[Joint preserving treatments of the knee]

Middle-aged patients with early onset arthritis or cartilage defects are difficult to treat. These patients are relatively young for joint replacement and relatively old for regenerative therapies, i.e.: a treatment gap. Therefore, the concept of joint preservation has emerged with the main goal to delay of even prevent joint replacement. Several novel surgical techniques and treatment algorithms for cartilage repair are developed. New insights show that knee joint preservation is best achieved by combining treatments, for instance cartilage repair and mechanical (alignment) correction. Since combining different surgeries introduces more complexity, a guideline has been drafted, which states that (part of) this care is perhaps best centralised. It is therefore important, to treat patients eligible for joint preservation in collaboration with expert centres. This brief clinical lesson provides the latest insights in the Dutch knee joint preservation care supported by the latest guideline.