Early Osteoarthritis of the Knee, North Wales Knee Clinic

Early Osteoarthritis of the Knee

Early arthritic changes in the knee joint are extremely common place in our population, partly as a result of increasing demands being placed on our knee joints and increased expectations with respect to activity levels and management of symptoms. The initial management of early arthritis or 'wear and tear' as doctors often call it, is non surgical.

Exercise and weight control are essential, your GP and physiotherapist will often be able to advise and help you with this. The occasional use of painkillers and anti-inflammatories will often be helpful as well, particularly before a long walk or round of golf. Increasingly patients are using non-prescription preparations, there is no doubt that fish oils can be beneficial and some patients report significant improvement on using Glucosamine/Chondroitin Sulphate preparations.

Physiotherapy for early arthritis can also be helpful for a number of reasons. Keeping a knee mobile and the muscles around it strong preserves joint function. In the early stages of arthritis or 'wear and tear' the knee may start to develop a flexion contracture (preventing the knee from going fully straight), physiotherapy can often be helpful in restoring full or near full extension at this stage. The input of a physiotherapist can also be extremely helpful if a patient presents with an isolated area of arthritis behind the knee cap (patella-femoral arthritis).

The use of a knee brace can help some people, particularly during sporting activities such as skiing. Using a knee brace long term however is rarely a satisfactory answer for most people.

Surgical intervention for early osteoarthritis of the knee has to be carefully considered and discussed. The results can be very varied, depending upon the extent of damage in the knee. In the simplest form an arthroscopy may be appropriate to tidy up any torn or degenerate meniscal cartilage. This may be supplemented with chondroplasty or microfracture as required and occasionally excision of osteophytes. Performed all together you may hear this being referred to as 'debridement' of the knee.

In certain situations, realignment of the leg may be required. This procedure is called an Osteotomy and can be performed either above or below the knee depending upon the underlying problem.

	Correction of the valgus deformity
	Performing the HTO
	Opening the HTO to the calculated angle
	Fixing the HTO in the new position
	Assesment of the 'plumblines' in each leg - note the difference between sides
	Calculating the angle of HTO correction
	Calculating the angle of HTO correction