If opened, with new technologies, at the end of the last century a hope to slow the rise of treatments with PROSTHETIC KNEE SURGERY, without forgetting the combined treatments of CAR and warm/femoral osteotomies in these fourteen years of this century was presented with a great illusion, osteochondral transplantation, which so far have not been able to rely exclusively on to estimate that we have won the battle for Knee Osteoarthritis.
Neither autologous chondrocyte transplantation, nor the mesenchymal stem cells, over a few years, it has been found, one with calcification of cartilage degradation, tapering and showing fibrillation and surface irregularities. Passing in recent times to the search for genes capable of encoding chondroprotective substances or condroregenadoras, having multiple studies in use, but until today no certainty of success.
¿So what is the most optimal way to beat knee osteoarthritis ? As a pediatric orthopedist, on our first professional stage, we find that, like other colleagues, one knee congenital deformation in relation to their axes and the anomalous situation of the patella, had to stop her in time to allow to the prevention, the subsequent treatments were easiest for final correction.
If we start team Orthopedists, both experts in corrections non surgical, such as surgical, in these early stages, following preventive measures, physical therapy, obesity control, hygiene footwear, postural hygiene, occupational ergonomics, personalization of exercise, etc., in the future of these patients could possibly avoid increasing the prosthetic surgery.
That has been our experience in forty years and to this day, begins to assume the important thing is to fight to reduce total knee prosthesis in all Public and Private Services, but with advances in biomechanics and bioengineering, total or partial knee replacement, can be the best remedy for a Gonarthrosis varus/valgus/flexo, available to any Orthopaedic Surgeon, rising increasingly, for the prolongation of life in our Country, leading some sums of concern expenditure Private and Public System Cias.
Without using the familiar and useful algorithms to achieve success in a surgical intervention knee, with a mild or severe injury of cartilage, to this day, after a long period of time our attitude has always been based on conservative techniques, as comfortable for the patient, within biocompresivos them with methods of fixation of warm/femoral shaft corrective osteotomies to prevent the progression of osteoarthritis. These and other behaviors to avoid surgical placement of prostheses, as late as possible, has been a constant in our last ten years.
We agree also that, like other orthopedists, by our long experience in more than six thousand arthroscopies adults, 60 percent are injuries cartilage, you precursor some of osteoarthritis of the knee to be treated with prosthesis, less frequently in patients below 30 years, where we found just below the five percent. We consider why, with new generations from Orthopedists Children, adults should follow preventing prevention and evolution of lower extremity deformities, curable at these ages by conservative and surgical methods.
In our adolescent and adult patients with family history and with mild and moderate disorders axes are supporters, as described previously, to personalize as treatments from nutritionists, orthotists, fisioosteopatas, postural hygiene, downloads and in cases of discomfort permanent, conservative treatments, collagen injections, hyaluronic alternating with, or growth factors-enriched plasma.
The simple or extensive loss of cartilage in cargo area, our long experience with osteochondral IMPLANTS OR AUTOGRAFT ( Technique mosaicplasty ) associated or not with other surgical techniques ( Tibial Osteotomy normocorrectivas ), together with the use of enriched plasma factors growth, and general measures raised previously, has ensured us to reduce the number of cases in prosthetic surgery.