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I am a 26-year-old woman. My mum has been advised to undergo surgery for osteoarthritis of the knee. I am clueless about the surgery and which one is the best. Does every person suffering from knee pain or osteoarthritis have to undergo knee surgery? Are there any other ways to get treated? What are the latest treatment options available for osteoarthritis or knee pain? What is the difference between arthroscopy, osteotomy, joint fusion and joint replacement (arthroplasty)? Please explain.
The query is answered by Dr Vibhore Singhal, Senior Orthopaedics Surgeon, Columbia Asia Hospital, Palamvihar.
There are various technological breakthroughs in the surgical and non-surgical treatment of OA in the knee. A lot of people with osteoarthritis actually may not need surgery. But if the pain and stiffness is very severe that you can t get around, your doctor might suggest it. Braces, shoe inserts, and walking aids can help you get around more easily and take some of the stress off your joints. Lately, the effectiveness of braces for stability has been extensively studied and is a common practice in athletics. Wearing a brace on your knee redistributes weight and takes some of the pressure off the joint. Braces are particularly useful when used along with treatments like medication and physical therapy. Doctors may even suggest the use of a splint or soft sleeve, to support sore wrist joints. Also read about can osteoarthritis be cured?
Arthroscopy, osteotomy, joint fusion and joint replacement (arthroplasty) are common surgical procedures for osteoarthritis in the knee. Arthroscopy is a keyhole surgery of the joint whereas osteotomy means cutting the bone for correction of alignment. Joint fusion or arthrodesis is a procedure where movement of the joint is stopped permanently by fusing the two bones. Joint replacement or arthroplasty is making new joint surfaces to improve mobility. It can be an artificial substance or natural material taken from the patient's body. You may also like to read 4 reasons to avoid a total knee replacement surgery.
Total knee arthroplasty (TKA): Also known as joint replacement, it is a surgical procedure in which parts of the knee joint are replaced with artificial parts called prostheses. Currently, we have patient specific instrumentation where a CT or an MRI data is provided to the computer, and a 3 D printer makes a cutting jig specific to that patient at a predetermined level. A doctor has to place the implant through a surgery. Robotics are taking the place of surgeons where precision matters in millimetres. Here are common queries on knee replacement answered.
Other surgical treatments that are considered before total knee arthroplasty include High Tibial Osteotomy (HTO) and Unicondylar or Partial Knee Arthroplasty (UKA).
High Tibial Osteotomy (HTO): It is a procedure done to relieve pain from osteoarthritis. HTO is beneficial when one has early stage osteoarthritis that has damaged just one side of the knee joint. In this, a cut is made in the tibia (shinbone and its height is either increased from the inner side or decreased from outer side making the alignment better for weight bearing and relieve pressure on the knee joint.
Unicondylar or Partial Knee Arthroplasty (UKA): This is a surgical procedure used to relieve arthritis in one of the knee compartments in which the damaged parts of the knee are replaced. This surgery helps reduce post-operative pain and have a shorter recovery time too. It refers to replacing only one compartment of the knee when it is worn off, which is usually the inner side. The knee has three compartments the inner, the outer and one between the knee cap and thigh bone. Also read about why pinless knee replacement surgery is better than the conventional one.
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