The orthopaedic approach to managing osteoarthritis of the knee

Osteoarthritis of the knee is common, affecting almost a tenth of the population aged over 55.1 This proportion is likely to increase with extended longevity and a bigger body mass index. Most patients with osteoarthritis of the knee are able to manage their symptoms without medical treatment, but a large proportion of those referred to orthopaedic surgeons have debilitating disease, presenting chiefly with pain and stiffness. Classically the pain depends on activity, and in severe cases not only limits the distance patients can walk and their daily activities, but also disrupts sleep. Moreover, whereas most patients are past retirement, a major proportion is of working age, leading to difficulties with work and presenting an important economic cost to society.

Non-surgical treatment of osteoarthritis of the knee is primarily carried out in the community. This article concentrates on the interventions and surgical options used by orthopaedic surgeons for the treatment of this disease, indications for their use, and likely outcomes.