Dr. Wolfson performs Joint preservation surgery in the San Francisco Bay area. The most common form of joint preservation surgery is arthroscopic. In this circumstance, a clean out of all the pain mediators in the knee may be indicated. This would involve removing irritated synovium, releasing scar tissue and contractures, removing offending bone spurs, and trying to improve a patient’s motion in both their patellofemoral joint and the tibiofemoral joint. This would especially involve patellar mobilization and trying to regain full knee extension.
Arthroscopic joint preservation surgery has been found to be very effective at The Wolfson Orthopedics when it is combined with an aggressive post-operative rehabilitation program with focus on daily physical therapy for 1-2 weeks after surgery to make sure the patient has maintenance of their range of motion, has reactivation of their muscles and has attempts to decrease swelling post-operatively. It is especially important to try to control knee swelling because this will cause quadriceps shutdown and atrophy, increased pain, and can limit motion. In general, the results of joint preservation surgery are very dependent upon the patient working with a physical therapist following surgery. A properly guided rehabilitation program is essential to achieve one’s maximal outcomes after this type of surgery. In fact, if a patient cannot participate in this type of therapy program, we will generally discourage an arthroscopic joint preservation surgery because we have found that in patients who do not participate in physical therapy commonly have a recurrence of stiffness, scarring, and muscle atrophy.