What is Osteoarthritis?
Osteoarthritis (OA) is the leading type of arthritis affecting millions of patients. OA of the knee is the most common cause of disability in the aging population. It results from the degeneration of cartilage which covers the ends of the bones in the knee. The loss of cartilage can result in a loss of normal alignment, increased friction with motion, loss of impact absorption and loss of fit. All of these things contribute in some measure to the ultimate result of a painful, poorly working knee. It is believed that the average person takes about one million steps per year on each leg. OA of the knee can make each of these steps painful, eventually limiting function and lowering the quality of life.

Current Osteoarthritis Continuum of Care Therapies
Non-Medication Therapy
Many doctors will treat the beginning pain of OA with simple non-drug therapies such as suggesting weight loss, exercise, use of a cane, proper footwear and braces. Research has shown that weight loss and exercise together are better than either one alone for relieving the pain. These interventions are good, low-cost, self-directed and low risk. Usually the non-drug interventions are not able to reduce the pain and restore function by themselves but they are useful and can be helpful when used along with certain medication treatments.

Medication Therapy
For early stages of OA, over-the-counter nonsteroidal anti-inflammatory drugs (NSAID’s) such as, acetaminophen or ibuprofen may be useful for moderate pain relief. Other prescription medications are available for more severe OA pain, however all medications have side effects and risk factors. Constant use of these medications may enhance side effects and must be closely monitored by your doctor.

Surgical Intervention
Arthroscopic Surgery:
Arthroscopic treatments for OA of the knee include a meniscus repair or cartilage repair.

Other procedures, such as microfracture treatment, can be used together with the ones mentioned on patients with bone-on-bone OA to help promote the growth of new cartilage. The results of these additional therapies are variable, especially as we age. Arthroscopic treatment can be effective for some patients with early or moderate disease.

Uni-compartmental Knee Replacement:
Uni-compartmental replacements have several benefits including less post-operative pain, shorter recovery time, and potentially less cost over total knee replacements. They are technically more difficult to perform than a total knee replacement. Implanting a uni-compartmental involves the removal of bone from the effected side of the knee. This can make a subsequent total knee replacement more difficult. Recently, there has been interest in minimally-invasive uni-compartmental replacement techniques. These operations utilize a small incision (2-3 inches) and remove very little bone on the tibia, although there are still parts of the implant that use cement to keep them in place, which can loosen over time. Uni-compartmental replacements have an advantage of shorter operating room time and greater patient satisfaction. However, there is a learning curve for these operations and the survivorship, revision rates, and degree of difficulty converting to a primary total knee replacement are not yet known.

Total Knee Replacement:
Total knee replacement is the standard treatment for advanced stages of OA of the knee. A total knee replacement involves removing the surfaces of the femur and tibia, and replacing them with a metal femoral component and metal and plastic tibial components. Total knee replacement is the surgery of choice for people where OA has affected all compartments (medial, lateral, patellar) of the knee, but is also being used in patients where OA affects one part of the knee, most often in the medial compartment. When surveyed one year after surgery patients seem to be very satisfied with the procedure. The down sides of a total knee replacement are the typically long recovery period after surgery, high overall cost and the limited life of the implant may result in a more difficult revision surgery.

OrthoGlide Medial Knee Implant
A New Alternative for Patients with Osteoarthritis
The OrthoGlide Medial Knee Implant is a metallic, disc shaped device designed for patients who mostly have pain on the inside part of the knee and have exhausted all other non-surgical options. The OrthoGlide has special design features that contour to surface of the tibia allowing it not to move and provides an unconstrained, smooth top surface for the femur to move on. Insertion of the implant involves a minimally invasive procedure; requiring no bone cuts and a small two- inch incision. The OrthoGlide does not “burn any bridges” if further, more invasive surgical procedures are needed (i.e. uni-compartmental, total knee replacement) to relieve pain. The OrthoGlide is a minimally invasive alternative surgical option for people who have knee pain and do not want a total knee replacement. Ask your physician if you are a candidate for the OrthoGlide Medial Knee Implant. Click here to print-out an information sheet FOR YOU AND YOUR PHYSICIAN.