
A Closer Look at the Knee
The knee, the largest joint in the body, is central to nearly every activity. It consists of the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and the knee cap (patella). Ligaments connect the bones, and a cartilage lining coats them to allow easy, flexible movement and to protect the joint from wear.
Arthritis – The Leading Cause of Knee PainOne of the most common causes of knee pain and loss of mobility is the wearing away of this cartilage. When this happens, the bones rub together, causing significant pain and swelling known as osteoarthritis. Trauma or direct injury to the knee can also cause osteoarthritis.
Conservative treatments such as steroidal and non-steroidal anti-inflammatory drugs, physical therapy, and cortisone injections may effectively relieve pain and restore mobility. However, more severe pain and disability frequently require knee resurfacing surgery.
Minimally Invasive KneeThere is simply no reason to hobble around on an arthritic knee any longer. Not today in an age where rapidly advancing orthopaedic treatments are boosting the quality of life for countless Americans.
In fact, a new minimally invasive procedure has arrived, bringing with it the promise of relief to thousands of patients who until nowwere not considered strong candidates for knee replacement. The new procedure is called uni-compartmental knee replacement, also known as a uni-knee. It is perfectly suited for patients who have osteoarthritis that is confined to one side of the knee. Instead of replacing the entire knee, just the diseased portion is removed.
And, thanks to the uni-knee, beloved phrase minimally invasive is now associated with knee replacements for the very first time. The uni-knee typically takes less than one hour to perform. The scar is only about 3 to 4 inches long, and it requires less hospitalization and rehab time than a traditional knee replacement.
Because the uni-knee involves the replacement of only one side of the knee, the surgeon does not have to resurface the kneecap or remove much bone in the area. As a result, the uni-knee also feels more natural and offers a better range of motion for many patients.
"This is a procedure that will be in high demand and we are pleased to be able to offer it to appropriate patients", says Naples Community Hospital Orthopaedic Surgeon, H. Morton Bertram, III, M.D., who became the first surgeon in the area to perform minimally invasive uni-knee replacement at Naples Community Hospital about two years ago. "The procedure is much less traumatic so that patients get back to life much more quickly."
What's more, the uni-knee makes great surgical candidates out of people who were previously in knee replacement no mans land: they were experiencing considerable pain but did not have arthritis in enough of the knee to warrant the total knee replacement.
"The great thing about this procedure is that it fills that gap between patients who needed a knee replacement and patients who were not benefiting from an arthroscopic debridement for an arthritic knee," explains Dr. Bertram. "Now we have a procedure which can help those patients that were previously unable to be helped."
There are a lot of patients that fit this description out there. Currently less than five percent of knee replacements are of the uni-compartmental variety, but that figure is expected to climb as high as 30 percent.
So who might be a candidate for the uni or even knee replacement? Namely those who have aching pain in the knee often associated with activity, that walk with a limp, experience stiffness, swelling, or nighttime pain.
Still, surgery is not the first treatment option. "We use an algorithm to decide in our office what is right for each individual patient," explains Dr. Bertram. "We try many nonsurgical treatment options before deciding to go down the path of surgery." As a matter of fact, Dr. Bertram has developed a "Knee Arthritis Algorithm", which he uses daily in his office to show patients exactly what their options are. This handout gives the patients a list of all available non-surgical and surgical options.
Technically speaking, the uni-compartmental knee is not a revolutionary procedure. It was first done in the 1970s, but a new specialized procedure utilizing a different technique with a smaller incision makes the procedure less invasive. If chronic knee pain is hindering your activities, please call to make an appointment to seek the advice of Dr. Bertram.
Arthritis may be a part of the normal aging process, but sacrificing your quality of life does not have to be.