Knee Arthritis

The knees are major weight bearing joint and are therefore subject to extreme physical stresses which can over time result in the deterioration of the cartilage within the joint. This is the most common type of arthritis to affect the knee and is a condition called osteoarthritis or ‘wear and tear’ arthritis. Other types of arthritis include post traumatic arthritis which is arthritis secondary to a fracture or traumatic injury to the knee and inflammatory arthritis which is related to connective tissue diseases such as rheumatoid arthritis. The symptoms associated with knee arthritis are knee, thigh and leg pain, limping, weakness and joint stiffness. Typically there will be a progressive inability to perform routine activities such as putting on shoes and socks. Treatment for cases of minor or moderate arthritis are oral anti-inflammatory medications, injections, exercise and physical therapy.

Treatment

In cases of mild to moderate arthritis where non-invasive treatment has not been effective and injectable medication to cushion and lunricate the joint can be used. This medication is a form of hyaluronic acid which is the normal lubricant and cushion in the knee and tends to lose its biomechanical properties as part of the degenerative process. By restoring the level of hyaluronic acid in the knee to normal symptoms of pain and stiffness can be substantially relieved. The level of response to this treatment and the duration of the effect is variable but may be near complete releief of symptoms in some cases and can last for more then 1 year. In cases where the relief is substantial and long lasting the injections can be repeated every 6 months. In some cases where arthritis is associated with loose bodies and meniscus tearing an arthroscopic procedure is recommended prior to injection for the purpose of optimizing the mechanics of the environment and eliminating any other potential sources of pain from the knee. When this is done it is an ambulatory procedure and injections can start within 1-2 weeks of the procedure.

In cases of moderate or severe arthritis where other less invasive treatment have not been effective, more invasive procedures can provide relief. These include such things as realignment osteotomy, cartilage transplantation (see other section), unispacer, partial knee resurfacing or total knee replacement.

Unispacer is a procedure preformed typically for unicompartmental degeneration affecting either the medial or lateral weight bearing compartment. It is a device that is implanted into the knee and functions to separate the bones helping to correct the alignment of the joint and also add a cushion to the surfaces. It is an ambulatory procedure and performed through a small 3 inch muscle sparing incision. Weight bearing can begin immediately and healing time is 4-8 weeks.

In advanced cases or cases where medical treatment has not provided adequate relief, a knee replacement is recommended. At Regional Orthopedics, 2 types of knee replacement are offered, partial knee resurfacing and total knee replacement. Both procedures are performed through a minimally invasive small 4 inch incision over the anterior aspect of the knee. The procedure that we employ is an advanced technique wherebye the muscles are not detatched from the bone. This allows for not only for much less postoperative pain and a more rapid recovery, but also allows for the restoration of natural joint mechanics and improved joint stability. This procedure will typically involve a 1-2 day hospital stay for partial replacement or a 3-4 day hospital stay for total knee replacement. ( See also cartilage transplant and osteotomy)