Can TKA be avoided? Alternate strategies.

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Biomedical Engineering

Background:

• Knee joint disease often necessitates surgical intervention, with total knee arthroplasty being a common but not the only option.
• Alternative surgical techniques aim to preserve or restore native joint function, addressing cartilage defects and mechanical malalignments.

Purpose of the Study:

• To review the indications, efficacy, and advancements of surgical techniques alternative to total knee arthroplasty for knee joint disease.
• To provide a comprehensive overview of cartilage restoration, osteotomy, and partial knee arthroplasty procedures.

Main Methods:

• Review of existing literature on surgical treatments for knee joint disease.
• Categorization of procedures based on mechanism: cartilage regeneration, mechanical correction, or prosthetic replacement.
• Analysis of factors influencing treatment selection, including patient demographics and lesion characteristics.

Main Results:

• Alternative options include bone marrow stimulation, grafting, autologous chondrocyte implantation for cartilage repair, and osteotomy for mechanical correction.
• Unicompartmental and bicompartmental knee arthroplasty offer prosthetic solutions for specific knee compartments.
• Patient age, activity level, and lesion specifics (size, location, severity) dictate the most appropriate surgical strategy.

Conclusions:

• A range of surgical interventions exist as alternatives to total knee arthroplasty for knee joint disease.
• The selection of the optimal treatment modality requires careful consideration of individual patient factors and the nature of the knee pathology.
• Advancements in surgical techniques continue to expand options for knee repair and restoration.