osteoarthritis
OSTEOARTHRITIS

Osteoarthritis is a chronic progressive disease where there is degeneration & loss of articular cartilage that occurs together with new bone formation at the joint surfaces and margins, that causes pain and deformity.

The patient experiences pain, stiffness, decreased movement, inflammation and crepitus.

The pain is usually aggravated by pain and relieved by rest.

Surgical Intervention

  • Patients with severe symptomatic OA that has no improvement with medical therapy & with progressive limitation in daily activities should be referred to an Orthopedic surgeon for evaluation & management

Arthroscopic Debridement

  • Some studies have shown short-term symptom relief, but has no effect on function & stiffness
  • May be useful in patients with history of mechanical locking or giving way that may be due to meniscal tear or intra-articular loose body in radiographic exams

Joint Replacement Surgery

  • Recommended for patients with severe pain & reduced function that failed to respond with conservative & pharmacological management
    • May be suggested at the 1st sign of functional limitation & presence of severe pain
  • Effective in relieving pain, correcting deformity, & improving quality of life
  • Should be based on the severity of pain & disability, age, & comorbidities

Unicondylar/Unicompartmental Knee Replacement

  • Used when only 1 of the 2 major joint compartments of the knee is severely involved
  • Advantages over total knee replacement:
    • Less bone loss at surgery
    • Easier revision when & if it becomes necessary
    • Usually have shorter operating time & recovery period

Osteotomy

  • High tibial osteotomy is an alternative in a young patient with severe medial compartment OA with minimal involvement of the lateral joint compartment resulting in varus deformity
    • Delays the need of joint replacement for 10 years & has only 25% overall failure rate after 10 years
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