The Surgical Treatment of Osteoarthritis

Abstract

Osteoarthritis is a degenerative condition affecting the whole joint with the underlying bone, representing a major source of pain, disability, and socioeconomic cost worldwide. Age is considered the strongest risk factor, albeit abnormal biomechanics, morphology, congenital abnormality, deformity, malalignment, limb-length discrepancy, lifestyle, and injury may further increase the risk of the development and progression of osteoarthritis as well. Pain and loss of function are the main clinical features that lead to treatment. Although early manifestations of osteoarthritis are amenable to lifestyle modification, adequate pain management, and physical therapy, disease advancement frequently requires surgical treatment. The symptomatic progression of osteoarthritis with radiographical confirmation can be addressed either with arthroscopic interventions, (joint) preservation techniques, or bone fusion procedures, whereas (joint) replacement is preferentially reserved for severe and end-stage disease. The surgical treatment aims at alleviating pain and disability while restoring native biomechanics. Miscellaneous surgical techniques for addressing osteoarthritis exist. Advanced computer-integrated surgical concepts allow for patient personalization and optimization of surgical treatment. The scope of this article is to present an overview of the fundamentals of conventional surgical treatment options for osteoarthritis of the human skeleton, with emphasis on arthroscopy, preservation, arthrodesis, and replacement. Contemporary computer-assisted orthopaedic surgery concepts are further elucidated.

Lisfranc Sports Injuries: What Do We Know So Far?

“…This approach is crucial for ensuring the best possible outcome in these complex Lisfranc injury cases [ 25 ]. Specific surgical interventions and techniques can be guided to some extent by secondary objectives, such as the preservation of articular cartilage to prevent post-operative osteoarthritis [ 26 ].…”

Osteoarthritis as an Umbrella Term for Different Subsets of Humans Undergoing Joint Degeneration: The Need to Address the Differences to Develop Effective Conservative Treatments and Prevention Strategies

“…For most patients, conservative management is often piecemeal, and various interventions are tried as individual “one-offs” until something is found to offer relief. When such an intervention subsequently fails, the search continues until more invasive options are entertained; such options include pre-joint replacement surgical interventions such as osteotomies [ 81 ], drilling/microfracture of the bone [ 94 , 95 ], or debridement alone or in combination with other treatments [ 96 , 97 , 98 ]. While many of these invasive surgeries offer transient relief for a number of patients, they have not been evaluated for effectiveness regarding knee OA subsets as defined in this review.…”

Adductor Canal Block Versus Local Infiltration Analgesia for Postoperative Pain Management in Total Knee Arthroplasty

“…Current therapeutic modalities encompass patient education, exercise regimens, weight management, physiotherapy, and pharmacotherapy [ 4 ]. Surgical interventions, such as total knee arthroplasty (TKA), are primarily reserved for advanced degenerative knee joint disease [ 5 ].…”