Surgical Management


Three types of surgeries are recommended for management
of osteoarthritis. These include:
.
• arthroscopy;

• correction of the alignment of the knee; and

• changing the knee joint. None of these surgeries cureosteoarthritis. Your doctor may recommend anyone of theseoptions depending upon the condition of your knee.
• Arthroscopy. Your doctor m ay recommend if you eitherhave.

• mechanical problems such as something stuck or looseinside the joint or

• repeated swelling of the kneejoint. Although the relief maybe partial or temporary, it is often recommended because itis a safe and 'minor' procedure.
As mentioned earlier, your doctor can view the inside of the knee directly through an arthroscope and assess the condition of the cartilage covering the bone-ends and the semi-lunar cartilages. Your doctor will also be able to remove (a) any loose or torn pieces of semi-lunar or articular cartilages or

• loose or over-grown tissue lining the knee. The joint willthen be washed thoroughly with saline water to completelyremove damaged pieces.


Correction of alignment of the knee. Your doctor may suggest a surgery called High Tibial Osteotomy (HTO) to correct the alignment of the knee. This surgery is usually recommended if you have painful osteoarthritis of the knee with bowing of the legs. When your legs are bowed, more body weight passes through the inner side than the outer side of the knee. During the surgery the bone just below the knee is cut and realigned so that the more body weight passes through the outer side of the knee. After this surgery more than seventy percent patients have relief from pain for almost eight to ten years. It is effective for mild to moderate arthritis, and people who are either young or not obese.

High tibial osteotomy or HTO is a major surgery and. requires a plaster cast for a month after the operation. You can however start walking to the toilet with the plaster about one week after the surgery. Your doctor will also recommend physiotherapy for a few weeks after the cast is removed.


Changing the knee joint.

This is a relatively new technique in which the damaged ends of the bones of the kneejoint are removed and replaced with artificial parts. A cup-like part is fixed on the end of the thigh bone and a plate-like part is fixed on the end of the leg bone with a special glue called bone-cement. The new parts of the knee are smooth and therefore there is no pain during normal movements of the joint. Although this surgery gives instant relief from pain, it is not always effective. You may have to observe several restrictions in movements so that the new joint may last for five to eight years. Also, the artificial knee joint is very expensive. This surgery is usually recommended for people who are not able to walk within the house also.