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Knee Resurfacing

Knee resurfacing is an operative procedure that addresses localised cartilage (joint surface lining) defects in the knee joint and improves pain and function.

What is a femoral condyle cartilage defect?

The knee joint consists of three bones; the femur; the tibia, and the patella or knee cap. The ends of the femur and tibia glide against each other as you move. Cartilage is the slippery shock absorbing material that covers the ends of bones to allow pain free movement. A femoral condyle cartilage defect disrupts this surface which can lead to pain and loss of movement. If these defects are not treated they typically grow in size and depth until the pain is unmanageable.

Most of these defects are routinely treated by a technique called micro-fracture (drilling small holes in the bone) to promote some healing and eventually sealing off the defect with a layer of fibrocartilage.

Generally, in people aged between 35-65, sometimes these defects are quite large and the results with the micro-fracture technique are not very predictable or successful and in other people sometimes the micro-fracture treated areas fail and in both these situations using an implant to address the localised cartilage defect helps with pain and function.

There are various knee resurfacing options with different sized implants and materials and even patient specific implants.

The implants I routinely use to address these defects are Biopoly and Episurf.

What is the BioPoly RS Device?

BioPoly RS is an implant utilizing an advanced biomaterial to resurface (RS) cartilage defects. The BioPoly RS material contains hyaluronic acid, a naturally occurring biomolecule found in the joint fluid. This gives the implant enhanced lubricity and allows the femur and tibia to glide against each other without causing pain or additional damage.

So what does this mean?

We can now replace only the damaged portion of cartilage with an implant that interacts favourably with the surrounding tissues. Since the implant and procedure are minimally invasive you can recover rapidly and return to a pain free active lifestyle quickly.

How much time will I be off work and what is the recovery process?

The exact amount of time you will need to recover before going back to work will depend to a certain extent on how large the defect is an where in the knee it is, but, the BioPoly RS implant allows you to begin walking immediately, resulting in rapid rehabilitation and return to activity.

Images of cartilage defects and Bioploy implant are below.

Episurf

Episealer Knee Trochlea

Episealer Femoral Condyle

Episealer® Femoral Condyle, Knee Trochlea & Epiguide® – a patient-specific approach

The Episealer® Femoral Condyle and Knee Trochlea are individually customised resurfacing implants intended for the knee condyle or trochlea for treatment of localised cartilage defects. This treatment is for patients suffering from pain and reduced mobility due to cartilage damage in the knee, and is designed to eliminate pain and to enable recovery of the mobility of the joint.

For Whom – a typical patient

This is an effective treatment for patients between the ages of 35 and 65 who have been diagnosed with a focal cartilage lesion on the femoral condyle or trochlea. These categories of patients are often too old to effectively undergo biological treatments like micro-fracturing, yet are too young and active to undergo knee replacement surgery. Therefore the Episealer® Femoral Condyle and Knee Trochlea implants for this group of underserved patients allow treatment of early stage focal cartilage damage by replacing the damaged area only. The ultimate goal is to save patients from years of pain by restoring the joint function, yet at the same time maintaining the possibility for future treatment options.

The Episealer® Femoral Condyle and Knee Trochlea implants are designed to offer an alternative for patients who might have endured years of pain and loss of knee joint function while waiting to reach the appropriate age for joint replacement surgery.

Individually customised implants and surgical tools – enabling high precision and predictable surgery for optimal positioning of the implant.

Episurf provides a patient-specific system where the implant and surgical tools are individually customised to the joint anatomy as well as to the size and position of the lesion. This allows for the controlled removal of pathological tissue with the maximum amount of healthy tissue being preserved, keeping options for future surgical choices open. The Episealer® implant is customised to each patient’s injury and joint anatomy, recreating a smooth, continuous weight bearing surface.

A patient-specific approach

 The patient-specific designs of the Episurf implants and surgical guides are based upon MRI imaging. By processing the MRI data, a 3D model of the damaged joint is recreated. The lesion is identified and the implant and surgical guide are designed to enable the replacement of the damaged area with a perfectly fitting implant.

The use of individually customised tools increases the precision of the surgical procedure enabling an optimal positioning of the implant.

  • BMI THE ALEXANDRA HOSPITAL
  • Spire Cheshire Hospital - Spire Healthcare
  • St Helens & Knowsley NHS Trust
  • Ten Harley Street
  • BMI Beaumont Hospital
  • Spire Manchester Hospital