Arthritis of the knee is now the most common reason for a patient to be offered a total knee replacement. The most common form is osteoarthritis, which means wear and tear of the cartilage. If this occurs after accident damage to a knee, it is known as post-traumatic arthritis. Other forms of arthrtis include rheumatoid arthritis and psoriatic arthritis. These are inflammatory forms of arthritis and tend to affect mulptiple joints. Whatever the form of arthritis affecting usually starts with pain in the knee when walking long distances but, unfortunately, it usually gets worse with time. Early treatment options include analgesia (painkillers) and therapy if stiffness is a major issue. With time, the knee tends to become more stiff and pain begins to occur at rest. This can be temporarily treated with injections in some circumstances. In cases of arthritis in just one side of the knee, in a young and active patient, it may be an option to realign the leg with n operation called an osteotomy.
As the joint damage worsens, it tends to reduce the ability to walk all but short distances and the analgesia becomes ineffective. This can lead to the patient being kept awake at night with often a dramatic effect on quality of life. It is at this point that joint replacement is likely to be the only option available. If only part of the knee is damaged and the ligaments are all working, it is possible to replace just a part of the knee, typically the inside half of the joint or the patellofemoral joint (between the kneecap and the thigh bone). If most of the knee is damaged, a total knee replacement is usually best.
Deciding which treatment option to use is vital as knee replacements are complex operations and failure to plan properly will significantly reduce the chances of a successful outcome