The Arthritic Knee ~ Treatment Options ~ A. John Campbell FRCS Surrey and Sussex NHS Trust.

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Presentation transcript:

The Arthritic Knee ~ Treatment Options ~ A. John Campbell FRCS Surrey 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 ARTICULAR CARTILAGE 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 ARTICULAR CARTILAGE WASH OUT DEBRIS AND CRYSTALS

OSTEOTOMY Varus / valgus deformity

PUDDU  opening wedge osteotomy

UNICOMPARTMENT REPLACEMENTS

NEED  intact ACL  intact lateral compartment  minor fixed deformity

ADVANTAGES  small incision  rapid rehabilitation  greater mobility

PATELLA ARTHROPLASTY

PAIN / SWELLING GOOD FLEXION PAIN ON STAIRS / SLOPES

TOTAL KNEE ARTHROPLASTY

INSALLNEW YORK

UNCONSTRAINED CONDYLAR PROSTHESIS

PAIN >> NIGHT ~ REST MOBILITY LIMP PATIENT MOTIVATION

PATIENT EXPECTATIONS

BEST RESULT WELL INFORMED / MOTIVATED PATIENT ACCURATE SURGERY INTENSIVE REHABILITATION

THE A. John Campbell FRCS Surrey and Sussex NHS Trust The Arthritic Knee ~ Treatment Options ~ END