Osteoarthritis: surgical treatment options - Patient Education Portal

Osteoarthritis is a chronic degenerative joint disease that can significantly impact the quality of life of affected individuals. When conservative measures fail to provide relief, surgical interventions become essential to manage symptoms and restore joint function.

Joint Replacement Surgery

Total joint replacement surgery is a common and effective intervention for severe osteoarthritis, especially in weight-bearing joints such as the hips and knees. This procedure involves removing the damaged joint surfaces and replacing them with artificial implants. Total hip and knee replacements have proven efficiency and success, emphasizing improved patient outcomes and satisfaction.

Arthroscopy

Arthroscopy is a minimally invasive surgical technique for visualizing and treating joint issues, particularly in the knee. A narrow tube with a tiny camera is inserted into the joint through a small incision to visualize the joint cavity and make some manipulations. However, randomized trials proved arthroscopy to have only limited effect in threatening osteoarthritis.

Osteotomy

Osteotomy involves surgically repositioning or realigning bones to relieve pressure on the affected joint. This procedure is often considered for younger individuals with localized joint damage, particularly in the knee. A systematic review in the Journal of Bone & Joint Surgery found that high tibial osteotomy was a viable option for medial compartment osteoarthritis, offering pain relief and improved function.

Joint Preserving Procedures

For individuals with early-stage osteoarthritis, joint preserving procedures aim to address specific joint abnormalities and slow down the progression of the disease. Procedures such as microfracture and autologous chondrocyte implantation (ACI) focus on stimulating the growth of new cartilage. One prospective study investigated the outcomes of microfracture for treating knee osteoarthritis, demonstrating improvements in pain and function.

Synovectomy

In cases where inflammation is a predominant feature of osteoarthritis, synovectomy may be considered. This surgical procedure involves the removal of the synovial membrane, which can help reduce pain and inflammation. Some significant improvements in symptoms and joint function were reported after assessing the outcomes of synovectomy in patients with knee osteoarthritis.

Surgical treatment options for osteoarthritis are diverse, ranging from joint replacement surgery for advanced cases to joint preserving procedures for those in the early stages. The choice of intervention depends on factors such as the severity of the disease, the patient's age, and overall health. Surgical decisions should be made in consultation with healthcare professionals, considering individualized treatment plans tailored to the specific needs of each patient.