Surgical Treatment Options
When Is Surgery Considered for Knee Arthritis?
Most patients do not arrive in Dr. Tauchen’s office excited about the idea of surgery. In fact, most have already tried a long list of treatments before they even consider discussing an operation.
They have tried:
- Anti-inflammatory medications
- Physical therapy
- Activity modification
- Weight loss efforts
- Cortisone injections
- Hyaluronic acid injections
- Bracing
Sometimes those treatments work extremely well, but they eventually stop working. The decision to consider surgery is never based on an X-ray alone.
Dr. Tauchen often tells patients:
“I don’t replace knees to make x-rays look pretty. I do it to help improve your quality of life.”
The real question is not how bad the arthritis looks. The real question is how much it is affecting a patient’s life.
If knee pain is preventing someone from exercising, golfing, traveling, walking comfortably, sleeping well, or enjoying everyday activities, it may be time to discuss surgical options. The good news is that knee replacement is not the only operation available for knee arthritis. The best treatment depends on the severity of arthritis, the location of the damage, the patient’s age, activity level, and overall goals.
One of the most common misconceptions in orthopedics is that every painful arthritic knee needs a knee replacement.
That is simply not true.
Patients with relatively mild arthritis and symptomatic meniscus tears may sometimes benefit from arthroscopic surgery. Arthroscopy involves placing a small camera inside the knee through tiny incisions to evaluate and treat specific problems.
Potential procedures may include:
- Partial meniscectomy
- Loose body removal
- Chondroplasty (cartilage smoothing)
- Debridement of damaged tissue
It is important to understand that arthroscopy does not cure arthritis. In patients with advanced bone-on-bone arthritis, arthroscopy will not provide much benefit and is not recommended. However, in carefully selected patients with mild arthritis and mechanical symptoms, it may still play a role.
Dr. Tauchen does not perform arthroscopic knee surgery.
When he believes a patient may benefit from arthroscopy, he refers them to trusted fellowship-trained sports medicine surgeons within his practice who specialize in these procedures.
For certain younger, active patients with arthritis isolated primarily to one side of the knee, an osteotomy may be considered. A high tibial osteotomy, or HTO, involves cutting and realigning the tibia to shift weight away from the damaged portion of the knee. The goal is to unload the arthritic compartment while preserving the patient’s native knee joint. Think of it like rotating the tires on a car to redistribute wear. For carefully selected patients, particularly younger individuals hoping to delay joint replacement, osteotomy can be an excellent option.
Dr. Tauchen does not perform osteotomies.
When he feels a patient may be a good candidate, he refers them to fellowship-trained sports medicine surgeons with expertise in joint preservation procedures.
For patients with arthritis isolated to a single compartment of the knee, a partial knee replacement may be one of the most attractive surgical options. Rather than replacing the entire knee, only the damaged portion is resurfaced. The most common type is a medial partial knee replacement, which treats arthritis on the inside portion of the knee.
One of the reasons Dr. Tauchen loves partial knee replacement is simple:
“You get to keep more of your own parts.”
Patients maintain:
- Their ACL
- Their PCL
- Their healthy cartilage in the remaining compartments
- Much of their native anatomy
For the right patient, this often leads to a knee that feels more natural than a total knee replacement.
Dr. Tauchen performs robotic-assisted partial knee replacement using the Mako system and considers it one of the most rewarding procedures in orthopedic surgery.
When arthritis affects multiple compartments of the knee or has progressed beyond the point where partial replacement is appropriate, total knee replacement often becomes the most reliable surgical solution. This is the most common knee surgery that Dr. Tauchen performs.
Total knee replacement removes the damaged joint surfaces and replaces them with artificial components designed to restore function and reduce pain. For many patients, this procedure can be life-changing. Activities that once seemed impossible become possible again.
Patients frequently return to:
- Walking comfortably
- Traveling
- Golfing
- Cycling
- Pickleball
- Exercising
- Keeping up with grandchildren
Dr. Tauchen specializes in robotic-assisted total knee replacement using the Mako robotic platform. He performs the procedure using a personalized kinematic alignment philosophy designed to restore each patient’s native knee anatomy whenever possible.
For patients with advanced arthritis, total knee replacement remains one of the most successful procedures available in modern medicine.
Some patients seeking treatment have already undergone knee replacement surgery and are now experiencing new problems.
Issues such as:
- Implant loosening
- Infection
- Instability
- Stiffness
- Persistent pain
- Component wear
Revision knee replacement is a highly specialized area of orthopedic surgery and varies tremendously depending on the underlying problem. Some revisions are relatively straightforward. Others are among the most complex procedures performed in joint reconstruction. Dr. Tauchen routinely evaluates patients with painful knee replacements and can help determine the cause of symptoms and whether revision surgery is appropriate.
One of the most important things patients can understand is that there is no “best” surgery for knee arthritis. There is only the best surgery for a particular patient.
A 45-year-old athlete with mild arthritis and a meniscus tear may have very different options than a 70-year-old patient with advanced bone-on-bone arthritis throughout the knee.
That is why Dr. Tauchen believes treatment should always be individualized. The goal is not simply to perform surgery. The goal is to match the right procedure to the right patient. Sometimes that means referral to a sports medicine specialist for arthroscopy or osteotomy. Sometimes it means a partial knee replacement. Sometimes it means a total knee replacement. And occasionally it means helping a patient understand that surgery is not yet necessary at all. At the end of the day, the objective remains the same: helping patients move better, hurt less, and get back to the activities they enjoy most.
Whether that means walking a golf course, riding a bike, traveling comfortably, chasing grandchildren, or simply getting through the day without knee pain, the focus is always on helping patients get their lives back—not just treating an X-ray.
At a Glance
Dr. Alex Tauchen
- Board-certified orthopedic surgeon
- Fellowship-trained joint replacement specialist
- Specializing in hip and knee replacement surgery
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