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