Question and Answer on Knee Arthritis

Knee Arthritis

What is knee arthritis?

Knee Arthritis is a condition where there is a loss of cartilage noted in any one or more than one compartments of the knee.  The knee has three compartments; medial compartment, lateral compartment, and patellofemoral compartment.  The medial and lateral compartments of the knee are inside and outside surfaces of the femur and tibia, respectively. The patellofemoral compartment is the articulation between the knee cap and the tibia.  If any one of these compartments become arthritic, you may experience pain when bending the knee, walking, or even at rest. 

What are symptoms of knee arthritis?

The number one symptom of knee arthritis is pain.  The pain can be intermittent in nature. It can be provoked by impact activities, such as running, jumping, and sports.  There can swelling.  The knee joint can feel warm.

How is knee arthritis diagnosed?

Standing X-rays are the first line diagnostic modality. If the x-rays don’t reveal significant arthritis, an MRI can be ordered as well.

What is the treatment for knee arthritis?

Non-steroidal anti-inflammatory medications (NSAIDS), such as ibuprofen, naproxen, or meloxicam, are first line treatment options. NSAIDs work by decreasing swelling and inflammation that generates the pain in the knee.  Tylenol can also help decrease pain.  Knee braces can provide support and reduce inflammation in the knee.  Physical therapy can be a useful adjunct to strengthen the muscles around the knee to support the joint and reduce pain in the knee. Corticosteroid injections into the knee work by reducing inflammation, similar to NSAIDs, and can possibly eliminate pain in the knee for 6 months or longer.  Hyaluronic acid injections, such as Supartz or Synvisc, are also used to improve lubrication of the knee.  The idea is if the knee is better lubricated, there will be less friction in the knee. Less friction will lead to less inflammation in the knee. The hyaluronic acid injections may take up to 3-4 weeks to see results.  Lastly, the most definitive solution for knee arthritis is knee replacement surgery.

There are two types of knee replacement surgery.  There is partial knee replacement and total knee replacement.

What is partial knee replacement and am I candidate?

Partial knee replacement surgery is used when a patient has one compartment that is arthritic.  For instance, if x-rays and mri reveal arthritis in just the medial compartment of the knee, this compartment can be replaced.  If a partial knee replacement is indicated, bone cuts are made in the arthritic compartment of the knee, and implants are cemented in place replacing only that area that was arthritic.

What is a total knee replacement?

Total knee replacement is a procedure that is performed when 2 more compartments of the knee arthritic.  In this surgery, the knee is opened, and bone cuts are made on the femur, tibia, and patella.  Implants can be cemented into place.  After this procedure, the patient no longer has arthritis.

What are some new technologies in knee replacement surgery?

Over the last ten years, knee replacement surgery has evolved from the use of jigs and alignment guides, to computer navigation, and now to robotics for making bone cuts to ensure proper alignment.  Robotic knee replacement involves the use of a robot to help Dr. Chandran to make bony cuts.

What is robotic knee replacement?

In my practice, robotic total knee replacement involves the use of Stryker Mako Robot to make surgical cuts on your femur and tibia to correct the alignment of your knee and for placement of implants. Prior to surgery, you will be going to the hospital to get a CT scan of your knee so that I can plan your surgery on the computer.  The bony cuts are preplanned on the computer. I then used the robot to precisely make those cuts on the bone. I then cement implants in place.  The use of the robot allows me to put your implants in perfect alignment.