{"id":11453,"date":"2025-02-03T06:00:34","date_gmt":"2025-02-03T05:00:34","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11453"},"modified":"2025-01-20T11:54:10","modified_gmt":"2025-01-20T10:54:10","slug":"unicompartmental-knee-pain","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2025\/02\/03\/unicompartmental-knee-pain\/","title":{"rendered":"Unicompartmental Knee Pain"},"content":{"rendered":"

Osteoarthritis (OA) is the most prevalent joint disease with a fifth of people aged over 45 years developing knee OA in their lifetime [1].\u00a0<\/span><\/p>\n

Many patients are often told to wait until they are candidates for total knee arthroplasty (TKA) without receiving symptomatic relief. This is because arthroplasty is relatively contraindicated without full thickness chondral loss or \u201cbone on bone\u201d contact. Younger, more active patients often fall into this treatment gap. TKA in this group also carries a higher risk of revision surgery and dissatisfaction due to the loss of native knee kinematics.\u00a0<\/span><\/p>\n

When arthroplasty is indicated, the vast majority of patients (85%) undergo TKA replacing the entire joint [2]. However, based on a meta-analysis by Stoddart et al., only a quarter of patients with knee OA have tricompartmental disease [3]. There is therefore a large number of patients with unicompartmental disease being overtreated with TKA. Overuse of TKA exposes patients to an increased risk of serious complications such as thromboembolism, myocardial infarction, and stroke as well as increased costs [4].<\/span><\/p>\n

There is clearly a requirement to raise awareness amongst patients and healthcare professionals from all specialties of the prevalence of unicompartmental knee OA and the current evidence-based knee preservation therapies available for this large cohort of patients. The infographic (figure 1) summarises and consolidates guidelines from a recent consensus statement on osteotomies around the knee [5], an algorithm paper for medial knee pain [6] as well as NICE guidelines on the management of OA [7].\u00a0<\/span><\/p>\n

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Figure 1<\/strong> Infographic summary<\/p>\n

Exercise and Education<\/b><\/p>\n

Exercise and education, prescribed as part of a physiotherapy program, are the recommended first-line treatments for people diagnosed with knee OA. Physiotherapy however remains extremely underutilized for the management of arthritic pain and <\/span>delayed initiation has recently been associated with a higher risk of opioid use in patients with knee OA\u00a0<\/span>[8].<\/span>
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