An innovative procedure to relieve pain in arthritic knees will soon be available in the Shenango Valley.

Hermitage orthopedic surgeon Dr. Robert Piston underwent training three months ago to start using the UniSpacer in his practice.

The UniSpacer, a kidney-shaped device made of smooth, polished cobalt chrome, is inserted in the side of the knee to open up space and take stress off the thigh and calf bones.

"In orthopedics, this is potentially the most useful device to come out in a long time," Piston said. "It's not just for a small amount of people. This will benefit a large portion of the community."

Piston is one of only four doctors trained in western Pennsylvania and the only one north of Pittsburgh. At the end of the year, only eight surgeons in western Pennsylvania will be trained.

"We're being very selective in who we choose to train," said Jim Grant, president of the Elizur Corporation, Pittsburgh, which distributes the UniSpacer for Sulzer Orthopedics Inc. "We want to make sure we pick the right surgeons, that they are trained well and that they choose the right patients for surgery."

The UniSpacer was developed by surgeon Dr. Richard Hallock. The device was approved for use in the United States in January 2001 and surgeons began training to use it this year, Grant said.

Piston will begin offering the surgery this month. Two patients are already lined up for surgeries in the middle of the month.

"It's exciting for me," Piston said. "No one else in the area has it. So people who want the UniSpacer will have to come here."

The UniSpacer is for people who suffer arthritis knee pain but are not old enough or debilitated enough to have a total knee replacement, Piston said.

Before the UniSpacer, people who suffered knee pain due to arthritis had few options.

Conservative treatment, such as anti-inflammatory medication, icing, knee braces and special shoes can relieve pain temporarily. The other extreme is a total knee replacement, which surgeons are reluctant to perform on younger people because they may have to undergo the procedure several times in their lifetimes.

A total knee replacement lasts about 15 to 25 years, less in younger people.

"If they're only 40 when they have a knee replacement, they will have to have another one at 55. Bone destruction keeps occurring," Piston said.

One of the advantages of the UniSpacer is surgeons can implant it without cutting any bone.

In a healthy knee, a piece of cartilage called the meniscus absorbs shock. But as the cartilage tears and breaks down, the bones become closer and closer together.

The UniSpacer opens up the space and takes stress off the ends of the bone, reducing "wobbling" in the knee caused by arthritis, Piston said.

The procedure is a minimally invasive one. The surgeon makes a small incision in the side of the knee and inserts the device. The patient only spends one night in the hospital and can quickly return to normal activities.

However, the UniSpacer is not for everyone.

"We're very selective in picking people for this because we want to see as many good results as possible," Piston said.

Although age is not a factor, patients must meet other criteria. Only patients with arthritis on the inner knee are eligible for surgery.

"If they have arthritis under the kneecap, we won't do it," Piston said. "There would still be pain under the kneecap even if it took the inner knee pain away ... even if it helps on one side of the knee, it's considered a failure if it doesn't help other parts of the knee."

Even if the UniSpacer fails, the knee remains the same as it was before surgery because no cartilage or bone was cut, Piston said. The patient can then go on to have a total knee replacement.

But Piston said he does not think the UniSpacer will fail.

The only way it could fail, he said, is through continued progression of arthritis through the knee, which would make the UniSpacer no longer useful, or by selecting the wrong candidate for the surgery.

"I'm very excited about it," Piston said. "I think it's the greatest thing to come along in a long time."