Surgical treatment of Osteoarthritis

Surgical treatment of osteoarthritis is required when pharmacological treatment or medical treatment is not satisfactory or not up to expectation. Sometimes surgery is combined with medical treatment for better results. In osteoarthritis of knee joints, surgical treatment is commonly used and there are several surgical procedures available for osteoarthritis of knee joints. Among all surgical procedures, arthroscopic debridement and lavage (removal of the debrided contents) is the most commonly used procedures and also most popular. Although there is no clear report/evidence of the superiority of arthroscopy over other surgical procedures used in osteoarthritis of knee for pain relief. There are also doubts about the usefulness of arthroscopic debridement for a mechanical symptom such as buckling is generally due to muscle weakness. Symptoms suggesting a recent injury such as knee catching or locking, which are suggestive of meniscal tear may require arthroscopic debridement for better results.

Surgery, such as high tibial osteotomy may be required to realign the knee to lessen medial loading in some cases of osteoarthritis.

When all medical treatment modalities fail to achieve much required pain relief in osteoarthritis, a total knee or hip arthroplasty may be required. Total knee or hip arthroplasty is a very effective surgery, which can cause pain relief in most of the patients, with a failure rate of only approximately 1% per year. The failure rate may be little higher in obese patients due to higher vulnerability and joint loading. The earlier a total knee or hip arthroplasty is done (before much damage to the joint occurs), the better is the result.

Cartilage regeneration and reconstitution in treatment of osteoarthritis:

Chondrocyte transplantation is not very successful in treatment of osteoarthritis, because it involves pathology of joint mechanics. Chondroplasty (abrasion arthroplasty) is also not very successful. Both of these procedures may give better result if done at the early stage of the disease.

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