Partial Knee Replacement

The partial knee replacement, also known as a unicompartmental or unicondylar knee replacement, is a surgery that has been revolutionizing the way patients think and feel about joint replacement technology. This minimally invasive procedure can most often be done as an outpatient and feels more like a normal knee than a traditional knee replacement. This makes it possible to dramatically change lives and restore mobility earlier on in life to active adults, with far less discomfort - even if you have arthritis or degeneration in only one part of your joint. Because the truth is, many active patients require only a partial replacement.

Outpatient Surgery

Partial knee replacement allows candidates to experience minimal discomfort, since pain management and a favorable experience with anesthesia are focused on, due to sensitivity to pain requirements. Usually most patients will be able to tolerate the procedure satisfactorily and be comfortable with being discharged that day. Recovery time is substantially shortened, with only typically a six-week period before being out on the putting green again, and an earlier return to the tennis court. And that's not to mention an elimination of the usual 2-4 days in the hospital, versus the PKR outpatient ambulatory surgical procedure.

The Benefits

Other dramatic benefits include a better range of motion versus a full replacement, a higher level of possible activity, a smaller incision, a smaller implant, and the fact that an entire 2/3 of the joint remain untouched and un-tampered with. Additionally, with this less invasive process, less blood is lost, meaning neither a tourniquet nor a Foley catheter drain used.

Osteoarthritis of the Knee - The Joint That Suffers the Most Injury

Our knees and hips are our largest joints, supporting the body's weight and providing the mobility that most people take for granted. The three basic types of arthritis that may affect the knee joint are Osteoarthritis, Rheumatoid Arthritis and Post-traumatic Arthritis, with Osteoarthritis being the most common form of knee arthritis and knee pain. Although osteoarthritis is rare in young adults, results show that one in three people over the age of 62 has some amount of osteoarthritis on one or both knees.

Knees Suffer More Injury than Any Other Joint

It is possible to develop osteoarthritis in any joint but the knee is especially vulnerable as it is a weight-bearing joint, which is susceptible to daily wear and tear and sudden injury. In addition to genetic predisposition, poor bone alignment and minor or major injuries, high stress activities over time often lead to osteoarthritis. In some cases, normal age-related changes, such as reduced muscle mass and bone density, may make you more prone to knee injury as you age.

Knee Pain and Excess Weight

Studies consistently show a link between excess weight and knee pain, with many knee problems being avoidable by maintaining a healthy weight. Carrying only 10 pounds excess weight increases the pressure on the knees by 30-60 pounds, and it was found that about 56% of severely obese people suffered from significant knee pain in comparison to 15% of people who were not overweight. In addition, it was indicated that obese women stand nearly 4 times the chance of developing knee osteoarthritis in comparison to non-obese women, and obese men standing nearly 5 times the chance.

Symptoms of Knee Arthritis

Although some people suffer from tenderness and swelling in the morning, many people find that knee pain increases during the day, sometimes arising in the afternoon and getting steadily worse. Some of the common signs of osteoarthritis of the knee are:
• Pain with activities
• Intermittent or steady pain
• Limited range of motion
• Swelling or tenderness
• Stiffness when getting up from sitting or lying down
• Grinding or crunching sounds
• Pain with passive motion

Medical Treatment for Osteoarthritis of the Knee

There is no medical cure for osteoarthritis and although it is possible to regrow cartilage in a laboratory, getting implanted cartilage to grow in an osteoarthritic knee has not yet been successful, as the implanted cartilage eventually dies. In most cases over-the-counter pain relievers are used but many of them have a variety of side effects such as stomach pain, digestive problems, headaches and dizziness. In addition, NSAIDs actually sabotage the body's own efforts to heal itself by preventing the formation of new cartilage and accelerating the degeneration of the joints. Some surgical procedures are used for knee osteoarthritis, including arthroscopic surgery and knee replacement surgery.

Alternative Treatments for Osteoarthritis of the Knee

• Exercising is a crucial part of treatment, helping to improve balance and sometimes relieving pain. Specific exercises can be designed to help spread the forces of everyday activity to other joints thus helping to protect the knee. Regular exercise also strengthens the muscles and other structures around the knee, with range-of-motion exercises helping to maintain joint function and relieve stiffness.
• Using a cane in the hand on the side opposite to the affected knee will help to decrease demand on the arthritic joint.
• Wearing soft-soled shoes or special shock-absorbing shoes, and replacing them frequently, will help to reduce the impact on your knees.
• Weight loss is one of the most important treatments, alleviating pressure placed on the joint.
• Following an anti-osteoarthritis diet can help to control the destruction of joints and reduce inflammation

Arthritis Treatment: Tibiofemoral Osteoarthritis, Diagnosis and Treatment

The most common presentation of osteoarthritis of the knee (OAK) is involvement of the tibiofemoral joint, the space between the femur (upper leg bone) and the tibia (the larger of the two lower leg bones.)

These are the two surface areas that contain the largest amount of hyaline cartilage inside the knee.

As mentioned earlier, hyaline cartilage is the "harder" of the two type of cartilage within the knee. Hyaline cartilage caps the ends of the long bones inside the joint while fibrocartilage, a softer more pliable cartilage is represented by the medial and lateral menisci of the knee. These are semicircular piece of cartilage that give added protection to the hyaline cartilage when it comes to shock absorption, gliding, and rotation.

Symptoms of OAK typically consist of stiffness, swelling, buildup of joint fluid, and tenderness along the joint line. Over time the ability to bend and straighten the knee will be compromised as well. While one compartment, either the medial (inside) or lateral (outside) compartment of the knee may be affected more than the other, often both compartments are affected. This causes diffuse pain.

The diagnosis can be suspected clinically by history and physical examination. It can be confirmed by positive changes seen on standing knee x-rays. Magnetic resonance imaging (MRI) is much more sensitive to changes of OAK which will consist of cartilage defects, bone edema (swelling), and fluid.

The typical treatment regimen is aimed at pain relief and maintenance of function.

If the patient is overweight, weight loss is a must. Regular exercise consisting of low impact aerobic exercise, resistance exercise, and stretching are components of a common-sense program for a patient with OAK.

Addition of non-steroidal-anti-inflammatory drugs taken either orally or given as a topical agent may also be used.

Removal of excessive joint fluid followed by Injections of glucocorticoids ("cortisone") are helpful for symptomatic relief. Glucocorticoids have a deleterious effect on articular cartilage and should be used sparingly, no more often than three times per year in a given joint.

The patient may also benefit from viscosupplement injections. These are substances consisting of hyaluronic acid which mimics the characteristics of normal joint fluid. These injections can also help provide symptomatic relief.

All injections need to be administered using ultrasound guidance to ensure accuracy.

Surgery is defined as being cartilage sparing or cartilage sacrificing. Cartilage sparing procedures involve osteotomy- removing a wedge of bone in order to line the knee joint straighter. This is used in young active adults to buy time. Cartilage sacrificing procedures refer top joint replacement. The trend recently has been for patients to get these operations done at a younger age. The downside is that these surgeries are associated with a small but real risk of severe complications including infection, blood clots, and death.

An option that is being proven to be an alternative is the use of autologous stem cells, a patient's own stem cells to help sustain and possibly regrow cartilage in an osteoarthritis knee.

(Wei N, et al. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee. J Applied Res. 2011; 11: 44-48)

Patella Tracking Disorder - What Are the Best Knee Braces For It?

What is patella tracking disorder? A sign of patella tracking disorder is if you feel or hear popping, slipping, grinding or catching in your knee when you walk. Other signs are pain and discomfort in your knee when you walk down stairs, sit for a long time, stand after sitting or when you squat. You may also feel that your knee cannot support your weight and is about to give out.

This condition occurs because your kneecap is out of alignment. This means that when you bend or straighten your leg your kneecap shifts out of place. If you have this disorder your kneecap will usually move too far towards the outside of the leg. This could be caused by ligaments, muscles, or tendons that are too loose or too tight. It may also occur if you have cartilage damage in your knee. Left untreated you may also develop osteoarthritis. Osteoarthritis is a common type of knee arthritis. It is more common for people who are over 50 or overweight. It may also cause stiffness, pain, swelling and inflammation in the joints.

Is there anything that will help my pain? If you have pain from this condition, you may want to try using a brace. Knee braces for patella tracking disorder can help you in several ways. These braces provide both compression and support for your knee. Knee braces for patella tracking disorder stabilize your knee cap, which keep the knee cap properly aligned. The force is directed to help keep the kneecap in the proper position and prevent misalignment with the use of this brace. Knee braces for patella tracking disorder can lessen your pain and help increase your activity level.

Knee braces for patella tracking disorder that you may want to consider using are: the Breg PTO High Performance Patella Femoral Knee Brace, the MedSpec DynaTrack Patella Stabilizer with Hinges, and the DonJoy Lateral "J". These braces offer level II (additional) and level III (advanced) support and protection. The Breg ($163.75) is a level III brace, and it has excellent customer reviews. Both the MedSpec ($98.96) and the DonJoy ($58.95) are level II braces. They are both good braces for patella tracking disorder.

These prices have been referenced from Braceshop.com.

Knee Braces for Osteoarthritis

Osteoarthritis is an extremely common condition in the knee-joint which is sometimes called 'wear and tear.' It is a degenerative condition of the articular cartilage which is made worse by repetitive impact or previous injuries in the knee. It also tends to have a genetic component, meaning it runs in families. As the disease progresses, the cartilage itself becomes thinner and in some cases may wear away altogether.

A knee brace or support can be worn by people with arthritis in the knee-joint to help relieve the pressure on the joint surfaces and to ease pain and discomfort. There are many different types of knee brace and support available which may be suitable for arthritic knees. These can also vary considerably in price.

At the top end is the hinged 'offloader' (sometimes called 'unloader') type of brace, of which there are several designs and manufacturers. These are thought to be very effective in easing the symptoms of severe cases of unicompartmental osteoarthritis, where the arthritis affects only one side of the joint. These braces work by taking the load off the affected side and put more on the unaffected side. This may also help to delay the need for knee replacement surgery.

Whilst a offloader brace may be very effective, many people prefer to start with a lower level (and lower budget!) support to try this for arthritis pain relief before investing in a offloader brace.

Neoprene is thought to be the best material in a knee brace for arthritis pain relief. Neoprene is known for its compressive and heat retaining properties which help to increase blood flow to the area which in turn brings the nutrients required for healing. Wearing a neoprene support has also been shown to aid proprioception - the sense of positioning, co-ordination and balance at the joint. This is beneficial in preventing movements at the knee which could cause pain or injury.

Additional support can be given to the joint in the form of metal parts and extra straps. A stabilised support has lightweight metal stays embedded into the sides of the brace. These will help to give a sense of stability to the knee and will resist lateral and twisting movements which tend to aggravate the condition and risk other injuries.

At a higher level, a hinged neoprene brace has a solid hinge on each side of the knee. These give even more resistance against these types of movements, essentially preventing them altogether. The drawback of this kind of brace is of course the size and bulk of them, although this is usually still less than a offloader brace.

Comfort is of course the most important factor to consider when purchasing a knee brace for arthritis. They should always fit snugly around the knee-joint without being too tight around the thigh or calf. Wrap-around supports are available for those who prefer to be able to adjust the support, or where the knee swells up with activity.

The Importance of a Knee Brace After an ACL Reconstruction - Special Report on Knee Support

An ACL Reconstruction

If you have had surgery recently, or are about to have an ACL reconstruction, you already know that you do not want to be back in the operating room ever again! At least if you can help it, right? After you have an ACL reconstruction, you will want to think about your knee brace options to help keep your knee safe.

Usually, there are two kinds of knee braces you will use.

1.) A Post Operative Knee Brace

This is the kind of support that is quite long and will extend from about 10 inches above to 10 inches below your knee. Maybe even more! These knee braces can really help keep your knee safe, because they will not let you move around. That is what you need when you just have had surgery, such as an ACL reconstruction. Although you use it first, you will probably not use a "post op" knee support for a really long time. Soon your doctor will probably suggest that you use another kind of knee brace to help keep your knee safe. And that kind of knee brace is....

2.) A Functional Knee Brace

Sometimes called an ACL knee support, or many other names, this kind of knee support is quite different than a post op knee brace. It is much shorter and there is not nearly the amount of material incorporated into its design as you will see in a post op support. Usually they are much more open and will allow much more airflow. However, if you want a wrap around design, these exist too.

One of the best ways to find this kind of knee support is to ask yourself a few basic questions.

Curious what those questions are?....

A.) What is your knee instability on a scale 1-10? This will help you determine if the instability is mild, moderate, or severe.

B.) What is your knee discomfort on a scale 1-10 as well?

If you have had an ACL injury, and a subsequent reconstruction, it might be best to get a more deluxe knee brace. Once you think about retearing your ACL after the surgery, you will almost jump at the chance to purchase one right away! - Its your choice to go with a knee support or not after an ACL reconstruction, but we recommend that you get one because the meaningful support can help to keep you safe and away from anymore invasive surgical procedures!

Jumper's Knee: Patellar Tendinopathy

Jumper's knee as the name suggests is more likely to occur in sports like long jumping. In addition, long and middle distance running as well as bounding and hopping activities on a chronic basis can cause it. Basically, the pathology involves inflammation of the tendon of the rectus femoris.

Mechanism of the condition:
Patellar tendinopathy as the name suggests is tendiopathy of the rectus femoris below the level of the patella or the knee cap. Commonest site where this lesion occurs is the deeper part of the tendon where it attaches to the lower pole of the knee cap.

Symptamatology of the condition:
The condition is usually characterised by an insidiuos onset, meaning that the pain increase in intensity gradually. Pain is localised over the lower part of the front of the knee. Pain increases in character and intensity on continued activity like jumping, hopping, bounding and running. Furthermore, eccentric or negative contraction increases pain as well.

Diagnosis of the condition:
Usually diagnosis is clinical, however, ultrasound as well as MRI are the gold standards for diagnosing as well as for confirming diagnosis.

Treatment:
Cessation of activity to tide over the acute phase is usually recommended. Usually, treatment is notorious to heal and takes long. Physiotherapy involves strengthening surrounding musculature, and joint structures. Also, eccentric training with the help of an assistance is helpful. Furthermore, biomechanical abnormalities in and around the knee joint as well as training deficiences need to be corrected. Only cases resistant to physiotherapy are considered for surgical intervention.