Most people take about 8,000 to 10,000 steps a day. In the average lifetime, that's 115,000 miles.

Most cars wear out by then -- so why shouldn't your knees?

More than 400,000 people will need knee replacements this year, but before Gen Xers go for the total trade-in, there's a new option that will keep younger knees in place longer.

They're the two loves of Melissa Link's life -- Elvis Presley and her son Sean. At the Rock and Roll Hall of Fame she enjoys both if she can keep up.

"It's hard to do things on the playground or to carry him or to do the physical things down on the floor, tying the shoes, everyday things you do," says Melissa

Melissa suffered severe knee pain since she was 14. Doctors said there was little they could do.

"He laughed at me and he told me my knees were bad and I wasn't old enough for knee replacements, that was just the way my life was going to be."

Anthony Miniaci -- orthopedic surgeon and director of the Cleveland Clinic Sports Health Center -- spent ten years inventing a device to help people like Melissa.

"This is a resurfacing replacement," says Dr. Miniaci.

This new "partial" resurfacing is designed for people in their 40's and 50's with the early signs of arthritis.

"You can see we can have different shapes and models to replace the parts of the joint that are arthritic without actually having to replace the whole joint," Dr. Miniaci explains.

Surgeons make a three-centimeter incision to place the metal implant. Unlike total replacement surgery, the knee cap stays in place and no muscle is cut.

Patients are in the hospital for one day instead of up to ten.

"What we've done here is that we actually replace your own anatomy so that once this is all healed and done, the function and range of motion of your knee should be exactly the same it was before."

The new approach removes very little bone compared to the traditional replacement.

For the first time in more than a decade, Melissa's knees are pain free.

"It's changed my life,” she says. “It's opened up being able to live life. You know, 29 years old is too young to have arthritis."

This procedure gives younger patients another option when stem cells and cartilage fail to help heal knees.

Doctor Miniaci says he hopes the partial resurfacing can ward off total knee replacement for 15 to 20 years.

RESEARCH SUMMARY
TOPIC: SAVING KNEES
REPORT: MB #3024

BACKGROUND: Arthritis is the leading cause of disability among Americans over
age 15, according to the Arthritis Foundation. The condition is second only to heart disease as a
cause of work disability. Knee pain caused by arthritis can be caused by one of three forms of arthritis. In osteoarthritis -- the most common form of arthritis in the knee -- the joint cartilage gradually wears away. Rheumatoid arthritis is an inflammatory type of arthritis that can destroy joint cartilage. Post-traumatic arthritis often develops after a knee injury, but presents itself similarly to osteoarthritis. Usually, arthritis pain develops gradually. Patients with knee arthritis often notice the joint becoming stiff and swollen, making it difficult to bend or straighten
the knee. Patients often report the pain being worse in the morning and causing a feeling of weakness in the joint that can lead to "locking."

WHO'S AT RISK? The risk of most types of arthritis increases with age and body weight. Women who are older than 50 are more likely to develop knee arthritis than men, and some
evidence suggests genetics may play a role. Other factors that increase a person's chances of developing osteoarthritis of the knee include previous trauma; repetitive stress to the joint like kneeling, squatting or lifting at least 55 pounds regularly; and participating in high-impact sports like soccer and tennis.

TREATMENT: The American Academy of Orthopaedic Surgeons says only one in four
people with knee osteoarthritis need surgery. Nonsurgical treatments include losing weight,
special exercises, medication and supportive devices like shoe inserts, braces and canes. When surgery is necessary, surgeons may turn to arthroscopic surgery to clean out the knee or repair torn cartilage; osteotomy to cut the shinbone or thighbone to improve the knee joint's alignment; or knee arthroplasty, which involves replacing severely damaged knee joint cartilage with metal and plastic. For some people with limited cartilage loss, cartilage grafting is an option. In cartilage grafting, cartilage is either transplanted from another part of the body into the knee or a sample of knee cartilage is removed and cultured in a lab.

FIXING YOUNG KNEES: Although arthritis most often affects middle-aged and older people, some patients begin having knee pain much younger. Treatments specifically for this
younger population are emerging, including partial knee resurfacing. The procedure involves removing only damaged cartilage and minimal bone and implanting a small replacement. Surgeons at the Cleveland Clinic use a system called UniCAP, which treats damaged surfaces on the inside or outside of the knee as well as under the kneecap.

FOR MORE INFORMATION, PLEASE CONTACT:
Dr. Anthony Miniaci
Cleveland Clinic Orthopaedic and Rheumatologic Institute
(216) 518-3480
miniaca@ccf.org

http://www.clevelandclinic.org/sportshealth