KNEE DISORDERS

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The knee joint is the largest joint in the body and is a weight bearing joint. Each bone end is covered with a layer of smooth shiny cartilage that cushions and protects while allowing near frictionless movement. In addition there is a special washer like cartilage between the joint surface of thigh and leg bones called meniscus. The cartilage which contains no nerve endings or blood supply, recievs nutrients from the fluid contained within the joint. Surrounding the knee structures is the synovial lining which produces this moisturising lubricant. If damaged, the cartilage is not capable of repairing itself.

Srong fibres called ligaments link the bones of the knee joint and provide stability and elasticity to the joint.

Arthritis

Arhtritis is a non specific term often misused to loosely describe symptoms like aches, pain and stiffness in the joints. Rheumatism is another term misused for aches and pains in muscles. A large majority of people including some doctors tend to use these terms imprecisely. In arthritis, the cartilage gets worn away gradually.

Types of Arthritis

OSTEOARTHRITIS: This is perhaps the commonest type of arthritis, where cartilage simply wears out due to overuse or old age, much like a car tyre.

RHEUMATOID ARTHRITIS: This is an autoimmune disease where body immune system which is designed to fight infections and help in healing wounds, goes haywire and attacks its own tissues, especially joints. Usually young adults develop this type of joint involvement and the patient feels ill.

Treatment

Depending on the severity of the patients condition and the doctors judgement, various surgical interventions are possible.

1. Arthroscopic Debridement - in this through a small key hole, a telescope is inserted , the knee is visualised on a tv screen, and the products of wear and tear are removed. It must be remembered that this procedure is likely to give only temporary relief.
2. High Tibial Osteotomy- the shin bone is cut at the upper end and realigned to distribute the load on knee.
3. Total Knee Replacement
4. Unicondylar Knee Replacement