Are Synthetic Plugs a Viable Alternative to Knee Replacement?

There’s another ‘alternative’ to knee replacement in development. But is it worth pursuing such alternatives? Alex explains.

Doctor Examining Patient's Knee*photo courtesy of Dmytro Zinkevych via shutterstock

Patients often ask me about alternatives to knee replacement surgery. They have good reason to. Surgery is never a knee surgeon’s first recommendation. You would always want to exhaust other possibilities because surgery inevitably carries greater risk—even if only a small risk—than non-surgical options.

Even when surgery is the best option for a patient with osteoarthritis, that doesn’t have to mean knee replacement. As I explore in my post about osteotomy, for example, other surgical options may be the better choice for certain groups (or age groups) of patients.

In younger patients, we may wish to avoid a knee replacement. Alignment and how weight travels through the knee is vitally important here. Offloading the effects of arthritis by transferring weight to other parts of the knee by using orthotics, braces or surgical realignment (like the osteotomy I mention above) can be effective. At the very least, it can help delay the need for knee replacement until such time as it’s a more viable option.

It’s a similar case with replacing lost cartilage.

   >   Discover more about knee replacements

The cartilage plug
You may have seen a new ‘alternative’ to knee replacement doing the rounds on news and social media pages recently. The synthetic cartilage-capped regenerative osteochondral plugs (CC-ROPs) are in development, and the developers suggest they could be used to address knee pain caused by cartilage loss. In doing so, they could also help delay or even prevent the need for knee replacement.

At least, that’s the theory.

It’s important to note that the plugs aren’t yet in clinical studies. But even if they pass all necessary trial stages, it’s likely the opportunities for use may be restricted to younger patients.

That’s because of the way cartilage loss occurs in patients of different ages. Younger patients are more likely to lose isolated pieces of cartilage. Like a jigsaw puzzle, it’s easier to identify a single piece that’s missing and (potentially) slot a similarly sized plug in its place. In older patients, cartilage loss doesn’t happen like that. It’s more general and less focused on a specific area. You cant plug a single gap because there isn’t one.

So it is possible the new plugs may in time become a tool that your knee surgeon may use in limited scenarios.

But for most patients, knee replacement will remain the most common form of surgery for arthritis. Over 100,000 of them are performed in the UK every year. The new plugs are unlikely to alter that situation.

To discuss your knee pain and options for knee replacement, call my Cheltenham knee clinic now on 01242 246549 or book your appointment.

>   Discover more about partial & total knee replacements
>   Discover more about osteoarthritis of the knee