondroplasty (joint smoothing) This entails using specially designed and dedicated instruments to smooth the joint surface. Dr. Davidson uses special temperature controlled devices to safely smooth and seal the irregular surfaces. Rendering partially damaged cartilage can often yield good relief.
Nanofracture Nanofracture is the “modern” version of microfracture. Using a better, safer and more precise technique, 1mm channels are created into the bone marrow, allowing a patient’s stem cells to help grow tissue on the joint surface. This process is often augmented with injected stem cells to promote growth of cartilage tissue.
Cartilage Grafting ( Cartiform) Using cryopreserved cartilage grafts with a small amount of bone, this procedure allows “patching” of large areas of the knee surface. This technique is preferred when the underlying bone is healthy and in many patellar defects.
Osteochondral Grafting This procedure has a been successfully used for decades to restore damaged joints. This technique allows restoration of cartilage and bone defects, especially in younger people.
Meniscal Repair Meniscal repair is critical to maintain the health of the knee. The meniscus protects the articular cartilage, and when the meniscus is removed, accelerated wear and tear may occur. Dr. Davidson employs special techniques, devices and methods to promote healing of the meniscus whenever possible. For many years the American Academy of Orthopedic Surgeons and the Arthroscopy Association of America have invited Dr. Davidson to teach his peers about advances in meniscal repair.
Meniscal Replacement (Transplantation) This procedure is undertaken in patients in whom the meniscus has been removed and they are having certain symptoms. This procedure is not common, and very few surgeons undertake this challenging surgery.
ACL Reconstruction – Biologically Enhanced The knee must be stable to function normally. Dr. Davidson performs ACL reconstruction including using the most advanced graft choices, including the combination of allograft and autograft. Dr. Davidson performs revision ACL surgery and complex combined ligament surgeries.
Fracture Repair Broken bones around the knee (Tibia, Femur, Patella) are almost always associated with injuries to the internal knee structures. Dr. Davidson combines expert fracture repair with repair or reconstruction of the anatomy within the knee.
Inlay Resurfacing Using minimally invasive prosthesis, Dr. Davidson is able to restore a smooth surface to damaged joints. This can prevent further wear and relieve pain with activities.
Onlay Resurfacing The knee has three parts: front, inside and outside. When one or two parts of the knee are damaged, they can be selectively resurfaced and restored. The healthy parts of the knee can be preserved. Onlay implants are created specifically for the patient using computer generated 3-D printing and manufacture.
Patellofemoral Surgery The “knee cap joint” is a particular area of interest for Dr. Davidson. As a long standing fellow of the International Patellofemoral Study Group, he is devoted to helping patients with anterior knee pain get relief and improve their function. Cartilage Restoration and Joint Resurfacing techniques are typically combined with realignment procedures to reconstruct the joint.
Complex/Combination Surgery Techniques of Cartilage Restoration, Joint Resurfacing and Reconstructive surgeries can be combined, when indicated, to restore knees with complex deformity. There are alternatives to TKA, especially in the active adult.
Total Knee Replacement (TKA) In certain situations TKA is a valuable and appropriate procedure. This surgery allows restoration of alignment, stability and motion. Dr. Davidson utilizes minimally bone sacrificing and ligament preserving techniques. In addition, he utilizes computer enhanced methods to digitize the limb and plan surgery pre-operatively.