1. Dai's Left knee (A) AP from front + (B) Lat from side

Blue line through the inside of the knee.

BUT the clue to partial knee replacement lies

NOT in the image (from the front) on the left (A), BUT

The Lateral View..

..taken from the side on the right (B above).

Let's zoom in a bit..

2. Dai's Left Knee from the side

There was a small gap between the bones on that first left hand image (1A)

BUT here from the side on lateral view there's clear bone-on-bone OA (2)

(There's no gap between the bones at the blue arrows)

That complete loss of cartilage is on the inside of his knee.

AND NOT right to the back of the knee..

3. Dai's Left Knee from the side

Importantly..

The cartilage loss has spared the back of the knee.

See that blue line of cartilage loss

..it curves up at the back.

The cartilage at the back of the knee remains intact.

That tells us that the anterior cruciate ligament (ACL) is intact.

The ACL is the ligament that footballers sometime injure or rupture

It gives the knee front to back stability

And stops the tibia coming forward.

So, if the cartilage at the back of the knee is intact

There must be an..

Intact ACL

AND a successful partial knee replacement relies on:

An intact Anterior Cruciate Ligament (ACL), and

An intact Medial Collatoral Ligament (MCL) on the inside.

(..and FWIW an intact lateral and Patella compartment)

This Inside-front pattern of osteoarthritis- short-handed to Antero-medial OA- implies an intact MCL + ACL.

And with those criteria met Dai should get a quicker recovery AND a better overall result**

And that makes sense 'cos Dai's knee is going to function more like a normal knee.. with normal functioning ligaments controlling how his knee moves.

Coming up 🙏

I'll write more on the evidence for partial or unicompartmental knee replacement some other time..

**For now, you can look up the TOPKAT Randomised Control Trial (RCT) here..

In the New Year I want to ask how on earth some people can keep running well into their 80s with no Knee OA 😃

On the face of it it doesn't make sense, but it gets to the heart of why I write these newsletters..❤️

Hip + Knee Pain TOOLKITs 🛠️

If you want to get a deeper understanding here's my toolkit of proven actions to do more with less pain in 3 months..

Click for lifetime access (£39 /$53)

Invite a friend.. ❤️

Forward this Newsletter on to anyone struggling with hip or knee pain. More than 600+ others read (and hopefully benefit!) each week..
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Oh.. and have a super Christmas one and all ❤️🎄

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Duchy Hospital
Truro
TR1 3UP
United Kingdom