Arthroscopy, Arthroplasty, and Osteotomy for Osteoarthritis
Osteoarthritis is the most prevalent form of arthritis, and is caused by the degeneration of cartilage in joints. It is most common in weight bearing joints such as hips, knees and ankles, but can be developed in any joint of the body. Osteoarthritis is characterized by pain, stiffness, swelling, inflammation, and limited range of motion in the joints.
There are a number of factors that can play a role in the development of osteoarthritis, with the most common factors being age and obesity. Due to the fact that osteoarthritis mostly affects weight bearing joints, being overweight increases the strain on each joint, and can cause the cartilage to wear down faster. Osteoarthritis also becomes more common with age, with the majority of cases flaring up after the age of 60. Some of the other factors that can lead to the development of osteoarthritis include genetics (family history), sex, previous joint damage, and repetitive overuse of a specific joint.
The symptoms and severity of these symptoms are different for each person dealing with osteoarthritis. The majority of people who are dealing with this disease are able to improve symptoms and their quality of life through anti-inflammatory medications and a lifestyle change. There are cases where medication does not help with the pain and inflammation, and these patients may require surgery to help repair the damage and reduce the pain levels.
Arthroscopy is generally used for osteoarthritis in the knee. An arthroscope is used to remove free-floating pieces of bone or other tissues from the knee joint. The free-floating pieces of bone or tissue will damage the cartilage, and wear down the surface of the bones in the knee – it can be very painful for the patient. Arthroscopy is generally done as a day surgery, and does not require a stay in the hospital.
Arthroplasty is done to replace all or part of the damaged joint. This type of surgery is done when the osteoarthritis has progressed to the point where all cartilage in the joint has worn down, and the joint is experiencing a bone-on-bone effect. Total joint arthroplasty is generally done on weight bearing joints such as the hips or knees. It is used to remove the affected joint and have it replaced by an artificial joint. It is 90 percent effective at eliminating the joint pain and increasing the range of motion in the affected joint. Resection arthroplasty is done to remove all or part of an affected joint to prevent the damaged joint surfaces from rubbing against each other. It is not done on weight bearing joints, but is primarily used on “hanging joint” such as the shoulder.
Osteotomy and arthrodesis are only done when joint replacement is not an option. Osteotomy is most often done on a knee affected by osteoarthritis. It is done when the patient has more cartilage damage to one side of the joint than the other. When looking at the knee, osteotomy surgery is done by removing part of the shin from below the affected knee. This will change the angle the shin makes, and will cause a shift in the weight bearing across the knee joint. This will help the joint to bend away from direction of the deformity in the joint. Arthrodesis (joint fusion) involves fusing the bones in the affected joint together so they will grow together to form one bone. This will help to makes the joint stable, however, it will no longer be flexible. This type of surgery is generally done only to the spine and smaller joints such as fingers, wrists, or ankles.