Dr.Ashok Ghanshyam Dalal

If you are suffering from arthritis, it is important for you to know about how it affects your knee and other joints. Arthritis is a chronic disease which damages your joints and connective tissues. Your knee is commonly affected by arthritis and there are three primary types of arthritis that occur in the knees. They include osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. 

Types of Arthritis 
The different types of arthritis affecting the knees occur due to different reasons. Osteoarthritis is a progressive condition, which wears away the joint cartilage over time. Rheumatoid arthritis is an inflammatory condition, which may occur at any age. Post-traumatic arthritis occurs after an injury is inflicted to the knee and may occur several years after a ligament injury or knee fracture. Major symptoms Arthritis pain may occur all of a sudden but develops slowly. 

In the early stages, the pain is observed in the morning after you have been inactive over the night. Pain is likely when you want to move around. Pain may be experienced even when immobile. Periodic inflammation is a common symptom of arthritis of the knee. You may have formation of bone spurs or excess fluids in your knee. The swelling gets pronounced after being active for a long period. The skin on your knee may look red and feel warm while you touch it. This may lead to chronic inflammation, and irreversible damage to the joint. 

Treatment 
There are several ways of treating knee arthritis. The mode of treatment depends on the severity and cause of knee arthritis. Appropriate physiotherapy may help in some patients NSAIDS or nonsteroidal anti-inflammatory drugs are commonly prescribed for dealing with arthritis pain temporarily. Other medicines used for knee arthritis treatment are as follows: 

1. Analgesics, which help in pain reduction act as good alternatives to NSAIDS. 
2. Corticosteroids are used for reducing inflammation. 
3. Certain DMARDs or disease-modifying antirheumatic drugs are used. 
4. Certain injections that are used for helping with knee arthritis. 

They include: 
Hyaluronic acid supplements, which ease the pain and inflammation by lubricating your knee joints. Corticosteroid injections also soothe inflammation and pain. PRP (Platelet Rich Plasma) BMAC (Bone Marrow Aspirate Concentrate) You may also require a surgery for dealing with knee arthritis when other modes of treatment fail. 

The most common surgeries are as follows: 

1. Joint Preservation Surgeries: Arthroscopy, where a keyhole incision is made in the knee for treating the damaged parts.  
2. Ligament repairs & reconstruction
3. Cartilage repair 
4. Meniscus repair & transplantation 
5. Osteotomy, where the knee bones are modified for optimising the function of and damaged knees. This avoids replacement of any part of the knee with an artificial prosthesis like a joint replacement. 
6. Joint Replacement Surgeries: Uni knee replacement/Total joint replacement where your knee is replaced with a prosthetic made of metal, plastic or ceramic.

It is recommended for you to consult a doctor, if you experience any symptom of knee arthritis. Early treatment will prevent the condition from worsening.

Knee problems can be quite annoying but if this problem becomes regular, it brings life to a standstill. The movement becomes restricted. Many associated problems slowly crop up. Thus, it is best to nip the problem in the bud. While some people might experience a problem in the full knee, in some people, only a single compartment (tissue or cartilage) of the knee may be affected. For such patients, Unicondylar Knee Replacement comes as a blessing.

The Unicondylar knee replacement, also known as the Unicompartmental Knee Replacement or Partial Knee Replacement is the most sought-after knee replacement surgery. The surgery involves replacing only the worn out or affected part (cartilage) of the knee, thereby preserving the healthier cartilages and tissues of the knee.

In the last few years, incidences of osteoarthritis have been on the rise. The unicondylar knee replacement surgery has made life a lot easier for people suffering from osteoarthritis (a condition where the articular cartilage or the connective tissue present within the knee joint begins to wear out).

The unicondylar knee replacement is ideal for people with:

• Severe osteoarthritis (Median or Lateral) that results in painful, swollen and stiffened knee.
• Only a small portion of the knee is affected.
• A person experiences great difficulty in movement.
• People over 48 years of age are mostly advised to undergo this surgery. Many young people with osteoarthritis opt for this surgery.

However, the surgery may not be a wise idea for

• A person with Rheumatoid Arthritis and Angular Deformity (acute).
• A person whose larger portion of the knee is affected.
• A person who had undergone osteotomy (surgical excision followed by reshaping of bones).
• People with an unstable or weak knee should avoid this surgery.

Pre- surgery, a person should

• Avoid taking any anti-inflammatory and herbal medicines (minimum 10 days before the surgery).
• Get yourself medically examined for any health complications (that might interfere with surgery).
• Follow a healthy lifestyle. Avoid smoking and drinking.

Procedure:

• For the surgery, the patient is either given a general anesthesia or a spinal (or epidural) one.
• Next, a compressing device (tourniquet) is put around the upper part of the thigh. This is done to avoid excessive blood loss during the surgery.
• A 7cm incision is made over the knee.
• The damaged parts (bones and cartilages) of the knee are then carefully removed.
• The surgeon next replaces the excised parts with metallic implants. Once the metallic part fits into the knee, it is adhered to the bone with (or without) bone cement.
• The surgeon then stitches the incised area, followed by dressing and bandage.

The recovery time is quick, between 3-4 weeks. However, the concerned person may require physiotherapy for the next 3-6 months.

Advantages:

• The surgery is less invasive with a quick recovery time.
• The surgery replaces only the affected knee part.
• Blood transfusions are seldom required.
• A person gets back to normal life faster.
• The surgery requires less time (~ 1-2 hours).

You need to be careful about:

1. Infection at the incision site, though it is very rare.
2. Injury in blood vessel, ligaments, or nerves.
3. Fracture in the bone