[Joint-preserving surgical options in osteoarthritis]

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Rheumatology

Context:

• Osteoarthritis (OA) develops due to uneven load distribution across joint surfaces.
• Joint-preserving surgical techniques aim to rectify these mechanical disbalances.
• Understanding of hip joint (coxarthrosis) pathophysiology has advanced joint-preserving strategies.

Purpose:

• To review the principles and applications of joint-preserving surgery for knee and hip osteoarthritis.
• To highlight the importance of addressing mechanical defects for successful outcomes.

Summary:

• Joint-preserving surgery corrects mechanical issues that cause uneven joint loading, a precursor to osteoarthritis.
• Techniques for axial correction at the knee are established.
• Recent advances in understanding coxarthrosis enable joint-preserving approaches for femoro-acetabular coverage issues (e.g., impingement, dysplasia).

Impact:

• Successful joint preservation can delay or prevent the need for total joint replacement.
• These techniques offer alternatives for younger patients or those with specific mechanical abnormalities.
• Joint-preserving surgery is less effective when significant osteoarthritis is already present or mechanical defects are absent.