Medial compartment osteoarthritis of the knee: a review of surgical options

Abstract

■ Osteoarthritis of the medial compartment, where the lateral compartment and patella-femoral joint are relatively spared, is a common orthopaedic presentation. ■ Most frequently, the treatment of choice would be a total knee replacement, which involves removing healthy joint surfaces in such patients. ■ Arthroscopic debridement in the osteoarthritic knee has fallen out of favour due to poor clinical results. ■ A trend has developed towards less invasive surgery with uni-compartmental knee replacement (UKR) and high tibial osteotomy (HTO) gaining increasing popularity. ■ Surgeons differ in their relative indications and contraindications to performing these procedures. ■ Total knee replacement (TKR) continues to have the lowest overall revision rate of the available options. ■ Growing evidence demonstrates more favourable patient- reported outcome measures in UKR and HTO patients, compared to TKR. ■ Knee joint distraction (KJD) has been demonstrated as an alternative method of treatment in such patients.