Osteoarthritis of the knee may develop through natural changes that come with age or overexertion. But most of the time, it occurs in connection with pre-existing conditions, in which case, it can be very difficult to stop the subsequent degradation. With current medical knowledge, however, we can slow the process so that the degradation does not progress so quickly. For this, we must know which method of treatment is the best. If you encounter problems with osteoarthritis of the knee, you should consult your doctor to make a treatment plan early, especially if your osteoarthritis is still in the early stages. Treating osteoarthritis of the knee can take many forms and does not necessarily involve surgery, even if the degradation is great. Surgery may, however, be needed if there is a great deal of pain, if knee function is impeded, or if the patient has difficulty when walking. Even in these cases, there are various types of surgery available, such as a high tibial osteotomy, total knee replacement, or, if the degradation is modest, then a partial knee replacement.
Knee replacement surgery consists primarily of two types: Total Knee Arthroplasty (TKA), and Unicompartmental Knee Arthroplasty, or partial knee replacement.
Unicompartmental Knee Arthroplasty (UKA) is the surgical removal of the specific knee compartment that is damaged, while the healthy bone and cartilage is preserved. In general, osteoarthritis of the knee that occurs with age tends to only present in one side of the knee joint, making UKA surgery a more suitable form of treatment than total knee replacement, which involves removing more cartilage and bone from the femur, tibia, and the knee cap. Total knee replacement is major surgery, with substantial postoperative pain, blood loss, tissue damage, and a long recovery time. Furthermore, the angle for bending and stretching at the knee may not be as good as it should be, leaving UKA the better alternative.
This procedure is effective in relieving the pain caused by osteoarthritis of the knee, occurring on the inner side of the knee joint, while preserving the healthy cartilage, compartments, and various tendons inside the joint. As a result, it is considered a minor procedure with little postoperative pain and blood loss, no need to cut tendon or muscular tissue, faster recovery times for the knee, shorter hospitalization time, and a quicker return to everyday routines.
A successful UKA procedure allows patients to use the knee almost in the same way as they would a healthy knee. Patients can bend and stretch the knee normally, sit on the floor, squat, and kneel, and feel natural while doing so. However, this kind of surgery may not be suitable for people wishing to run or take part in high-intensity sports, as the knee may wear down sooner than desired. By selecting patients for whom this procedure is suitable, and using an orthopedic specialist to carry out the procedure, good results can be attained. Partial replacements typically last between 10 to 20 years, and makes it easier for any revision surgery to be carried out than with total knee replacement surgery.
Candidates offered this treatment must be carefully selected. Most importantly, to be a candidate for UKA, the degradation must only have occurred on the inner side of the knee joint, the leg must not be too bent, and the condition must not have progressed into the middle stage. Considering these things, people of any age can undergo UKA depending on the level of functioning the patient currently has and the intensity of use. For people around the age of 50, with minor joint degradation and less intensity of knee usage, then we would recommend a partial knee replacement. This replacement can last 10 to 20 years, after which time, if the degradation has returned, then another round of surgery can be performed, or a total knee replacement can be performed. Partial knee replacement is most suitable for those 65 years old and over.
For younger patients who use the knee joint with intensity, such as playing sports, then a high tibial osteotomy (HTO) is recommended. The procedure adjusts the alignment of the knee to transfer weight from the damaged side of the joint to the healthy side, allowing the joint to carry weight more evenly, and result in more natural joint function.
“Bear in mind, patients being of a suitable age, the severity and location of the affected area, plus the expertise of the orthopedic specialist, are all crucial in achieving effective treatment results. However, are replacements as good as the original knee? Although replacements are strong, they wear down if overused or used incorrectly. However, our bones are both strong and flexible, and able to repair themselves. This flexibility can help reduce the amount of wear, much in the same way as an engine is lubricated with oil. Our bodies can create new cartilage cells, and, with proper care, will not wear, or will wear modestly over time. You should try to control your weight so that your joints do not need to support excess weight. Also, use your joints in the proper way, and make sure you get enough exercise. By following these steps, our joints will stay healthy for a long time.”
Bachelor of Science, Chulalongkorn University, 1972.