Partial Knee Replacement: Less Pain, but Not for Everyone

The ends of bones are soft, so they must be covered with a thick white gristle called cartilage. Many people suffer from knee pain because the cartilage is damaged. They may have osteoarthritis in which the cartilage wears away, or they may have damaged cartilage in an accident or by playing sports. Once damaged, cartilage can never heal; the person spends the rest of his life losing cartilage until the cartilage is completely gone and the knee hurts 24 hours a day.

Until recently, the only effective treatment has been to cut out the ends of the bones of the knee and replace the entire knee joint. Now for some people, a simpler procedure may be effective: partial knee replacement, called unicompartmental knee arthroplasty. The surgeon removes just part of the cartilages and bones on the upper and lower legs on one side of the knee.

However, this procedure is not for everyone. Since partial replacements are more fragile than total knee replacements and do not last as long, the patient should be over 60, not obese and not a vigorous exerciser. All of the knee ligaments should be intact, the other compartments of the knee should not be damaged, and there should be no disease, such as rheumatoid arthritis, that causes progressive joint damage. If a partial knee replacement fails, more extensive surgery will be required for a total knee replacement. If you think you may be a candidate for partial knee replacement, check with an orthopedist with experience in this procedure.

After any surgery on knee cartilage, you must protect that knee for the rest of your life. Running and jumping cause further damage, while pedaling and swimming usually do not. More on total knee replacement; more on arthroscopic knee surgery

Awkward Running Form Can Be Improved

Many people look terribly uncoordinated when they run. Telling them to change their form will just make them more uncoordinated. If a coach criticizes a team member for poor running form and doesn't correct the underlying causes, the person is likely to become self-conscious about how he or she looks, and run even more slowly. Coordination usually improves just with repeated practice in the chosen sport.

Running form can improve markedly if you can correct muscle imbalances and structural abnormalities with appropriate exercises and perhaps mechanical devices. A coach can videotape the athletes while they run, then review the tape in slow motion to analyze the mechanical defects. For example, leaning forward during running is often caused by weak back muscles, which can be treated with exercises to strengthen the back. Pointing the toes out is often caused by weak lower leg muscles and can be corrected by doing exercises to strengthen the shin muscles. Leaning back on the heels after foot plant can be caused by excessive rolling-in motion of the feet or weak calf muscles.

Treatment often includes special inserts in the shoes and calf strengthening exercises, such as toe raises while holding a heavy weight in the hands. Holding the shoulders up towards the ears during running is usually caused by weak shoulder muscles, which can be corrected by shrugging the shoulders while holding weights. A low knee-lift is often caused by weak quadriceps muscles in the front of the upper leg. The quadriceps can be strengthened by pedaling a bicycle, skating, or running up hills. How to run faster