scholarly journals Osteoarthritis of the knee in the elderly: is knee replacement always justified?

2019 ◽  
pp. 70-75
Author(s):  
A. V. Lychagin ◽  
A. V. Garkavi ◽  
V. A. Meshcheryakov ◽  
V. S. Kaykov
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Elderly Population ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
The Elderly ◽  
Osteoarthritis Of The Knee ◽  
Total Knee ◽  
Grading Scale

Osteoarthritis is a condition that mostly affects the elderly population and tends to be localized to the knee joint. At old age, active treatment options are limited by co-morbidities and a higher risk for surgical complications. Therefore, the search for strategies that could become a temporary alternative to knee replacement is a pressing concern. The aim of this study was to analyze how justifiable is total knee replacement in elderly patients with knee osteoarthritis and to propose a less aggressive therapeutic alternative to this surgery. The study included 178 patients over 60 years of age with clinically established knee osteoarthritis who had been previously recommended knee replacement but chosen not to undergo it. The choice of a treatment strategy tested in the study was based on the original grading scale for the evaluation of the knee joint dislocation syndrome. The treatment consisted of therapeutic arthroscopy and intraarticular injections of hyaluronic acid and platelet-rich plasma (PRP). The data were processed in Statistica 12. Data analysis revealed that 39.3% of the participants did not have compelling indications for knee replacement. The proposed combination therapy with intraarticular PRP injections and arthroscopy allowed all the patients to delay knee replacement for at least a year; unaided by arthroscopy, intraarticular injections worked well for only 40%.

Osteoarthritis of the knee

2018 ◽  
Vol 11 (4) ◽  
pp. 190-197 ◽  
Author(s):  
Raymond Leung
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Clinical Assessment ◽  
Elderly Population ◽  
The Elderly ◽  
Osteoarthritis Of The Knee ◽  
Evidence Based ◽  
Management Options ◽  
Common Features ◽  
Athletic Population

Osteoarthritis of the knee is a degenerative condition that is commonly seen in the elderly population and sometimes occurs earlier in the athletic population. Pain and stiffness are common features, which can be debilitating. Clinical assessment of the knee joint requires consideration of its associated muscles, ligaments, tendons, bursae and menisci. The aim of this article is to provide an overview of knee pain assessment, to discuss the diagnosis of knee osteoarthritis, and to review some evidence-based management options.

On the role of knee joint in balance control and postural strategies: Effects of total knee replacement in elderly subjects with knee osteoarthritis

2010 ◽  
Vol 32 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Gérome C. Gauchard ◽  
Guy Vançon ◽  
Philippe Meyer ◽  
Didier Mainard ◽  
Philippe P. Perrin
Keyword(s):  
Knee Joint ◽  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Balance Control ◽  
Elderly Subjects ◽  
Total Knee

Treatment Options in Knee Osteoarthritis: Total Knee Arthroplasty Versus Platelet-Rich Plasma

PM&R ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 377-386 ◽  
Author(s):  
Brian A. Klatt ◽  
Hector H. Lopez ◽  
Neil A. Segal ◽  
Gary P. Chimes
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Total Knee

scholarly journals Contemporary knee arthroplasty: one fits all or time for diversity?

2021 ◽  
Author(s):  
Johannes Beckmann ◽  
Malin Kristin Meier ◽  
Christian Benignus ◽  
Andreas Hecker ◽  
Emmanuel Thienpont
Keyword(s):  
Personalized Medicine ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Treatment Options ◽  
Patient Specific ◽  
Partial Knee Arthroplasty ◽  
Limited Series ◽  
Total Knee ◽  
The Individual

Abstract Introduction Total knee arthroplasty (TKA) has historically been the preferred solution for any type of knee osteoarthritis, independently of the number of compartments involved. In these days of patient-specific medicine, mono-compartmental disease could also be approached with a more individualized treatment, such as partial knee arthroplasty (PKA). Off-the-shelf (OTS) implants are often the compromise of averages and means of a limited series of anatomical parameters retrieved from patients and the pressure of cost control by limited inventory. Personalized medicine requires respect and interest for the individual shape and alignment of each patient. Materials and methods A Pubmed and Google Scholar search were performed with the following terms: “patient-specific knee” and “arthroplasty” and “custom implant” and “total knee replacement” and “partial knee replacement” and “patellofemoral knee replacement” and “bicompartmental knee replacement”. The full text of 90 articles was used to write this narrative review. Results Unicondylar, patellofemoral and bicompartmental knee arthroplasty are successful treatment options, which can be considered over TKA for their bone and ligament sparing character and the superior functional outcome that can be obtained with resurfacing procedures. For TKA, where compromises dominate our choices, especially in patients with individual variations of their personal anatomy outside of the standard, a customized implant could be a preferable solution. Conclusion TKA might not be the only solution for every patient with knee osteoarthritis, if personalized medicine wants to be offered. Patient-specific mono-compartmental resurfacing solutions, such as partial knee arthroplasty, can be part of the treatment options proposed by the expert surgeon. Customized implants and personalized alignment options have the potential to further improve clinical outcome by identifying the individual morphotype and respecting the diversity of the surgical population.

scholarly journals The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis

2021 ◽  
Vol 22 (11) ◽  
pp. 5492
Author(s):  
Dawid Szwedowski ◽  
Joanna Szczepanek ◽  
Łukasz Paczesny ◽  
Jan Zabrzyński ◽  
Maciej Gagat ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Operative Treatment ◽  
Animal Studies ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Treatment Protocols ◽  
Metabolic Functions ◽  
Inflammatory Drugs ◽  
Positive Effect

Knee osteoarthritis (KOA) represents a clinical challenge due to poor potential for spontaneous healing of cartilage lesions. Several treatment options are available for KOA, including oral nonsteroidal anti-inflammatory drugs, physical therapy, braces, activity modification, and finally operative treatment. Intra-articular (IA) injections are usually used when the non-operative treatment is not effective, and when the surgery is not yet indicated. More and more studies suggesting that IA injections are as or even more efficient and safe than NSAIDs. Recently, research to improve intra-articular homeostasis has focused on biologic adjuncts, such as platelet-rich plasma (PRP). The catabolic and inflammatory intra-articular processes that exists in knee osteoarthritis (KOA) may be influenced by the administration of PRP and its derivatives. PRP can induce a regenerative response and lead to the improvement of metabolic functions of damaged structures. However, the positive effect on chondrogenesis and proliferation of mesenchymal stem cells (MSC) is still highly controversial. Recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, significant progress has been made in understanding the mechanism of PRP action. In this review, we will discuss mechanisms related to inflammation and chondrogenesis in cartilage repair and regenerative processes after PRP administration in in vitro and animal studies. Furthermore, we review clinical trials of PRP efficiency in changing the OA biomarkers in knee joint.

Thalamic Neurometabolite Alterations in Patients with Knee Osteoarthritis Before and After Total Knee Replacement

2021 ◽  
Vol 22 (5) ◽  
pp. 601
Author(s):  
Akila Weerasekera ◽  
Erin Morrissey ◽  
Minhae Kim ◽  
Atreyi Saha ◽  
Yang Lin ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Before And After ◽  
Total Knee

scholarly journals High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state

2013 ◽  
Vol 95 (8) ◽  
pp. 569-572 ◽  
Author(s):  
JA Jansen ◽  
FS Haddad
Keyword(s):  
Vitamin D ◽  
Total Knee Replacement ◽  
Elderly Patients ◽  
Knee Osteoarthritis ◽  
Vitamin D Deficiency ◽  
Knee Replacement ◽  
Functional State ◽  
High Prevalence ◽  
Outcome Scores ◽  
Total Knee

Vitamin D deficiency has been reported previously in patients with osteoarthritis undergoing total hip arthroplasty. We found a high prevalence of vitamin D deficiency in elderly patients with advanced knee osteoarthritis scheduled for total knee replacement and also a significant association with a lower preoperative functional state. A review of the literature is given on vitamin D deficiency in patients with knee osteoarthritis and the association with lower outcome scores after arthroplasty is discussed.

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