The Arthritic Knee~ Treatment Options ~
A. John Campbell FRCSSurrey and Sussex NHS Trust
U.S.A. 55% people > 60 years old
U.K. 20% people > 45 years old
Be active
Live longer
REDUCE THE RISK OF ARTHRITIS
Pick the right parents
Weight reduction
Modify activities
SURGICAL MEASURES
ARTHROSCOPY partial meniscectomy
meniscal repair
STABILISE LIGAMENT DAMAGE
LOCALISED ARTICULARCARTILAGE DAMAGE
MICROFRACTURE
MOSAICPLASTY
AUTOLOGOUS CHONDROCYTE TRANSFER
NO JOINT DEFORMITY
LOCALISED DEFECT
ONE SURFACE
CONSERVATIVE MEASURES
WEIGHT REDUCTION
PHYSIOTHERAPY
BRACES / HEEL WEDGES
MEDICATION
ANALGESICS
ANTI-INFLAMMATORY DRUGS
GLUCOSAMINE 1500mg
COLLAGEN
INJECTION steroid
viscosupplementation hyaluronic acid
ARTHROSCOPY
assess wear pattern resect degenerative meniscal tear remove loose body
DEBRIDE ARTICULARCARTILAGE
WASH OUT DEBRISAND CRYSTALS
OSTEOTOMY
Varus / valgus deformity
PUDDU opening wedge osteotomy
UNICOMPARTMENTREPLACEMENTS
NEED
intact ACL intact lateral compartment
minor fixed deformity
ADVANTAGES
small incision rapid rehabilitation greater mobility
PATELLAARTHROPLASTY
PAIN / SWELLING
GOOD FLEXION
PAIN ON STAIRS / SLOPES
TOTAL KNEE ARTHROPLASTY
INSALL NEW YORK
UNCONSTRAINEDCONDYLAR PROSTHESIS
PAIN >> NIGHT ~ REST
MOBILITY
LIMP
PATIENT MOTIVATION
PATIENT EXPECTATIONS
BEST RESULT
WELL INFORMED / MOTIVATED PATIENT
ACCURATE SURGERY
INTENSIVE REHABILITATION
THE
A. John Campbell FRCSSurrey and Sussex NHS Trust
The Arthritic Knee~ Treatment Options ~
END