Abstract
Osteoarthritis is a degenerative joint disease that is extremely prevalent in society [4]. It effects more than 25% of Americans above the age of 18[1]. According to July 2020 publication by Center for Disease Control (CDC), osteoarthritis affects approximately 325 million Americans [2]. One of the organs that is most affected by osteoarthritis is the knee [5]. Over the years, we have developed non-surgical and surgical treatments for knee osteoarthritis (KOA). If a patient fails to non-surgical options, the patient may be considered for total knee arthroplasty (TKA) [6,7]. This review will investigate the data supporting the beneficial effects of surgical intervention compared with nonsurgical treatment for knee osteoarthritis.
Method: A systematic literature search was conducted using with PubMed. The terms used for advanced search included “osteoarthritis”, “total knee”, and “non-surgical treatments”. Of the 160 results, most articles were eliminated through just reading the title. The search was narrowed to focusing on studies comparing the effectiveness of non-surgical treatment vs. surgical treatments for KOA.
Results: After review of the literature, the data seems to indicate that patients receiving TKA with post-operative nonsurgical management have more symptomatic pain relief, better performance at sports and recreation, increased quality of life and activities of daily living compared to those receiving only non-surgical treatment for KOA at 12 month follow-up. [3]
Discussion: Physicians often have difficulty deciding whether to pursue conservative or surgical treatment for patients with KOA. Based on a wide data set, patients receiving TKA have more relief, better quality of life, improved functionality, and potentially quicker return to workforce compared to non-surgical therapy. However, a critical review of this important field of debate shows that there are limited randomized control studies comparing effectiveness of TKA and non-surgical treatments for KOA. We believe that this controversial topic needs further clinical investigation.
1. Chen D, Shen J, Zhao W, Wang T, Han L, Hamilton JL, Im HJ. Osteoarthritis: toward a comprehensive understanding of pathological mechanism. Bone Res. 2017 Jan 17;5:16044. PMID: 28149655; PMCID: PMC5240031.
2. Osteoarthritis. Center for Disease Control. https://www.cdc.gov/arthritis/basics/osteoarthritis.htm#:~:text=OA%20affects%20over%2032.5%20million%20US%20adults
3. Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O, Rasmussen S. A Randomized, Controlled Trial of Total Knee Replacement. N Engl J Med. 2015 Oct 22;373(17):1597-606. PMID: 26488691.
4. Haq I, Murphy E, Dacre J. Osteoarthritis. Postgrad Med J. 2003 Jul;79(933):377-83. PMID: 12897215; PMCID: PMC1742743.
5. Osteoarthritis. National Institute of Aging. https://www.nia.nih.gov/health/osteoarthritis#:~:text=The%20knees%20are%20among%20the,out%20of%20chairs%20and%20bathtubs
6. Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/osteoarthritis/diagnosis-treatment-and-steps-to-take..
7. Deveza, LA. Overview of the management of osteoarthritis. https://www.uptodate.com/contents/search.
8. United States Bone and Joint Initiative. The Burden of Musculoskeletal Diseases in the United States (BMUS). 2018. Fourth edition. 2018: https://www.boneandjointburden.org/fourth-edition/iiib10/osteoarthritis
