What Is Medial Compartmental Osteoarthritis?

Medial compartmental osteoarthritis is a type of osteoarthritis (OA) that affects only one part of the knee: the medial compartment.

The three compartments that make up the knee are the:

• lateral compartment, on the outer side of the knee
• medial compartment, near the middle of the knee, on the inner side
• patellofemoral compartment, consisting of the kneecap and part of the femur

OA can affect one or more of these compartments. In a study of data for 250 knees with OA, fewer than 15% involved only one compartment. If it affects all three compartments, it is called tricompartmental OA.

OA usually results from wear and tear as people get older, but it can also result from excessive use or injury.

There is no cure for OA, and symptoms usually worsen over time, but there are ways to manage it. In this article, learn more about this condition and the treatment options.

The symptoms of medial compartmental OA are similar to those of other types of OA of the knee.

They tend to develop over time and include:

• pain that gets worse over time, especially with activity
• stiffness, especially when you wake up in the morning
• swelling or inflammation
• “locking up” after sitting for a while
• symptoms that are more noticeable after vigorous activity
• instability in the knee joint, with the knee pulling toward the middle of the body

Eventually, pain and a loss of mobility can start to affect your quality of life.

The symptoms of medial compartmental OA might be more easily managed than tricompartmental arthritis.

Articular cartilage acts as a cushion between the bones of a joint. OA happens if that cartilage becomes damaged.

Without cartilage, the bones rub together when you move, causing friction and inflammation. This can irritate nerve fibers and cause pain and further damage.

The spaces between the joints may also narrow, and bone spurs can form on the bones in the knee.

Medial compartmental OA may result from:

• a traumatic injury that damages the cartilage
• knee misalignment
• overuse of an injured or misaligned knee
• a meniscus injury, which damages the fibrocartilage between your thighbone and shinbone

To diagnose medial compartmental OA, a doctor will likely:

• carry out a physical exam
• ask about your medical history, including any past injuries
• check for misalignment
• take an X-ray

An X-ray may show damage to the knee joint or cartilage and will help determine whether OA affects multiple compartments or the medial compartmental only.

Your doctor may recommend seeing a doctor who specializes in OA, such as:

• a sports medicine specialist
• an orthopedic surgeon
• a rheumatologist

Conservative, first-line treatment for medial compartmental OA can combine:

• medication
• exercise
• weight loss, if appropriate

Below are some specific treatment plans for people with arthritis of the knee.

OTC medication and home remedies

Over-the-counter (OTC) medications and home remedies may help manage pain and improve mobility.

They include:

• non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), which reduce pain and inflammation
• acetaminophen (Tylenol) for pain relief, if NSAIDs are not suitable
• topical ointments or creams containing NSAIDs or capsaicin
• heat and cold packs to reduce pain and inflammation

Here are some additional tips on managing knee pain, especially at night.

Prescription medication

OTC drugs can help manage mild symptoms. In time, however, you may need to use prescription drugs.

These include:

• tramadol, an opioid pain relief drug
• duloxetine (Cymbalta), which is also an antidepressant
• corticosteroid injections, which offer short-term relief from pain and inflammation

Apart from tramadol, experts do not recommend using opioid drugs, as they can have severe adverse effects, including dependency.

Exercise

Regular exercise can help manage OA in one of the following ways:

• It strengthens the muscles that support the knee.
• It helps maintain flexibility and mobility.
• It plays a role in weight management.
• It can reduce stress and boost overall health.

When you have knee pain, it can be daunting to start a new exercise program. Your doctor or physical therapist can help you make a suitable beginner schedule.

When starting an exercise schedule, consider these tips:

• Follow the advice of your knee specialist from the start.
• Begin slowly and work your way up to longer sessions.
• Don’t overdo one exercise, and get enough rest between sessions.
• Opt for low-impact activities, such as walking, cycling, swimming, water aerobics, tai chi, and yoga.
• Ask your specialist about knee-strengthening exercises, such as mini-squats, plus hamstring and quad stretches.

Strengthening the quadriceps, which are the muscles in your thigh, may help stabilize your knee and reduce or prevent pain. According to research, it may help slow the progress of symptoms.

Click here to learn more about muscle-strengthening exercises for the knee.

Other options that can help with mobility include:

• physical or occupational therapy
• assistive devices, such as a cane or walking frame
• a brace or knee support

Weight loss

If you are overweight, losing weight will reduce pressure on the knee joint. It can also boost overall health and reduce the risk of heart disease and other complications.

Experts strongly recommend weight loss as a therapy for people with overweight who have OA.

Your doctor or a dietitian can help you decide how much weight, if any, you need to lose, and how you can reach this goal.

Discover how weight loss can help OA here.

If other options are no longer effective, your doctor may recommend surgery knee replacement surgery.

Total knee surgery may not be necessary if OA affects only one part of the knee. Instead, a less invasive option may be possible, known as a partial knee replacement. The surgeon will use a small incision to access and resurface the damaged part of the joint.

They will replace the damaged compartment with a metal or plastic part, while preserving the healthy bone, cartilage, and ligaments.

The recovery time and pain level will usually be less for this type of surgery than with a total knee replacement.

However, if OA develops in other parts of the knee after surgery, a total knee replacement may be necessary.

There is no cure for medial or other types of OA, but a range of treatment options can help you manage it and reduce or delay the need for surgery.

They can also improve your quality of life and decrease the need for mobility devices.

Staying active and maintaining a healthy weight are crucial for managing medial compartmental OA.