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. 2011:2011:454873.
doi: 10.1155/2011/454873. Epub 2011 Apr 26.

Current surgical treatment of knee osteoarthritis

Karolin Rönn  1 , Nikolaus Reischl, Emanuel Gautier, Matthias Jacobi
Affiliations

Current surgical treatment of knee osteoarthritis

Karolin Rönn et al. Arthritis. 2011.

Abstract

Osteoathritis (OA) of the knee is common, and the chances of suffering from OA increase with age. Its treatment should be initially nonoperative-and requires both pharmacological and nonpharmacological treatment modalities. If conservative therapy fails, surgery should be considered. Surgical treatments for knee OA include arthroscopy, cartilage repair, osteotomy, and knee arthroplasty. Determining which of these procedures is most appropriate depends on several factors, including the location, stage of OA, comorbidities on the one side and patients suffering on the other side. Arthroscopic lavage and débridement is often carried out, but does not alter disease progression. If OA is limited to one compartment, unicompartmental knee arthroplasty or unloading osteotomy can be considered. They are recommended in young and active patients in regard to the risks and limited durability of total knee replacement. Total arthroplasty of the knee is a common and safe method in the elderly patients with advanced knee OA. This paper summarizes current surgical treatment strategies for knee OA, with a focus on the latest developments, indications and level of evidence.

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Figures

Figure 1
Figure 1
Schematic drawing of autologous cartilage implantation (ACI). The procedure consists of the following steps: (1) cartilage harvest generally performed during arthroscopic surgery, (2) cell culture with expansion of cells in monolayer flasks, and (3) reimplantation of the cells by injecting them underneath a sutured collagen membrane.
Figure 2
Figure 2
Unloading osteotomy: exemplary a valgisation open-wedge high tibial osteotomy in unicompartmental OA of the medial knee compartment. The corrected position is stabilized by a plate with angular locked screws.
Figure 3
Figure 3
Treatment of an isolated medial compartment OA by unicompartmental arthroplasty.
Figure 4
Figure 4
Treatment of advanced knee OA by total knee arthroplasty (example without patella resurfacing).
See this image and copyright information in PMC

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