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Osteoarthritis of the knee

What is osteoarthritis?

Osteoarthritis of the knee

Osteoarthritis of the knee is a condition commonly referred to as "wear and tear" arthritis.

Causes

Although the degenerative process may accelerate in persons with a previous knee injury, many cases of osteoarthritis occur when the knee simply wears out. Some experts believe there may be a genetic predisposition in people who develop osteoarthritis of the knee. Osteoarthritis of the knee is the most common cause for total knee replacement surgery.

Symptoms

The primary symptoms of osteoarthritis are pain in the knee, swelling and stiffening of the knee joint. In the early stages of osteoarthritis the pain may be mainly associated with activity. As the cartilage wears away and the bones of the joint rub against each other, pain can become more severe and constant, interfering with regular daily activities and disrupting sleep.

Treatment

In the early stages of osteoarthritis, treatment may involve several techniques. Behavioral and lifestyle changes including losing weight and changing routines to avoid painful situations can be very effective in relieving pain. Non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen sodium may also provide relief from pain. Cox-2 inhibitors are also effective in providing knee arthritis pain relief. Physical therapy may improve muscle strength and joint mobility, reducing the symptoms of osteoarthritis in the knee. Joint fluid therapy may lubricate the knee and reduce the pain and swelling of the joint. Partial or total knee replacement surgery may be necessary as the disease progresses and daily functioning becomes more impaired.


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References

  1. Hall, et al. Unicompartmental knee arthroplasty (alias uni-knee): an overview with nursing implications. Orthopaedic Nursing. 2004;23(3):163-171. Accessed April 25, 2019.
    • Based on pre-surgical pain levels in UKA patients.
  2. Mayman DJ, Patel AR, Carroll KM. Hospital related clinical and economic outcomes of a bicruciate knee system in total knee arthroplasty patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
  3. Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Techniques in Orthopaedics. 2018;33(1):37-41
    • Compared to non-JOURNEY II knees; Based on BCS evidence
  4. 1Short-term Range of Motion is Increased after TKA with an asymmetric bicruciatestabilized implant.AcceptedPoster Presentation, AAOS 2018 New Orleans. Kaitlin M. Carroll, Peter K. Sculco, Brian CMichaels,RichardL. Murphy, Seth A, Jerabek, David J. Mayman
  5. 2J Orthop. 2017 Jan 7;14(1):201- 206. doi: 10.1016/j.jor.2016.12.005. eCollection 2017. Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range
  6.  In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy Trevor F. Grieco, MS a, *, Adrija Sharma, PhD a, Garett M. Dessinger, BS a, Harold E. Cates, MD b, Richard D. Komistek, PhD. The Journal of Arthroplasty, September 2017
  7. Testing concluded at 45 million cycles, ISO 14242-1 and 14243-3 define test completion at 5 million cycles. The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors, such as bone structure, can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.
  8. Iriuchishima T, Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. doi:10.4103/ortho.IJOrtho_392_18.
  9. Smith JR, Picard F, Lonner J, et al. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. August 4-9, 2013. Natal, Brazil.
  10. Zardiackas, Lyle D., Kraay, Matthew J., Freese, Howard L, editors. Titanium, Niobium, Zirconium, and Tantalum for Medical and Surgical Applications ASTM special technical publication; 1471. Ann Arbor, MI: ASTM, Dec. 2005