Orthopaedic Institute of Dayton, Inc. is a patient-centered practice, committed to providing our patients with choices of care that are of the highest quality and are consistent with current medical and orthopaedic science.

OSTEOARTHRITIS OF THE KNEE

A very good reference site concerning osteoarthritis of the knee can be found on my home page at the link Kettering Joint Center.

Non-operative Treatment

1: 'Natural Treatment' can minimize stress on our knees. Weight loss and exercise are key to the success of this treatment.

Studies have shown that the force on the kneecap is proportional to about 8x body weight with certain activities. The force on the inside of the knee is about 4x body weight. When appropriate, weight loss is a major component of non-operative treatment.

Think of your muscles as 'shock absorbers'. The stronger your muscles, the potentially less pain. Low impact exercise can be beneficial to your knees. Your doctor may recommend a physical therapy program.

Use of a cane or walker can minimize stress on your knee.

2: Medications can be helpful. Analgesics act to diminish pain. A common analgesic is acetaminophen. Anti-inflammatories can be taken along with pain relievers. They act to diminish pain, and may also help relieve swelling and heat in the arthritic joint. Common anti-inflammatories are ibuprofen and naprosyn. Check with your physician before taking any medication on a regular basis, because all medications have side effects.

3: Injections can be helpful. Steroid injections are recommended for short term relief of severe knee pain. These medications are commonly administered with analgesics that some studies have suggested can further damage the knee, especially if given frequently. Gel injections can also be given for pain relief. The result of these injections are unpredictable, however, many patients feel better with this treatment. Note that neither treatment is meant to heal or cure osteoarthritis. These treatments are recommended for pain relief.

4: Supplements remain controversial. The 'American Academy of Orthopedic Surgeons' does not currently endorse any nutritional supplement.

Operative Treatment

Joint Replacement Indications

Knee Replacement (also referred to as knee arthroplasty or resurfacing) is considered when a patient has predictable discomfort in the knee which limits normal activities of daily living (things you cannot modify or avoid) and the patient reaches the point that they cannot cope. It also assumes a failure of non-operative care.

Replacement Procedures

Orthopaedic 3D animations of the following procedures can be found on our home page.

1: Partial Knee Replacement can be performed on patients with osteoarthritis confined to one area of the knee, usually on the inside or medial aspect of the knee. It involves removing the damaged surface from the inside of the knee and applying a metal coating. A polyethylene insert is then placed between the metal coatings.

Advantages of this surgery are a potentially faster recovery and a smaller surgical incision. Disadvantages are a higher short term and long term complication rate. If other areas of the knee develop osteoarthritis, a revision surgery to a total knee replacement may be necessary.

2: Total Knee Replacement is the most commonly performed surgical procedure for osteoarthritis of the knee. It involves removing all damaged surfaces of the knee and applying a metal coating. A polyethylene insert is then placed between the metal coatings.

Other Options

1: Arthroscopic Surgery is performed on those patients with early osteoarthritis of the knee who have symptoms of intermittent pain with catching, locking, or instability, despite non-operative care. This is an outpatient surgery in which a small camera or 'scope' is inserted in the knee to remove areas of meniscus that are torn or loose fragments of cartilage. The procedure is not helpful for those patients with advanced arthritis.

2: Tibial Osteotomyis performed on those patients with localized osteoarthritis (usually on the inside or medial side of the knee) and are not considered a good candidate for joint replacement. The most common patient would be someone too young for a replacement or someone who is too active (for example, involved in heavy manual labor).


Article by Richard Forster, M.D.

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