What are the surgical option for osteoarthritis?

The surgical options for knee osteoarthritis are usually final resorts to try and alleviate the symptoms where conservative treatment has failed or when we think conservative treatment is not an option. The first one, the surgical treatment, apart from injections, is the realignment procedures or osteotomies where we realign the bone to try and correct the deformity to offload or to relieve the pressure on part of the joint and that could be by doing a single osfeltomy or double osfeltomy. So realigning the bone in a way that allows relief of pressure on the joint itself and that's recommended usually in the younger age group especially a person who does manual labor are fairly active to try and preserve the joint and that involves resetting or refashioning of the actual bone usually the tibia but in some cases it will be a combined tibial and femoral realignment to try and correct that. The second option is what we call partial knee replacement where we don't replace the whole joint but we replace the part that's affected by arthritis and that's usually in most cases the inner aspect of the knee where we replace the joint with an artificial joint leaving the rest of the joint and the rest of the mechanics of the knee including the ligaments intact to try and preserve the function of the knee for as much as possible and make it feel more like a native knee. The outcomes of partial knee replacements are very good. I've seen patients who are able to play tennis, do a bit of running, swimming, cycling, easily with partial knee replacement as well as play golf. So it is possible to do sporting activities with partial knee replacement. They are less invasive and if they are done the right way and for the right reasons, they can last for a very long time and the patients are usually happy with the outcome. For severe arthritis, I would recommend knee replacements especially in the presence of arthritis throughout the joint where there is evidence of arthritis in all three compartments. And the outcomes of knee replacements is variable depending on the age of the person, the morbidity, also the weight of the patient, etc. Generally speaking, satisfaction rates from knee replacements in general is less than hip replacements and that has been a historical finding. Things are improving now by using robotic knee replacement and trying to make it even more accurate in the hope that this would make the outcome better. Knee replacements have improved quite a lot. They allow you to function and they are recommended if there is evidence of severe arthritis in the knee and severe arthritic symptoms in the knee. Generally speaking, patients with knee replacement are able to walk up and down the stairs, do play other sports as well, swimming, cycling, but they don't allow you to return to full function and they don't feel like you're on a native knee. So therefore they are a last resort.