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hi my name is Eric Nielsen Im a board-certified orthopedic surgeon today well be discussing a minimally invasive treatment alternative to both knee arthritis and knee replacement surgery [Music] there are over 600,000 total knee replacements done per year in the United States thats a big number and theres a 45 percent chance that you will have knee arthritis at some point in your lifetime so what is arthritis its not the presence of a disease its actually the loss of cartilage and so what happens is if you think of a end of a chicken bone without white on the end of a chicken bone thats cartilage and its on the end of every bone and it acts as a shock absorber and cartilage doesnt have any nerves so that cartilage wears away the bone ends feel pressure and so theres no cartilage and so that pressure builds up and it actually causes a subchondral fracture just beneath the joint line so whats the significance of a subchondral fracture well that pressure phenomenon we just talk