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Joint Resurfacing 

What Is Joint Resurfacing?

At OrthoCare, we often prefer the term joint resurfacing rather than “joint replacement” because it more accurately describes what is happening during surgery. In many cases, we are not removing the entire joint. Instead, we are carefully removing the damaged cartilage and a small amount of underlying worn bone and replacing those worn surfaces with smooth metal and medical-grade plastic components that recreate the joint surface. This is how major organizations describe knee arthroplasty as well.

For many patients, especially those with advanced arthritis, the pain does not come from the whole knee being “bad.” It comes from the joint surfaces having worn down, becoming rough, inflamed, and no longer gliding smoothly against one another.

The Tire and Rim Analogy

A helpful way to think about this is to compare the joint to the tires and rims on a car.

Over time, as a car is driven mile after mile, the tires gradually lose their tread. In a similar way, the smooth cartilage in a joint can wear down over many years of use. That cartilage is the cushion that allows the bones to move smoothly.

But when arthritis progresses, the problem does not stop with the “tread.” Once the cartilage wears away, the underlying bone can also become damaged and irregular. The joint surfaces may lose their smooth contour and proper fit. Instead of gliding, the joint begins to grind, catch, stiffen, and hurt.

Joint resurfacing is designed to address that problem by restoring those damaged surfaces. In simple terms, it is similar to replacing both the worn tire tread and the damaged rim with a new smooth surface built for motion.

What Happens During Joint Resurfacing?

In a knee resurfacing procedure, the damaged cartilage and worn bone are removed from the surfaces of the joint. The surgeon then precisely prepares the bone and places metal components that recreate the shape of the femur and tibia. A durable medical-grade plastic insert is placed between them to allow smooth motion. In some cases, the underside of the kneecap may also be resurfaced depending on the patient’s anatomy, arthritis pattern, and surgical judgment. This is consistent with how AAOS and Mayo Clinic describe total knee replacement.

The goal is to create:

• smoother joint motion
• improved alignment and congruency
• less grinding and mechanical irritation
• more reliable pain relief and improved function

Joint Resurfacing vs. Joint Replacement

Many patients are familiar with the term joint replacement, and that term is still widely used in medicine. In practical terms, patients may hear these phrases used interchangeably. The reason we often say resurfacing is because it helps patients better understand that the operation is focused on the damaged joint surfaces, not the complete removal of the entire limb or joint structure.

That said, this is still a major reconstructive procedure. It is designed for patients whose joint damage has progressed to the point that nonsurgical options such as activity modification, medications, injections, bracing, or physical therapy are no longer providing enough relief. Joint replacement surgery is commonly considered after these more conservative measures have failed to adequately control pain and loss of function.

Who May Be a Candidate?

Joint resurfacing may be an appropriate option for patients who have:

• significant arthritis causing pain with walking, stairs, standing, or daily activity
• stiffness, swelling, or loss of motion
• pain that interferes with sleep or quality of life
• X-ray evidence of advanced joint wear
• persistent symptoms despite appropriate nonsurgical treatment

Not every patient needs a full resurfacing of the entire knee. In some cases, if arthritis is isolated to only one part of the knee, a partial knee resurfacing may be considered instead of a total knee resurfacing. In unicompartmental knee replacement, only the affected portion of the knee is resurfaced.

At OrthoCare, we also offer the MISHA Knee System for appropriately selected patients as an alternative to traditional knee resurfacing or replacement in certain situations. MISHA is an implant placed alongside the knee joint to reduce load on the medial compartment rather than replacing the joint surfaces. The FDA authorized the MISHA Knee System in April 2023 for certain patients with medial compartment knee osteoarthritis who continue to have pain with daily activities after prior treatment and who are unwilling to undergo, or are not candidates for, total knee replacement due to age or the absence of advanced osteoarthritis.

If you are interested in learning whether you may be a candidate for joint resurfacing, partial knee resurfacing, or the MISHA implant, our team can help guide you through the options based on your symptoms, imaging, goals, and stage of arthritis.

Learn more about the MISHA Knee System

Our Goal at OrthoCare

Our goal is not simply to perform surgery. Our goal is to help restore comfort, function, and confidence in movement.

When joint surfaces become severely worn, every step can become a reminder that something is wrong. Joint resurfacing is intended to restore a smoother mechanical surface so that the joint can move more comfortably again. For the right patient, this can mean less pain, better function, and a return to many of the activities that arthritis has made difficult.

A Better Way to Understand the Procedure

For many patients, the phrase “joint replacement” can sound more intimidating than what is actually being done. Thinking of the surgery as resurfacing worn-out joint surfaces often provides a clearer and more accurate picture of the procedure.

You are not losing your whole knee. Instead, the damaged surfaces are being reconstructed so the joint can function more smoothly again.

Schedule an Evaluation

If knee arthritis is limiting your mobility, interfering with sleep, or keeping you from the activities you enjoy, OrthoCare can help you understand your options. We will review your symptoms, imaging, prior treatment, and goals to determine whether continued conservative care, partial resurfacing, or total joint resurfacing is the best path forward.