Osteoarthritis affects more
than 21 million individuals in
the United States.
Degenerative joint disease or
osteoarthritis is one of the
oldest and most common forms
of arthritis. The disease
causes the normal smooth
cartilage of the joint to
breakdown, causing pain and
discomfort. This arthritis
process results in bone
against bone friction and pain
associated with swelling,
discomfort, loss of movement
and loss of mobility.
Osteoarthritis usually affects
the weight bearing sections of
the knee, which include the
junction of the lower leg bone
(the tibia) with the upper leg
bone (the femur) and beneath
the kneecap (the patella.)
Disease may affect one section
of the knee (medial or inside)
leaving the other two sections
relatively healthy (outside or
lateral and kneecap), or it
may affect two or three of the
sections of the knee.
Symptoms include joint pain
and often pain or discomfort
at night with some eventual
loss of motion. There are
several options for treatment
of arthritis and as you know,
several promises and cures and
remedies have been explored
throughout the years.
Unfortunately, these
palliative treatments can help
assist with some pain,
swelling and keep people
going, but ultimately when the
pain and arthritis get so
severe, surgery is needed.
Conservative measures include
icing, exercising, range of
motion, physical therapy, and
weight management to relieve
stress on the weight bearing
joints, as well as
anti-inflammatory medication
(Motrin, Naprosyn, Celebrex,
or Vioxx), as well as
cortisone injections or
Synvisc injections.
Ultimately if the arthritis
progresses to the point where
it causes pain or limitation
of motion and restriction of
your normal lifestyle, then
surgical treatment is needed.
Surgical treatment for knee
replacement has normally been
a complete total knee
replacement, replacing all
three of the surfaces of the
knee using metal and plastic
materials to resurface the
ends of the bone. Our newer,
minimally invasive solution
(MIS) incision is designed to
allow shorter hospital stays
minimal blood loss and quicker
rehabilitation secondary to
the smaller incision.
Based on the examination with
your surgeon and after
obtaining a x-ray, it will be
decided whether or not you are
a candidate for knee
replacement. Partial knee
replacement is a more
conservative alternative if
indeed your arthritis is
limited to one compartment of
the knee joint. If indeed you
are a candidate for the
procedure, typically the MIS
procedure is a treatment
option for approximately 10 to
20% of patients who are
suffering from knee
arthritis. Using the new
specialized instrumentation,
we are able to perform a
minimally invasive procedure
through a 3-inch incision as
opposed to an 8 or 12-inch
incision required for
traditional knee replacement
surgery. I only remove the
diseased portion of the knee
and cement in implants of the
prosthesis, while leaving the
healthy portions of the knee
untouched. This procedure
usually requires half the
rehabilitation time or
hospital stay, minimal blood
loss and quicker
rehabilitation. We also feel
that the patients will
experience quicker return of
normal range of motion and
recovery after a successful
unicompartmental knee
replacement is performed.
Partial knee replacements are
designed to last approximately
ten years.
Often younger people are
candidates for this procedure,
based on the fact that they
are too young to receive a
total knee replacement. This
is a very excellent procedure
to be able to, what we call,
buy time and allow for a
functioning lifestyle until
traditional knee replacement
can be utilized. Partial knee
replacements are used for
people who have osteoarthritis
limited to one compartment
and/or people who develop
osteonecrosis, which is a loss
of bone cartilage secondary to
a problem with the blood
supply to the bone, but is not
utilized for patients who are
suffering from rheumatoid
arthritis.
In summary, the results of
this procedure are very
successful and do allow quick
rehabilitation and improvement
with a good long-term pain
relief, accomplishing a 95 to
98% pain relief satisfaction
score. Again, the limited
knee surgery hurts less,
allows less time in the
hospital, and allows a more
normal range of motion and
functioning knee. If you have
any further questions, there
is other information available
on the Internet, including
information available at
www.pacewithlife.com.
Dr. Ronald Romanelli
practices medicine at
Orthopaedic Center of Illinois
in our
Springfield
office