Abstract
Purpose
To update current surgical management of knee osteoarthritis.
Methods
A literature review was done using standard keyword search. Articles were scrutinized by the investigators to ensure relevancy to the purpose of this review.
Summary of the review
Arthroscopy, osteotomy and arthroplasty are three major techniques for knee osteoarthritis. Arthroscopy is more and more common as it is diagnostically and therapeutically useful, especially for patients with painful osteoarthritis with mechanical symptoms. Recently, arthroscopic techniques to treat subchondral bone marrow lesions associated with knee osteoarthritis have been developed. Osteotomy is a technique that preserves the natural biomechanics of the joint and reestablishes joint alignment. Its accuracy has been improved with the advancement of computer-assisted surgery. Arthroplasty includes Unicompartmental knee arthroplasty (UKA) and Total knee arthroplasty (TKA). In UKA, patient selection is a key factor for good outcomes, which can be enhanced with newer implant designs and robotic technology. TKA is the mainstay technique for end-stage osteoarthritis. Minimally invasive TKA was developed to overcome major limitations of conventional technique. Considerable number of new technologies have been introduced for patients requiring TKA, such as gender-specific knee implants, computer-assisted navigation, robotic-assisted surgery and patient-specific cutting guides.
Conclusion
As advances in surgical techniques and tools continue and numerous options are available, appropriate patient selection and understanding indications to each options are critical to success.
