Reumatizam, Vol. 62 No. suppl. 1, 2015.
Review article
SURGICAL TREATMENT OF OSTEOARTHRITIS
Domagoj Delimar
Krešimir Crnogaća
Goran Bićanić
Abstract
Osteoarthritis is a chronic joint disease, with a waxing and
waning course. It is the leading cause of musculoskeletal
disability worldwide. Nonpharmacologic interventions
such as physical therapy and weight loss should be the
cornerstones of osteoarthritis therapy. Referral to an orthopedic
surgeon is mandatory if the osteoarthritis fails to
respond to pharmacologic and nonpharmacologic therapy.
Goals of operative treatment include pain relief, functional
improvement, and the capacity to maintain functional
status. Joint preservation procedures include halting the
progression of the disease and restoration of the cartilage
to some degree, as well as the restoration of alignment and
joint stability. The ideal patient for cartilage restoration is
a younger patient who has a focal cartilage defect with a
well-aligned stable limb or one that can be aligned by an
osteotomy procedure. The principle of realignment osteotomy,
another joint-preserving procedure, is to transfer
weight-bearing forces from the arthritic, damaged portion of the joint to a healthier location in the same joint. Jointsacrificing
procedures are arthroplasties and arthrodeses.
With the success of arthroplasty, the role of arthrodesis in
the primary treatment of arthritis has become practically
obsolete. Arthroplasty, the gold standard against which all
procedures are compared, consists of the surgical removal
of joint surfaces and the insertion of an endoprosthesis. It
has traditionally been described as the most predictable
procedure for pain relief in any form of arthritis. At a minimum,
10-15 years of viability are expected from joint replacement
in the absence of complications. Arthrodesis or
joint fusion consists of the union of bones on either side of
the joint. This procedure relieves pain but prevents motion
and puts more stress on the surrounding joints. In general,
early surgical treatment is encouraged because of the
tremendous functional gains, pain relief, and cost savings.
Keywords
osteoarthritis; knee; hip; total arthroplasty
Hrčak ID:
182775
URI
Publication date:
10.10.2015.
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