title: [Osteoarthritis of the knee in the young patient--who should receive total knee arthroplasty and who should not?].
abstract: The incidence of total knee arthroplasty in young patients continues to rise in certain countries despite evidence of decreased patient satisfaction and increased likelihood for revision in patients 55 years of age or less. As long as sufficient pain relief and functional improvement can be obtained by alternative means, total knee arthroplasty should be avoided whenever possible. In young patients with unicompartmental osteoarthritis, and a partially conserved joint space, correctional osteotomy around the knee accompanied by cartilage surgery should be preferred in the presence of the respective deformity. In cases of advanced unicompartmental arthritis, unicompartmental arthroplasty should be considered even in younger patients. Only if advanced arthritic changes in more than one compartment or accompanying tibiofemoral instability are present in younger patients, is total knee arthroplasty indicated in selected cases. The strongest predictor of satisfaction even in younger patients is, however, a realistic expectation about the outcome of surgery.
authors: Orthopädische Universitätsklinik Ulm am RKU, Universität Ulm.
authors: D
authors: D
authors: Dornacher
authors: Orthopädische Universitätsklinik Ulm am RKU, Universität Ulm.
authors: T
authors: T
authors: Kappe
authors: Orthopädische Universitätsklinik Ulm am RKU, Universität Ulm.
authors: H
authors: H
authors: Reichel
mesh_terms: D000293:Adolescent; D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007720:Knee Prosthesis / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010003:Osteoarthritis / Q000453:epidemiology* / Q000601:surgery*; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult