The knee joint is made up of three bones: the thigh bone (femur), the shin bone (tibia) and the kneecap (patella). The end of each of these bones is covered by a smooth, shiny, white, gristle-like layer of tissue called articular cartilage. This layer allows these bones to glide smoothly over each other during knee motion. Articular cartilage damage and wear that accumulates over time results in osteoarthritis. Arthritis development or exacerbation can be induced by minor or major trauma to joint, and is strongly correlated to factors like patient weight, activity level and occupation (amount of weight bearing), among others. Genetic predisposition also plays a role in the development and symptomatology of arthritis. Various coexistent pathology can be present including meniscus damage, loose bodies and bone spurs. Involvement can be localized to one section of the joint or spread diffusely though the entire joint.

Arthritis results in pain, loss of motion, deformity and functional limitation, usually exacerbated by weight-bearing. Patients may also notice intermittent swelling in the knee and/or a grinding sensation with knee movement. As the arthritis progresses, there may be a loss of range of motion in the knee. Some patients complain of pain associated with weather changes
The diagnosis of osteoarthritis of the knee is typically made by a combination of the patient’s history, the findings on physical examination, and x-rays.
Treatment for osteoarthritis of the knee depends upon the severity of the arthritis and the patients symptoms. Initially non-surgical treatment methods are recommended; options include: activity modifications, weight loss for patients who are overweight, use of assistive and corrective devices (such as a shoe inserts, a brace, a cane, or a walker), nutritional supplements (such as glucosamine and chondroitin), and medications (such as Tylenol or anti-inflammatory medications).

If these options fail to control the symptoms, injections into the knee, either in the form of a steroid (such as cortisone) or visco-supplementation injections (eg. Synvisc or Euflexxa ) may be attempted. If conservative measures fail, knee replacement surgery is recommended. In this surgery the arthritic ends of the bones are cut away and replaced by metal and plastic components.

Depending on several factors, including the location and degree of arthritis involvement, associated deformity, and instability, in addition to other patient-related factors, a partial knee replacement can be considered. This allows for restoration of native mechanics of the knee based on the preservation of some soft tissue structures. Patients report a more “natural feeling” knee, and tend to recover faster.

Some patients can benefit from a MAKOplasty procedure, which is a robotic assisted partial knee replacement surgery, which helps restore the anatomy and alignment of the joint with a high degree of accuracy.

At Oceana Sports Medicine and Orthopaedic Center, Dr. Aboka provides innovative treatments for segmental knee arthritis, tailored to each individual patient, with added qualification and certification in robotic assisted MAKOplasty surgery, as well as Uni-compartmental partial knee replacement procedures.