Tricompartmental osteoarthritis is a type of knee osteoarthritis (OA) that affects all three knee compartments.
- the medial femoral-tibial compartment, on the inside of the knee
- the patellofemoral compartment, formed by the femur and kneecap
- the lateral femoral-tibial compartment, on the outside of the knee
OA can affect any of these parts. When it occurs in all three, this is tricompartmental osteoarthritis. The impact can be more severe when OA affects three compartments rather than just one.
The symptoms of tricompartmental OA are similar to those of unicompartmental OA, but they affect all three parts of the knee joint.
Symptoms may include:
- swelling and stiffness in the knee
- difficulty bending and straightening the knee
- inflammation, especially after activity
- pain and swelling that worsens while sleeping or in the morning
- pain that increases after sitting or resting
- creaking, clicking, snapping, or grinding noise from the knee
- weakness or buckling in the knee
- impaired gait (walking), usually bow-legged or knock-kneed
- lumps on the bone
- locking of the joint, due to bone fragments and deformation
- difficulty getting around without support
An X-ray may reveal loose bone fragments and damage to cartilage and bone.
Several factors increase your risk of developing OA, including tricompartmental OA.
Obesity. Extra body weight puts stress on weight-bearing joints, such as the knees. Experts advise people with OA and obesity to work with their doctor to establish an appropriate target weight and develop a plan to reach this goal.
Older age. As you get older, parts of your joint can gradually wear away. Regular physical activity and stretching can help slow down this process. OA is not an automatic part of aging, but the chances of it happening increase with age.
Sex. Women are more likely to develop OA than men, especially after the age of 50 years.
Injuries to the joint. If you have had a knee injury in the past, you are more likely to develop OA.
Certain activities. Over time, certain forms of physical activity can stress the knee joints. Examples include regularly lifting and moving heavy objects, doing certain sports, and climbing multiple flights of stairs each day.
Genetics. If you have a close family member, such as a parent, with OA, you have a higher chance of developing it, too.
Bone and soft tissue deformities. Some people are born with knee joints and cartilage that are more prone to OA.
Your doctor will ask about your symptoms.
The criteria for a diagnosis of OA of the knee include knee pain and three or more of the following symptoms:
- stiffness in the morning lasting up to 30 minutes
- cracking or grating feeling in the knee, known as crepitus
- enlargement of the bony part of the knee
- tenderness of the knee bones
- minimal warmth on the joint
The doctor may also want to carry out an imaging test, such as an X-ray.
The results can show details of the space between the bones of the knee joint. Narrowing of the joint space suggests a more severe disease, including erosion of the cartilage.
Your doctor will also look for the formation of bony growths called osteophytes. Osteophytes are a result of bones rubbing against each other.
In the early stages of OA, these changes may not be visible on X-rays. However, tricompartmental OA tends to be more severe, and these features are usually clear.
Other assessments may include:
- lab tests to rule out other diagnoses
- an MRI, which can reveal damage to soft tissues, such as cartilage and ligaments
There’s no cure for tricompartmental or other types of OA, because it is not yet possible to replace cartilage that is already damaged.
Instead, treatment focuses on managing symptoms and slowing the progression of OA.
Weight management and exercise
Weight management and exercise play a key role in managing OA.
Losing weight can help reduce the pressure on the knee. Exercise keeps the knee muscles strong and helps support the knee joint.
A doctor or physical therapist may recommend switching from high-impact exercises — like running — to low-impact ones, like swimming and water aerobics.
Other suitable options include tai chi, walking, cycling, and stretching exercises. Ask your doctor about suitable options for you.
Get some tips here on low-impact activities for people with OA.
- a walking cane or walker
- a brace or splint
- kinesiotape, a kind of dressing that supports the joint while allowing it to move
Experts do not currently recommend using modified shoes, as there is not enough research to show which kind of modification is appropriate.
At-home treatments include:
- ice and heat packs
- over the counter non-steroidal anti-inflammatory drugs (NSAIDs)
- topical creams containing capsaicin or NSAIDs
If OTC and home remedies don’t help, or if symptoms affect your daily life and mobility, your doctor may prescribe oral or injectable medication.
- tramadol for pain relief
- injectable corticosteroids
If those treatments are ineffective or stop working, your doctor may recommend surgery.
Surgery can help people who are experiencing:
- severe pain
- difficulties with mobility
- reduction in quality of life
Your doctor may recommend total knee replacement surgery if tricompartmental knee OA affects your ability to carry out everyday tasks.
This surgeon will remove the damaged bone and cartilage and replace it with an artificial joint made of metal or plastic.
Up to 90 percent of people who have a total knee replacement say it reduces pain levels and increases mobility, according to the American Academy of Orthopaedic Surgeons.
However, it can take several months to recover from the operation. Follow-up will include medication and visits with the orthopedic surgeon.
If you have tricompartmental OA, self-management of your condition can help prevent it from getting worse.
Here are some ways to do this:
- avoid smoking
- follow a healthful diet
- find a suitable balance between activity and rest
- establish regular sleeping patterns
- learn how to manage stress
What kind of diet is good to follow with OA? Find out here.
Knee OA affects many people, especially as they get older. Tricompartmental OA affects all components of the knee joint.
Common ways to improve pain and mobility include exercise, and severe cases, surgery.
Your doctor can help you make a suitable plan to maintain or improve your quality of life with OA.