Helping Arthritic Knees Hold Out for ReplacementSurgeons in Japan are using a new arthroscopic surgery to treat osteoarthritic (OA) knees. It's called posteromedial release (PMR). Surgeons use a long needle with a tiny TV camera on the end (an arthroscope) to go inside the joint. The meniscus, ligament, and joint capsule are taken out from the inside (medial edge) of the joint.
Patients in this study all had OA with medial knee joint pain. Motion was limited and the knee could no longer straighten all the way. This is called a knee flexion contracture. The surgeons describe their technique to perform this operation.
Long-term results of the treatment are reported. Patient pain levels, function, and satisfaction were used as measures of success. X-rays and MRIs were also used to assess the results. Patients were followed for up to five years.
Most of the patients had decreased pain and increased function. Three-fourths of the patients were happy with the results. Only six patients had continued knee pain. They ended up getting a total knee replacement (TKR) anywhere from one to two and a half years later.
The authors concluded that the results of PMR aren't as good as a TKR. PMR is still a good option for some patients. After PMR patients are much better than before surgery, and the results last at least two (or more) years. The bone is preserved and the patient gets improved motion. Patients can still have a TKR later.
Hideshige Moriya, MD, et al. Arthroscopic Posteromedial Release for Osteoarthritic Knees with Flexion Contracture. In Arthroscopy. December 2004. Vol. 20. No. 10. Pp. 1030-1039.
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