STORY BYDorothy Frost was in her 50s when arthritis attacked both her knees, making it a painful chore to walk even the shortest distance.
Her symptoms didn’t respond to anti-inflammatory medications and other non-surgical therapies, but the damage to her knees wasn’t extensive enough to warrant a total knee replacement.
Like other patients whose arthritis is confined to one compartment of the knee, Frost and her orthopedic surgeon, Terry Clyburn, M.D., director of total joint research at The University of Texas Medical School at Houston, decided that a uni-compartmental device was the best option for relieving her pain. That was more than 10 years ago.
The uni-compartmental device is designed to restore limb alignment, relieve pain, improve knee function and prevent or delay the need for a total knee replacement. The ideal candidate is someone who is between the ages of 50 and 60 who is healthy and expected to live 20 to 25 more years.
Michael Mann, M.D.
“This technique fills a much-needed gap,” says Michael Mann, M.D., assistant professor in the Department of Orthopaedic Surgery at the medical school.
If a person didn’t respond to anti-inflammatories, activity modification, physical therapy, bracing or joint injections, there wasn’t much left to do. “The only options we really had to offer in the past were arthroscopy for mechanical symptoms, osteotomy [removing a section of bone in the leg to change the load on the knee] or total knee replacement.
“This minimally-invasive surgical approach offers the advantage of restoring range of motion and reducing knee pain without interfering with possible future total joint replacement,” Mann said.
Clyburn, assistant professor of orthopedics at the university, said the uni-compartmental device may serve as a stopgap to total joint replacement.
The surgery can be done as an outpatient or short-stay procedure. First, surgeons perform a knee arthroscopy, and then insert the device through an extended three-inch incision and fix it with bone cement.
Patients are encouraged to walk within two to three hours after surgery.
The recovery time is minimal, Mann said. Generally, patients do not need formal rehabilitation and can return to their normal activities within six weeks. Many are driving within two weeks. Running and jumping activities are discouraged, but participation in other sports is allowed.
Clyburn added that because only a third of the knee is replaced, patients generally report that it feels more natural.
The relief from the uni-compartment device, which is considered temporary, may last 10 to 12 years before arthritis spreads to other areas of the knee or the plastic in the device wears thin.
Eventually, the osteoarthritis progressed in her right knee, and Clyburn had to do a total knee replacement. The left uni-knee is still doing well.
“The key here is to delay total knee replacement,” Clyburn said. “With a total knee replacement, the patient is in the hospital five or six days. They spend another 2-3 weeks on crutches, and it is 6-8 weeks before they are able to get around real well.”
He added that it’s easier on both patient and surgeon to replace a uni-compartmental device with a total knee than it is to do a total knee revision, which is a much more invasive procedure.
Repicci II, the uni-compartmental device used by Mann and Clyburn, has a good track record. In a recent study, 86 percent of patients had excellent to good results eight years after the surgery.
UPDATED: 6-16-2003
Editorial Board | Legal Disclaimer | Privacy & Security | Contact Us
©2000-2006 Office of Institutional Advancement, UT-Houston
Dr. Terry Clyburn is an assistant professor and director of research in the Department of Orthopaedic Surgery at the UT Medical School.
See Dr. Clyburn also at:
Special Instructions for Children Being Vaccinated Against Flu for the First Time:
Children 6 months up to 9 years of age getting a flu vaccine for the first time will need two doses of vaccine the first year they are vaccinated. If possible, the first dose should be given in September or as soon as vaccine becomes available. The second dose should be given 28 or more days after the first dose. The first dose "primes" the immune system; the second dose provides immune protection. Children who only get one dose but who need two doses can have reduced or no protection from a single dose of flu vaccine. Two doses are necessary to protect these children. If your child needs two doses, begin the process early, so that children are protected before influenza starts circulating in your community. Be sure to follow up to get your child a second dose if they need one. It usually takes about two weeks after the second dose for protection to begin.
Because flu viruses change every year, the vaccine is updated annually. So even if you or your children got a flu vaccine last year, you both still need to get a flu vaccine this season to remain protected. If October and November slip by, and you haven’t gotten your children or yourself vaccinated, get vaccinated in December or later.
