Continuing Medical Education: Understanding Osteoarthritis.
Edited By: Gregory C. Gardner, M.D.
Last updated Friday, January 07, 2005
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Surgical therapyKnee arthroscopy in osteoarthritis Conditions that make arthroscopy useful
- Meniscal tear - Symptoms that suggest a meniscal
tear include: recent onset of pain and swelling on top of previous OA
symptoms, localized joint line tenderness, relatively normal X-rays for
the amount of pain, locking, or joint giveway. The degenerative
meniscus may be more likely to tear with less trauma. MRI can confirm
the tear
- Loose body - Symptoms are usually knee locking and possibly giveway. If loose body is calcified, may be visible on X-rays
Conditions that make arthroscopy less useful
- Severe OA
- Varus or valgus deformity
- Chondrocalcinosis
- Previous meniscectomy
Total joint arthroplasty Information to discuss with patient
- Cost of surgery is about $25,000 with expenses not
completely covered by medicare and supplemental. Need to get cost
estimate from surgeon's office
- Hospital 3-7 days
without complications; protected ambulation and therapy for 6 weeks;
return to full activities may take 6 months. There is a limitation to
activity level as well.
- Complications include risks of anesthesia, DVT/PE, infection, and later loosening of the prosthesis.
Good candidates for TJA
- Uncontrolled pain - This is the main reason for
considering TJA. If medical Rx in not satisfactory and the patient is
willing to go through the risks and hassels of surgery, then >80% of
patients will have good to excellent pain relief
- Immobility - Less important to pain in my mind but also a factor
- Age over 70 - Patients at this age are easier on prostheses and few require revision due to wear and tear
- Slender build - Easier on the prostheses
- Good health
- Sedentary lifestyle - Easier on prostheses and will find permitted activities acceptable
Surgery for arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 to make an appointment. Our clinical center is located in Seattle Washington, USA
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