Knee osteoarthritis is the progressive loss of the cartilage surfaces that line the bones of the knee joint. As cartilage fails, the joint narrows, bone grinds on bone, and mobility becomes painful and limited. Knee arthritis is one of the most common orthopaedic conditions worldwide and the leading cause of knee replacement surgery. Dr. Chudik performs robot-assisted partial and total knee replacement using computer navigation technology, which improves implant placement and long-term outcomes.
What Is Knee Osteoarthritis?
The knee has three compartments: medial (inside), lateral (outside), and patellofemoral (behind the kneecap). Each compartment has articular cartilage that covers the bone ends and allows the joint to glide almost frictionlessly. Osteoarthritis can affect one compartment, two compartments, or all three, and the specific pattern drives treatment.
- Medial unicompartmental arthritis: the most common pattern, producing pain on the inside of the knee
- Lateral unicompartmental arthritis: less common, often associated with prior meniscus surgery or valgus alignment
- Patellofemoral arthritis: cartilage loss behind the kneecap, producing pain with stairs, squatting, and prolonged sitting
- Tricompartmental arthritis: involvement of all three compartments, the typical pattern requiring total knee replacement
Cartilage has no blood supply and limited capacity to repair itself. Once lost, cartilage does not regenerate to its original structure, and progression tends to continue over time.
Causes and Risk Factors
- Age, with increasing prevalence through the sixth and seventh decades
- Prior knee injury including meniscus tear, ligament injury, or fracture
- Prior knee surgery, particularly meniscectomy
- Obesity, which increases loading of the joint
- Malalignment (varus or valgus deformity), which concentrates load on one compartment
- Family history of knee arthritis
- Occupational or recreational patterns involving heavy repetitive loading
Symptoms
- Pain with activity initially, progressing to pain at rest in advanced disease
- Morning stiffness that typically resolves within 30 minutes
- Swelling with increased activity
- Crepitus or grinding with knee motion
- Loss of motion, particularly terminal flexion and extension
- Progressive difficulty with stairs, prolonged standing, and squatting
- Buckling or giving-way in advanced disease from muscle weakness and cartilage loss
Diagnosis
Dr. Chudik’s evaluation includes the pain pattern, functional limitations, and prior knee history. Physical examination documents alignment, range of motion, crepitus, and any ligamentous laxity. X-rays are the primary imaging study and show joint space narrowing, osteophytes, and subchondral changes. Weight-bearing views are critical for accurate assessment of joint space. MRI is added when cartilage loss is suspected but not yet visible on X-ray, or when associated meniscus pathology is suspected. CT is obtained for surgical planning in complex deformities. The Westmont office has on-site high-field MRI and X-ray.
Treatment
Non-surgical treatment is effective for early and moderate disease. Options include:
- Activity modification and weight loss when applicable
- Anti-inflammatory medication
- A targeted physical therapy program for quadriceps strengthening, flexibility, and impact reduction
- Corticosteroid injection for flare control
- Hyaluronic acid injection in selected cases
- Bracing for unloading a single compartment
When non-surgical treatment no longer controls symptoms, surgical options depend on the pattern and severity of arthritis:
- Unicompartmental knee arthroplasty (partial knee replacement), for isolated single-compartment disease. Dr. Chudik performs robot-assisted unicompartmental replacement (MAKOplasty), which improves implant positioning and ligament balance.
- Total knee arthroplasty, for tricompartmental disease. Dr. Chudik performs computer-navigated robot-assisted total knee replacement, which allows virtual surgical planning before incision and improves implant position, ligament balance, and long-term outcomes.
- Patellofemoral arthroplasty, in select cases of isolated patellofemoral arthritis
- Arthroscopic debridement, in limited cases with mechanical symptoms from meniscus tears alongside arthritis
Recovery and Outcomes
Recovery after knee replacement typically includes same-day or next-day mobilization with physical therapy, progressive walking and motion over the first two weeks, return to daily activities by four to six weeks, and full recovery over three to six months. Return to low-impact activity is typical. Return to high-impact sport is not recommended after knee replacement.
Long-term survivorship of modern knee replacement is excellent, with reliable outcomes at 10, 15, and 20 years for both total and unicompartmental implants.
When to See Dr. Chudik
Schedule an evaluation if knee pain, stiffness, or loss of function has persisted despite non-surgical treatment, or if previous treatment no longer controls symptoms. Call 630-324-0402 or request an appointment online.