No, I'm not going to lather my knee in flaxseed oil or indulge in the homeopathic approaches to my knee ailment. Once again I sought outside counsel on my knee options, looking for answers and justification. Another second opinion could never hurt right?
Opinions are alike elbows though; everyone's got a couple. This holds true with orthopedic surgeons as well and their opinions are typically centered around the sound philosophy they abide by.
Case in point: the doctor I consulted with last week. This orthopedic surgeon came highly recommended from a website forum that I frequent (note: if you're interested in personal testimonials and experiences from others dealing joint replacements, visit www.bonesmart.com. It's an amazing website with lots of information and support). His name is Dr. Bugbee and he specializes in cartilage restoration and osteochondral allograft transplantation. Basically, he provided a biologic alternative to a mechanical knee restoration.
Dr. Bugbee's philosophy is simply this: preserve the native infrastructure as much as possible.
To do this, he goes to great lengths to circumvent knee arthroplasty until it is absolutely necessary, especially in younger patients like myself. For example, he is a huge fan of knee osteotomy procedures. Google "knee osteotomy x-ray" and tell me it doesn't look like the most medeviel, archaic form of surgery you've ever seen. Essentially, they cut out a wedge of bone and insert it into a groove cut into your femur. The idea here is to unload the damaged knee compartment by adjusting the alignment of your leg: A dozen screws later, the hardware is in place and your alignment is neutral once again:
Opinions are alike elbows though; everyone's got a couple. This holds true with orthopedic surgeons as well and their opinions are typically centered around the sound philosophy they abide by.
Case in point: the doctor I consulted with last week. This orthopedic surgeon came highly recommended from a website forum that I frequent (note: if you're interested in personal testimonials and experiences from others dealing joint replacements, visit www.bonesmart.com. It's an amazing website with lots of information and support). His name is Dr. Bugbee and he specializes in cartilage restoration and osteochondral allograft transplantation. Basically, he provided a biologic alternative to a mechanical knee restoration.
Dr. Bugbee's philosophy is simply this: preserve the native infrastructure as much as possible.
To do this, he goes to great lengths to circumvent knee arthroplasty until it is absolutely necessary, especially in younger patients like myself. For example, he is a huge fan of knee osteotomy procedures. Google "knee osteotomy x-ray" and tell me it doesn't look like the most medeviel, archaic form of surgery you've ever seen. Essentially, they cut out a wedge of bone and insert it into a groove cut into your femur. The idea here is to unload the damaged knee compartment by adjusting the alignment of your leg: A dozen screws later, the hardware is in place and your alignment is neutral once again:
Are you kidding me? I'm looking for pain relief, not Forrest Gump's magic shoes. Certainly this wasn't the biologic approach he alluded to. Abiding by his own mantra, Dr. Bugbee explained how an osteotomy would be the the most bone conserving surgical option since there would be no resurfacing involved. It would allow me to resume my usual high-impact activities as well and preserve future joint replacement options.
Why a knee osteotomy not a feasible option for me:
1) My personal research has shown that knee osteotomy is preferrably indicated in patients with several vagus/valgus deformity (ie, bow-legged or knock-knee's). I have neither.
2) An unloader brace attempts to re-create the mechanics of this procedure. So relief from an unloader brace should translate to relief from this procedure. The unloader brace wasn't significantly helpful for me.
3) Statistically, an osteotomy has an average lifespan of about 10 years with a 70% failure rate after that. From there, a total knee replacement is almost inevitable. Unicompartmental resurfacing has a 10 year survival rate of >90% and there's a possibility that the compartment could be revised so as to delay a total knee replacement.
In the end, Dr. Bugbee realized I wasn't receptive to procedure, nor would I be a suitable candidate for it. And with that, he agreed that Dr. McBride's initial treatment plan was a feasible option for my condition. I can't blame him for suggesting such an alternative. Besides, isn't that the point of a second opinion?
Why a knee osteotomy not a feasible option for me:
1) My personal research has shown that knee osteotomy is preferrably indicated in patients with several vagus/valgus deformity (ie, bow-legged or knock-knee's). I have neither.
2) An unloader brace attempts to re-create the mechanics of this procedure. So relief from an unloader brace should translate to relief from this procedure. The unloader brace wasn't significantly helpful for me.
3) Statistically, an osteotomy has an average lifespan of about 10 years with a 70% failure rate after that. From there, a total knee replacement is almost inevitable. Unicompartmental resurfacing has a 10 year survival rate of >90% and there's a possibility that the compartment could be revised so as to delay a total knee replacement.
In the end, Dr. Bugbee realized I wasn't receptive to procedure, nor would I be a suitable candidate for it. And with that, he agreed that Dr. McBride's initial treatment plan was a feasible option for my condition. I can't blame him for suggesting such an alternative. Besides, isn't that the point of a second opinion?