Document Title: Iorio-JBJS-Jul03.shtml
Article Title: Unicompartmental Arthritis of the Knee (Current Concepts Review)
Authors: Richard Iorio, MD and William L. Healy, MD
Publication: The Journal of Bone and Joint Surgery (American)
Date: July 2003
Volume 85, pages 1351-1364
Keywords: unicompartmental osteoarthritis, osteoarthritis bracing, drug treatments, anti-inflammatories, NSAIDs, surgery, surgical options.

(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)

Comments: This comprehensive and superbly written overview of unicompartmental-osteoathritis treatments is full of wisdom and helpful nuggets of information. It provides interesting insight into non-surgical treatments such as weight loss, Synvisc/Neovisc (hyaluronic acid or hyaluronan) injections, cortisone injections, and osteoarthritis-type sideways-forcing braces.

Introduction

• Unicompartmental arthritis of the knee is a degenerative condition characterized by abnormal articular cartilage in the medial or lateral part of the tibiofemoral joint, which may be associated with meniscal disruption, ligamentous instability, and limb malalignment.

• Nonoperative treatments for unicompartmental degenerative arthritis of the knee include oral and injectable medications, weight loss, exercise, physical therapy, canes, crutches, braces, and orthoses.

• Arthroscopy for unicompartmental arthritis of the knee can provide a clinical benefit in terms of reduced pain and improved function for patients with mechanical symptoms, mild degenerative disease, and minimal or no malalignment. Meniscal tears, loose bodies, osteophytic spurs, or chondral flaps can cause mechanical symptoms, which can be treated successfully with arthroscopy.

• Proximal tibial valgus osteotomy and distal femoral varus osteotomy for treatment of unicompartmental arthritis of the knee can realign a deformed limb, reduce pain, and improve function for active, high-demand patients with a projected life expectancy of twenty years or more.

• As a patient's life expectancy and expectations for activity decrease as a result of age and disease, unicompartmental and total knee arthroplasty provide predictably successful surgical options for the treatment of unicompartmental arthritis of the knee.

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