What to know about Tricompartmental Osteoarthritis

Tricompartmental osteoarthritis is a severe and progressive form of knee osteoarthritis that affects all three compartments of the knee joint: the medial, lateral, and patellofemoral compartments. This condition leads to significant cartilage degeneration and pain, significantly impairing a person’s mobility and quality of life. In this comprehensive guide, Zextrasure will reveal everything about tricompartmental osteoarthritis, including its causes, symptoms, diagnosis, and treatment options.

1. What is tricompartmental osteoarthritis?

Osteoarthritis (OA) is a degenerative joint disease that involves the gradual breakdown of cartilage, which protects the joints from friction. When this occurs in the knee, it leads to pain, inflammation, and limited mobility. Tricompartmental osteoarthritis is a form of knee OA where all three knee compartments are affected. These compartments include:

• Medial compartment: Located on the inner side of the knee.
• Lateral compartment: Found on the outer side of the knee.
• Patellofemoral compartment: Between the patella (kneecap) and the femur (thigh bone).

Unlike unicompartmental osteoarthritis, which only affects one compartment, tricompartmental osteoarthritis involves the entire knee, leading to more severe symptoms and greater impairment. Over time, the disease can cause the knee joint to become stiff and deformed, resulting in chronic pain and difficulty with movement.

In tricompartmental osteoarthritis, all three knee compartments are affected by arthritis

2. Symptoms of tricompartmental osteoarthritis

The symptoms of tricompartmental osteoarthritis are typically progressive and worsen over time as the condition advances. These symptoms can significantly affect a person’s daily life, limiting their mobility and ability to perform common activities. Recognizing the signs early on can help individuals seek treatment before the condition becomes severe.

Persistent knee pain

The most common symptom of tricompartmental osteoarthritis is persistent knee pain. This pain is usually aggravated by movement, particularly weight-bearing activities such as walking, climbing stairs, or standing for long periods. As the cartilage in the knee deteriorates, bone-on-bone friction increases, leading to intense discomfort.

Stiffness and reduced range of motion

People with tricompartmental osteoarthritis often experience stiffness, particularly after periods of rest or inactivity. The stiffness makes it difficult to fully bend or extend the knee, reducing the range of motion and impairing activities such as walking, squatting, or kneeling.

Swelling and inflammation

Inflammation in the knee joint is a hallmark of osteoarthritis. As the cartilage breaks down, the body produces more synovial fluid to lubricate the joint. However, this excess fluid can lead to swelling and discomfort. Swelling is often more pronounced after physical activity and may be accompanied by a feeling of warmth in the joint.

Tricompartmental osteoarthritis causes swelling, discomfort, and warmth

Weakness and instability

The muscles surrounding the knee may weaken as a result of tricompartmental osteoarthritis. This can lead to knee instability, where the knee feels like it might “give way” during activities. This instability increases the risk of falling and further damaging the joint.

Audible crepitus

Crepitus refers to the grating or popping sound that occurs when the knee is moved. This sound is caused by the roughened surfaces of the bones rubbing together due to the lack of protective cartilage. Crepitus is common in individuals with tricompartmental osteoarthritis and may be accompanied by discomfort or pain.

3. Who’s at risk for tricompartmental osteoarthritis?

Several factors contribute to the development of tricompartmental osteoarthritis. While some risk factors are beyond an individual’s control, many can be managed through lifestyle changes, proper medical care, and early intervention. Understanding the causes of tricompartmental osteoarthritis is essential for preventing or slowing its progression.

The causes of tricompartmental osteoarthritis

• Age: The risk of developing tricompartmental osteoarthritis increases with age and symptoms generally and usually appear in people over 50.
• Previous Injuries: Past knee injuries can alter joint mechanics and increase cartilage wear and the risk of osteoarthritis.
• Obesity: Excess weight puts added stress on knee joints and accelerates cartilage breakdown and raises osteoarthritis risk.
• Genetics and Family History: A family history of osteoarthritis can increase susceptibility, especially with genes affecting cartilage and inflammation.
• Gender: Women, especially after age 50 will develop a higher risk of knee osteoarthritis due to hormonal shifts affecting joint health.

4. How serious is tricompartmental osteoarthritis?

Tricompartmental osteoarthritis is a serious condition with several distinct impacts on joint health and daily function:

Widespread cartilage degeneration

Unlike other forms of OA that affect one or two knee compartments, tricompartmental involves the medial, lateral, and patellofemoral compartments. This broad cartilage breakdown leads to more severe and persistent pain, stiffness, and inflammation.

Severe impact on mobility

All three compartments are affected, and joint movement becomes significantly restricted. Tasks such as walking, climbing stairs, or standing up can become difficult, impacting daily independence and quality of life.

Tricompartmental osteoarthritis makes you walk difficultly

Visible deformities and alignment issues

Mild tricompartmental osteoarthritis often causes changes in knee alignment, such as valgus (knock-knee) or varus (bow-leg) deformities. These misalignments increase joint strain and pain, contributing to further degeneration.

Progressive nature and disability risk

Tricompartmental osteoarthritis is progressive, meaning symptoms generally worsen over time without treatment. Advanced cases can lead to severe disability, so it is difficult or impossible to carry out basic activities.

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5. Tricompartmental osteoarthritis diagnosis

Tricompartmental osteoarthritis diagnosis is essential to develop an effective treatment plan. Healthcare providers will typically use a combination of physical exams, imaging techniques, and medical history to confirm the diagnosis.

Physical examination

During a physical exam, a doctor will assess the knee joint’s range of motion, check for signs of swelling, and evaluate pain levels. They will also examine for tenderness, warmth, or deformities in the knee, which can indicate tricompartmental osteoarthritis.

Doctors check knee motion, swelling, tenderness, and deformities for diagnosis

Imaging Tests

• X-Rays: X-rays are the primary tool for diagnosing knee osteoarthritis. They provide clear images of bone structure and can identify changes such as joint space narrowing, bone spurs (osteophytes), and signs of misalignment, all of which are common in tricompartmental osteoarthritis.
• MRI (Magnetic Resonance Imaging): MRIs offer detailed images of the soft tissues, including cartilage, tendons, and ligaments. This imaging is particularly useful for assessing the extent of cartilage damage and identifying other issues such as meniscal tears.
• CT Scans: In some cases, a CT scan may be used to obtain more detailed images of the bones, especially if the X-ray results are inconclusive.

Joint Aspiration

If the doctor suspects joint inflammation, they may use a needle to remove fluid from the knee joint for analysis. This can help rule out infections, gout, or other inflammatory conditions that may mimic the symptoms of tricompartmental osteoarthritis.

6. What is the treatment for tricompartmental osteoarthritis?

There is no cure for tricompartmental osteoarthritis because cartilage restoration is not possible yet. Treatment primarily aims to manage symptoms and slow OA progression.

Weight management and exercise

Losing a small amount can significantly reduce the pressure on the knee joints and help alleviate symptoms of tricompartmental osteoarthritis. A healthy and balanced diet combined with regular exercise can lead to lasting improvements in joint health.

Losing weight reduces knee joint pressure and tricompartmental osteoarthritis symptoms

Medical devices

Devices that support the joint and aid mobility, such as a walking cane or walker, knee brace, splint, or kinesiotape can be helpful. However, experts advise against modified shoes due to a lack of evidence about their effectiveness.

Home remedies

Simple at-home treatments may include using ice or heat packs, taking over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs), or applying topical creams containing capsaicin or NSAIDs.

Prescription medications

If OTC methods don’t work, or if symptoms impact daily life, doctors may prescribe medications such as tramadol, duloxetine, or corticosteroid injections for pain and inflammation management.

Lifestyle management

Effective self-management can slow the progression of OA. This includes avoiding smoking, eating a joint-healthy diet, balancing activity and rest, maintaining good sleep habits, and managing stress.

Surgery

When conservative treatments are no longer effective, surgery might be recommended. Total knee replacement surgery can help those with significant pain and mobility issues, allowing for a better quality of life. In this procedure, the surgeon replaces the damaged cartilage and bone with an artificial joint. 

Tricompartmental osteoarthritis is a complex condition that can significantly impact an individual’s quality of life. Early diagnosis, lifestyle changes, and medical interventions can help alleviate symptoms and slow the progression of the condition.