Advancements in the surgical and alternative treatment of arthritis.
OBJECTIVE
Surgical and nonsurgical treatment of arthritis is a rapidly developing and evolving field. It is vital for clinicians to keep up on the latest advances. This review focuses on clinical trials or large prospective studies over the past year that evaluated orthopedic surgical techniques for the treatment of arthritis and new nonsurgical therapies that may prevent the need for surgical intervention. Increasing attention has also been focused on the relation between surgeon or hospital case load and the quality of outcomes after surgery.


RESULTS
No fewer than 10 studies have been published over the past year evaluating the use of hyaluronic acid (a visco-supplement) or corticosteroid injections as alternative treatments to knee arthroscopy for osteoarthritis of the knee. Joint replacement research has explored minimally invasive and computer-guided or robot-guided joint replacement surgery, the best operative choice for advanced shoulder arthritis (hemiarthroplasty compared with total shoulder replacement), the role of patellar resurfacing during total joint replacement, and the use of bisphosphonates for retention of bone density after joint replacement.


CONCLUSIONS
The increasing attention on high-quality surgical trials should continue to improve surgical options based on sound research for patients with arthritis. Future research should continue to improve the available high-quality research for treatment choices.
Lyman
Stephen
S
Foster Center for Clinical Outcome Research, Hospital for Special Surgery, New York, New York 10021, USA. LymanS@hss.edu
Sherman
Seth
S
Dunn
Warren R
WR
Marx
Robert G
RG
D019643:Arthroplasty, Replacement; D001182:Arthroscopy; D002986:Clinical Trials as Topic; D006801:Humans; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000601:surgery*; D011446:Prospective Studies; D012219:Rheumatology / Q000379:methods*; D016896:Treatment Outcome