Temple University Health Sciences Center
Contact: Andrew Smith, (215) 707-8229
Temple Surgeons Eliminating Pain From Arthritic Knees by Intentionally Fracturing Patients Leg Bones
PHILADELPHIA -- It sounds strange, but it works. To help eliminate pain caused by arthritic knees, Temple University Hospital surgeons are intentionally fracturing patients leg bones and then letting the patients pull apart the fracture 1 millimeter a day. As the fracture widens, new bone grows in the crack and fills it in.
The purpose of this procedure, called Hemicallotasis, is to shift a patient's weight off of the area in the knee where cartilage has worn away. Arthritic knees usually occur when cartilage wears away between bone. This causes the bones to rub against each other. If the cartilage has worn away on the part of the knee that bears the brunt of a person's weight, the pain is even worse.
The goal of this surgery is to shift a person's weig! ht onto a part of the knee that still has its cartilage. To do this, surgeons intentionally create a fracture on the side of the leg in which the cartilage has worn away. They then insert screws into the bone on either side of the fracture and connect them with a rod. Over a period of three weeks, the patient will turn a dial on the rod once a day. This expands the rod and pulls the fracture open by 1 millimeter a day. As the fracture grows wider, the patient's bone will naturally grow in the crack and fill it in.
"Think of it as jacking your car up," says Dr. John Kelly, one of the orthopedic surgeons performing the procedure at Temple. "When you jack up your car, the weight of the car is placed on the two tires opposite the side of the jack."
In the past, surgeons would try to achieve the same result by removing a large wedge of bone from the leg. However, this made the person's leg shorter and made it difficult to do a knee replacement if one was needed later. This procedure does not require a cast and allows the patient to begin physical therapy immediately.
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