Arthritis & Joint Replacement
What is Arthritis?
Arthritis is a condition which causes a degradation of the cartilage lining of a joint. Symptoms may include joint pain, tenderness, stiffness, catching, and fluid in the joint. The joint typically is less painful at rest, and painful with prolonged activity. Knee with arthritis may occasionally give way. In more severe cases, night pain may impair sleep and walking may be severely restricted.
There are many different causes of arthritis, but the main type requiring operation is osteoarthritis. Osteoarthritis is a process of gradual wearing of the joint over a long period of time. The wearing process goes from minimal damage isolated to a specific section of the joint progressing through to established wear and bone on bone contact affecting larger regions of the joint. In the final stages, joint replacement surgery is often advised.
What Treatment is available?
Initial treatment for osteoarthritis include rest, avoidance of vigorous weight bearing activities, and the use of non-narcotic analgesic and/or anti inflammatory medications. It is important to stay active. With worsening symptoms a cane or a knee brace may be helpful. Also injections with steroids may give relief.
If these measures fail, surgery might be indicated. Surgical options are:
arthroscopy for removal of loose cartilage / fragments in earlier stages of arthritis
osteotomy: correcting the bend in the leg to off-load the worn part of the knee
Joint replacement surgery
Joint Replacement
Total Knee Replacement (TKR)
This is most appropriate where the arthritis affects the majority of the knee, if there is significant deformity, or if there is an inflammation type of arthritis, such as rheumatoid arthritis. It involves removal of the diseased cartilage throughout the entire knee, and replacement with a metal and plastic prosthesis.
Unicompartmental Knee Replacement (UKR)
The advantages of unicompartmental knee replacement are of a smaller incision, less bleeding, less post-operative pain, reduced stay in hospital, and a feeling of a more normal knee. It is appropriate where the arthritis is confined to one area or compartment of the knee. The medial (inside) compartment is most often affected. The arthritis may spread to other areas of the knee with time, and may require revision to a total knee replacement.