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 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 ARTICULARCARTILAGE

WASH OUT DEBRISAND 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

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