ARTHRITIS OF THE KNEE JOINT

Knee disease can be treated by other surgical methods besides total knee replacement.

1. Unicompartmental Knee Replacement - Each knee actually has two “compartments” - an inner and an outer compartment. Not infrequently one compartment will be severely affected by arthritis while the other may be almost normal. In these circumstances you may best be served by having only the “bad” compartment replaced (called a “unicompartmental knee replacement” or a “uni”). The advantages of uni include a better range of motion, quicker recovery and somewhat more lenient long-term restrictions. The main disadvantage is that the non-replaced compartment may continue to deteriorate and later need to be resurfaced anyway: quite frequently within three to four years after the first operation. Unicompartmental knee replacement has been more widely accepted by both surgeons and patients in Europe than in the United States.

2. Arthroscopic Surgery - Mild to moderate cases of knee arthritis frequently benefit from an arthroscopic “clean-out”. But the benefits are usually temporary. At best, arthroscopy may delay the time for more major surgery by a year or two.

3. Synovectomy - Is mainly of benefit in selected cases of rheumatoid arthritis. The soft tissue joint lining (synovium) is removed. This may be performed arthroscopically or be an open operation. Unfortunately, the synovium can grow back and the arthritis can then progress.

4. Osteotomy - This is another procedure by which knee arthritis can be treated. This is an operation in which either the tibia or the femur bone is cut and the alignment of the leg is changed. Most patients, as they develop arthritis in the knee, either become increasingly bow-legged or knock-kneed. This deformity of the leg actually accentuates and accelerates the arthritis in the knee. If the leg can be straightened by “osteotomy” then the symptoms of knee arthritis will usually be improved. Osteotomy of the knee is usually reserved for younger patients who have mild disease and bow legs, and who can still straighten their knee completely. Osteotomy under the right circumstances can give excellent pain relief but the results are not as predictable as knee replacement surgery. Even those patients who have an excellent result can expect to have a knee replacement at some time in the future.

5. Knee Fusion - This is a procedure in which the femur bone is made to fuse to the tibial bone. This results in