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Arthroscopic and Supplementation Therapy in Osteoarthritis of the Knee

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Surgery of the Meniscus

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Abstract

The purpose of this chapter is to highlight arthroscopic and supplementation treatment options in osteoarthritis of the knee. Respective therapies are described with indications, contraindications, and literature workup.

Arthroscopic knee osteoarthritis treatment comprises lavage, debridement, abrasion arthroplasty, and microfractures. While stand-alone lavage and abrasion arthroplasty can no longer be recommended, debridement with resection of chondral flaps, non-stable meniscus tears, scar tissue, and loose bodies causing mechanical symptoms as well as inflammatory synovia can yield good results in selected patient populations.

Both intra-articular and oral supplementations in knee osteoarthritis are controversially discussed. There are no clear recommendations for intra-articular injection therapy with corticosteroids, hyaluronic acid, or PRP (platelet-rich plasma). Still, studies suggest good short-term results with corticosteroids and good long-term result with hyaluronic acid and PRP. Combined with their safety profile, they constitute viable options for patients not qualifying for surgical therapy or suffering comorbidities limiting oral NSAID (nonsteroidal anti-inflammatory drug) use. Oral NSAIDs are an important part of treatment regimes for all stages of knee osteoarthritis, whereas other oral supplements at best have mild influence on pain.

Arthroscopic and supplementation therapies play important roles in comprehensive knee osteoarthritis treatment. To achieve good results, appropriate patient selection is key.

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Author information

Authors and Affiliations

  1. Knee Surgery and Sports Traumatology, OCM-Clinic Munich, Steiner Str. 6, Munich, 81369, Germany

    Amelie Stoehr & Alfred Hochrein

  2. Clinic of Orthopedic & Trauma Surgery, University Hospital Freiburg, Hugstetter Straße55, Freiburg, 79106, Germany

    Hermann O. Mayr

Authors
  1. Amelie Stoehr
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  2. Alfred Hochrein
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  3. Hermann O. Mayr
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Correspondence to Amelie Stoehr .

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Editors and Affiliations

  1. Orthopaedics & Traumatology, Unit INSERM, Normandy University, Caen university Hos, Caen, France

    Christophe Hulet

  2. Orthopedic Department, Centro Hospitalar Póvoa de Varzim –Vila, Póvoa de Varzim, Porto, Portugal

    Helder Pereira

  3. University of Milan, Dpt. of Biomedical Sciences for Health, Milano, Italy

    Giuseppe Peretti

  4. Istituto Clinico Humanitas, Monza, Italy

    Matteo Denti

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Stoehr, A., Hochrein, A., Mayr, H.O. (2016). Arthroscopic and Supplementation Therapy in Osteoarthritis of the Knee. In: Hulet, C., Pereira, H., Peretti, G., Denti, M. (eds) Surgery of the Meniscus. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49188-1_42

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  • DOI: https://doi.org/10.1007/978-3-662-49188-1_42

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