Table of ContentsView AllTable of ContentsSymptomsDiagnosisConservative TreatmentSurgical Replacement
Table of ContentsView All
View All
Table of Contents
Symptoms
Diagnosis
Conservative Treatment
Surgical Replacement
Tricompartmentalosteoarthritis(OA) is a type of knee arthritis. It occurs in all three compartments of the knee (places where bones join together), instead of just one or two. While OA affects knees more than any other joint, a review of more than 3,700 cases found the tricompartmental diagnosis in just 17% of cases.
This article explains tricompartmental osteoarthritis and how its symptoms are diagnosed. It explains treatment options, including why tricompartmental osteoarthritis can be serious and require surgery.
B.BOISSONNET / BSIP / Corbis / Getty Images
Tricompartmental Osteoarthritis Symptoms
Osteoarthritis of the knee leads to symptoms of pain andinflammation, sometimes making the knee stiff and difficult to bend. The knee may creak, pop, or make bone-on-bone sounds calledcrepitus.
The OA symptoms may be worse in the morning or after being still, or they may flare up with activity. Knees also change shape and the deformity can be visible. Some people feel as though the knee cannot support the body.
When all three knee compartments are involved, the OA can be considered end-stage. Often, it will require a totalknee arthroplasty(replacement) procedure.Your healthcare provider will assess the severity using the Kellegren–Lawrence grading system for OA, based on exams, imaging, and other tools.
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Tricompartmental Osteoarthritis Diagnosis
A physical examination may provide the first indication of which compartment is affected. Your healthcare provider will ask you to stand and to walk. They watch for:
Your healthcare provider will also check forjoint laxityand check yourrange of motion. They will observe the knee forjoint effusion, feeling the knee when in a flexed position, as well as check for signs ofmuscle atrophyand skin changes.
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Imaging Tests
X-raysor magnetic resonance imaging (MRI) may be needed to confirmcartilage lossand joint damage associated with the abnormalities observed during your physical examination.
On X-ray imaging, cartilage loss will be visualized as anarrowing of the joint space.Often, the narrowing will develop unilaterally (on one side).
Nearly 30% of people age 45 and older show evidence of knee OA on MRI or other imaging studies. About half of these people have knee symptoms.
Treatment options for knee osteoarthritis depend on the severity of joint damage, pain level, and activity level.Weight managementandpain medicationare fist-line treatment approaches.
Before considering surgical options, your healthcare provider also may try:
New treatments, like anti-nerve growth factor (NGF) injections, are under study.Still, few lasting options exist. The relief from interventions like physical therapy, using braces at the joint, taking nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, or receiving injections can be short-lived.
Tricompartmental Arthritis and SurgeryNot everyone responds to nonsurgical care, and the 2023 guidelines of the American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) detail why longer waits may not help and knee replacement for people with moderate to severe OA should move forward.There are special situations, though, including:Obesity: It may not be necessary to postpone surgery until a specific weight loss goal is reached, but it remains a consideration.Diabetes: Knee replacement should wait until there’s evidence that blood sugars are controlled well.Smoking: Surgery should be delayed until smoking cessation or, at the least, a drop in nicotine use. People who smoke may be at greater risk of complications.
Tricompartmental Arthritis and Surgery
Not everyone responds to nonsurgical care, and the 2023 guidelines of the American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) detail why longer waits may not help and knee replacement for people with moderate to severe OA should move forward.There are special situations, though, including:Obesity: It may not be necessary to postpone surgery until a specific weight loss goal is reached, but it remains a consideration.Diabetes: Knee replacement should wait until there’s evidence that blood sugars are controlled well.Smoking: Surgery should be delayed until smoking cessation or, at the least, a drop in nicotine use. People who smoke may be at greater risk of complications.
Not everyone responds to nonsurgical care, and the 2023 guidelines of the American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) detail why longer waits may not help and knee replacement for people with moderate to severe OA should move forward.There are special situations, though, including:
Joint Pain Causes and Treatment Options
More than 700,000 total knee replacements are done each year in the United States, and OA is the reason in more than 90% of the cases.When conservative treatments yield inadequate results, the next step may be surgery, and that’s especially likely with tricompartmental osteoarthritis.
Models suggest that about 50% of people with knee OA will undergo a total knee replacement at some point.Arthroscopic debridementorosteotomymay be considered appropriate in certain cases, prior to consideringtotal knee replacement, but tricompartmental OA often requires the procedure.
Keep in mind that studies suggest people with a total replacement are less likely to need further surgeries than those with partial knee replacements, but the risk of complications is higher. These complications can include:
In the end, your healthcare provider will assess the severity of your condition and recommend the best course of action for your individual case.
When One or Two Compartments are AffectedWhen only one knee compartment is involved, your healthcare team may recommend apartial knee replacement. There is also a bicompartmental knee replacement option for people with knee osteoarthritis of the medial and patellofemoral compartments.The main advantage of a partial knee replacement is that normal bone and the twoanterior cruciate ligamentsare preserved. Hospitalization time, recovery time, and the risk of complications are also reduced.
When One or Two Compartments are Affected
When only one knee compartment is involved, your healthcare team may recommend apartial knee replacement. There is also a bicompartmental knee replacement option for people with knee osteoarthritis of the medial and patellofemoral compartments.The main advantage of a partial knee replacement is that normal bone and the twoanterior cruciate ligamentsare preserved. Hospitalization time, recovery time, and the risk of complications are also reduced.
When only one knee compartment is involved, your healthcare team may recommend apartial knee replacement. There is also a bicompartmental knee replacement option for people with knee osteoarthritis of the medial and patellofemoral compartments.
The main advantage of a partial knee replacement is that normal bone and the twoanterior cruciate ligamentsare preserved. Hospitalization time, recovery time, and the risk of complications are also reduced.
Summary
Treatment options, especially surgical options, are likely with tricompartmental knee OA. However, an accurate diagnosis is essential for managing knee osteoarthritis and finding appropriate treatment. An orthopedic specialist may be needed to treat the condition.
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9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stoddart JC, Dandridge O, Garner A, Cobb J, van Arkel RJ.The compartmental distribution of knee osteoarthritis - a systematic review and meta-analysis.Osteoarthritis Cartilage. 2021 Apr;29(4):445-455. doi: 10.1016/j.joca.2020.10.011.Arthritis Foundation.What is osteoarthritis?American Academy of Orthopaedic Surgeons.Arthritis of the knee.Parente A, Medetti M, Basile G, Parente F.One-stage tricompartmental hypoallergenic UKA for tricompartmental osteoarthritis: A case report.Healthcare (Basel). 2023 Nov 20;11(22):2999. doi:10.3390/healthcare11222999.Katz JN, Arant KR, Loeser RF.Diagnosis and treatment of hip and knee osteoarthritis: A review.JAMA. 2021 Feb 9;325(6):568-578. doi: 10.1001/jama.2020.22171Kolasinski SL, Neogi T, Hochberg MC, et al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Rheumatol. 2020;72(2):220-233. doi:10.1002/art.41142DeBernardis D, Stark M, Ford E, McDowell C, McMillan S.Percutaneous skeletal fixation of painful subchondral bone marrow edema of the knee.Arthrosc Sports Med Rehabil. 2020 Oct 5;2(5):e583-e590. doi: 10.1016/j.asmr.2020.07.006Hannon CP, Goodman SM, Austin MS, Yates A Jr, Guyatt G, Aggarwal VK,et al.2023 American College of Rheumatology and American Association of Hip and Knee Surgeons clinical practice guideline for the optimal timing of elective hip or knee arthroplasty for patients with symptomatic moderate-to-severe osteoarthritis or advanced symptomatic osteonecrosis with secondary arthritis for whom nonoperative therapy is ineffective.Arthritis Rheumatol. 2023 Nov;75(11):1877-1888. doi: 10.1002/art.42630Sabatini L, Giachino M, Risitano S, Atzori F.Bicompartmental knee arthroplasty.Ann Transl Med. 2016;4(1):5. doi:10.3978/j.issn.2305-5839.2015.12.24
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stoddart JC, Dandridge O, Garner A, Cobb J, van Arkel RJ.The compartmental distribution of knee osteoarthritis - a systematic review and meta-analysis.Osteoarthritis Cartilage. 2021 Apr;29(4):445-455. doi: 10.1016/j.joca.2020.10.011.Arthritis Foundation.What is osteoarthritis?American Academy of Orthopaedic Surgeons.Arthritis of the knee.Parente A, Medetti M, Basile G, Parente F.One-stage tricompartmental hypoallergenic UKA for tricompartmental osteoarthritis: A case report.Healthcare (Basel). 2023 Nov 20;11(22):2999. doi:10.3390/healthcare11222999.Katz JN, Arant KR, Loeser RF.Diagnosis and treatment of hip and knee osteoarthritis: A review.JAMA. 2021 Feb 9;325(6):568-578. doi: 10.1001/jama.2020.22171Kolasinski SL, Neogi T, Hochberg MC, et al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Rheumatol. 2020;72(2):220-233. doi:10.1002/art.41142DeBernardis D, Stark M, Ford E, McDowell C, McMillan S.Percutaneous skeletal fixation of painful subchondral bone marrow edema of the knee.Arthrosc Sports Med Rehabil. 2020 Oct 5;2(5):e583-e590. doi: 10.1016/j.asmr.2020.07.006Hannon CP, Goodman SM, Austin MS, Yates A Jr, Guyatt G, Aggarwal VK,et al.2023 American College of Rheumatology and American Association of Hip and Knee Surgeons clinical practice guideline for the optimal timing of elective hip or knee arthroplasty for patients with symptomatic moderate-to-severe osteoarthritis or advanced symptomatic osteonecrosis with secondary arthritis for whom nonoperative therapy is ineffective.Arthritis Rheumatol. 2023 Nov;75(11):1877-1888. doi: 10.1002/art.42630Sabatini L, Giachino M, Risitano S, Atzori F.Bicompartmental knee arthroplasty.Ann Transl Med. 2016;4(1):5. doi:10.3978/j.issn.2305-5839.2015.12.24
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Stoddart JC, Dandridge O, Garner A, Cobb J, van Arkel RJ.The compartmental distribution of knee osteoarthritis - a systematic review and meta-analysis.Osteoarthritis Cartilage. 2021 Apr;29(4):445-455. doi: 10.1016/j.joca.2020.10.011.Arthritis Foundation.What is osteoarthritis?American Academy of Orthopaedic Surgeons.Arthritis of the knee.Parente A, Medetti M, Basile G, Parente F.One-stage tricompartmental hypoallergenic UKA for tricompartmental osteoarthritis: A case report.Healthcare (Basel). 2023 Nov 20;11(22):2999. doi:10.3390/healthcare11222999.Katz JN, Arant KR, Loeser RF.Diagnosis and treatment of hip and knee osteoarthritis: A review.JAMA. 2021 Feb 9;325(6):568-578. doi: 10.1001/jama.2020.22171Kolasinski SL, Neogi T, Hochberg MC, et al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Rheumatol. 2020;72(2):220-233. doi:10.1002/art.41142DeBernardis D, Stark M, Ford E, McDowell C, McMillan S.Percutaneous skeletal fixation of painful subchondral bone marrow edema of the knee.Arthrosc Sports Med Rehabil. 2020 Oct 5;2(5):e583-e590. doi: 10.1016/j.asmr.2020.07.006Hannon CP, Goodman SM, Austin MS, Yates A Jr, Guyatt G, Aggarwal VK,et al.2023 American College of Rheumatology and American Association of Hip and Knee Surgeons clinical practice guideline for the optimal timing of elective hip or knee arthroplasty for patients with symptomatic moderate-to-severe osteoarthritis or advanced symptomatic osteonecrosis with secondary arthritis for whom nonoperative therapy is ineffective.Arthritis Rheumatol. 2023 Nov;75(11):1877-1888. doi: 10.1002/art.42630Sabatini L, Giachino M, Risitano S, Atzori F.Bicompartmental knee arthroplasty.Ann Transl Med. 2016;4(1):5. doi:10.3978/j.issn.2305-5839.2015.12.24
Stoddart JC, Dandridge O, Garner A, Cobb J, van Arkel RJ.The compartmental distribution of knee osteoarthritis - a systematic review and meta-analysis.Osteoarthritis Cartilage. 2021 Apr;29(4):445-455. doi: 10.1016/j.joca.2020.10.011.
Arthritis Foundation.What is osteoarthritis?
American Academy of Orthopaedic Surgeons.Arthritis of the knee.
Parente A, Medetti M, Basile G, Parente F.One-stage tricompartmental hypoallergenic UKA for tricompartmental osteoarthritis: A case report.Healthcare (Basel). 2023 Nov 20;11(22):2999. doi:10.3390/healthcare11222999.
Katz JN, Arant KR, Loeser RF.Diagnosis and treatment of hip and knee osteoarthritis: A review.JAMA. 2021 Feb 9;325(6):568-578. doi: 10.1001/jama.2020.22171
Kolasinski SL, Neogi T, Hochberg MC, et al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Rheumatol. 2020;72(2):220-233. doi:10.1002/art.41142
DeBernardis D, Stark M, Ford E, McDowell C, McMillan S.Percutaneous skeletal fixation of painful subchondral bone marrow edema of the knee.Arthrosc Sports Med Rehabil. 2020 Oct 5;2(5):e583-e590. doi: 10.1016/j.asmr.2020.07.006
Hannon CP, Goodman SM, Austin MS, Yates A Jr, Guyatt G, Aggarwal VK,et al.2023 American College of Rheumatology and American Association of Hip and Knee Surgeons clinical practice guideline for the optimal timing of elective hip or knee arthroplasty for patients with symptomatic moderate-to-severe osteoarthritis or advanced symptomatic osteonecrosis with secondary arthritis for whom nonoperative therapy is ineffective.Arthritis Rheumatol. 2023 Nov;75(11):1877-1888. doi: 10.1002/art.42630
Sabatini L, Giachino M, Risitano S, Atzori F.Bicompartmental knee arthroplasty.Ann Transl Med. 2016;4(1):5. doi:10.3978/j.issn.2305-5839.2015.12.24
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