• 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 osteoarthritis 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