Treatment Strategies
The goal of treatment for mono-compartment osteoarthritis of the knee is to restore the functionality of the joint and delay the need for joint replacement surgery, specifically a total knee replacement (TKR). TKR replaces the joint with a prosthetic made of metal and plastic. Joint preservation techniques, on the other hand, seek to reconstruct the joint in order to eliminate or delay the need for replacement surgery.
Osteoarthritis of the Knee
Joint preservation techniques include specialized osteotomies (surgical bone cuts) and distraction to realign the joint. These techniques are usually more successful if the patient is young and the arthritis is limited in the joint (i.e. mono-compartment). Although many patients who undergo joint preservation never require TKR, we perform the osteotomy with the assumption that every patient must remain an optimal TKR candidate after surgery.
Damage of the cartilage leads to various deformities of the bone (femur and tibia) and joints (soft tissues).
Bone Deformities of Femur and/or Tibia
- Varus (inward angulation)
- Valgus (outward angulation)
- Recurvatum (knee bends backwards)
- Procurvatum (knee bends forwards)
- Torsion
- Limb length discrepancy
Joint Deformities
- LCL laxity
- Medial collateral ligament (MCL) laxity
- Plateau depression
- Lateral subluxation
- Patellar maltracking
- Flexion contractures
There are three different compartments in the knee: Medial, Lateral, and Patellofemoral. Mono-compartment osteoarthritis is osteoarthritis affecting a single compartment. When there are multiple compartments affected, joint preservation techniques with osteotomy are unlikely to be effective treatment. In these cases, total knee replacement (TKR) should be considered.
Treatment strategies for mono-compartment osteoarthritis of the knee will depend on which compartment is affected:
- Treatment for Medial Compartment Osteoarthritis (MCOA)
- Treatment for Lateral Compartment Osteoarthritis (LCOA)
- Treatment for Patellofemoral Osteoarthritis