Tricompartmental osteoarthritis is a severe form of knee arthritis that affects all three compartments of the knee joint.

The knee is a complex joint made up of three compartments – the patellofemoral where the kneecap (patella) and thigh bone (femur) meet, the medial tibiofemoral on the inside of the knee and the lateral tibiofemoral on the outside of the knee.

Osteoarthritis – sometimes called wear and tear arthritis – occurs when cartilage in the knee joint breaks down over time. It can affect any of the compartments of the knee. However, if all three compartments are affected it is called tricompartmental arthritis. This is a more severe form of the disease than unicompartmental or bicompartmental arthritis as the entire knee joint is affected, leading to widespread loss of cartilage as well as damage to the synovium (lining of the knee joint).

 

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Symptoms of Tricompartmental Osteoarthritis

Arthritis is a degenerative disease, which means the symptoms gradually worsen over time. As the cartilage and synovium in the knee wears away, bony spurs may develop which can further exacerbate painful symptoms. If you have tricompartmental osteoarthritis you may experience:

• Knee pain and swelling, which can be severe.
• Weakness in the knee joint which may buckle or give way.
• Joint stiffness, particularly when you have been sitting still or lying down.
• Locking in the knee joint caused by the formation of bony spurs.
• Difficulty walking or walking in a different way to normal
• Water on the knee (joint effusion).
• Overall loss of knee function.

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Diagnosis of Tricompartmental Osteoarthritis

During a physical examination, a doctor will be looking for certain signs that could indicate you have osteoarthritis of the knee, including pain, stiffness (especially after periods of inactivity), a grating feeling (crepitus), cracking or popping in the knee, swelling or tenderness in the joint or a feeling of coldness or warmth.

An X-ray will normally be ordered to confirm the diagnosis. This will show any signs of cartilage loss or bony growths. In addition, some patients will be given an MRI scan to check the condition of the knee cartilage and other soft tissues including the synovium and ligaments

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Treatment of Tricompartmental Osteoarthritis

The treatment will depend on the extent of damage to your knee joint and how advanced the arthritis is. In the early stages, you may be able to treat the disease using ice or heat packs and elevation to reduce swelling. Anti-inflammatories and painkillers may provide some relief as well as modification of activities. For more advanced osteoarthritis, you may be offered an injection of corticosteroid and hyaluronic acid (joint lubricating fluid) into the knee joint to relieve pain and inflammation.

As the disease progresses you may need to avoid exercises that put pressure on your knee, such as running and jumping. You can still do low impact activities like swimming or cycling. Using a walking stick, knee brace or insoles can help to reduce the impact on knee joints.

In severe cases, you may need knee replacement surgery. In the case of tricompartmental osteoarthritis you will need a total rather than a partial knee replacement. This involves replacing the entire knee joint with a prosthetic implant.

Carrothers Orthopaedics offer Mako robotic arm assisted surgery, to ensure pinpoint accuracy during knee replacement surgery. Clinical studies show Mako helps protect soft tissues and ligaments from damage and patients also report lower pain scores and higher satisfaction levels. We are specialists in this type of surgery.

Following knee replacement surgery you will need regular physiotherapy to build up strength and flexibility in your knee joint.

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Prevention

It is not always possible to prevent osteoarthritis, which is linked to previous joint trauma, ageing and can be hereditary. The condition is more common in women than men, particularly after menopause. However, you can reduce the stress on knee joints by maintaining a healthy body weight and avoiding high impact exercises such as excessive running which can increase wear and tear on the knee joint.

If you have suspected tricompartmental arthritis, speak to an orthopaedic surgeon who can provide an accurate diagnosis and advise on the best course of treatment.

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