title: Surgical treatments for osteoarthritis.
abstract: There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance. Osteoarthritis symptoms are usually the consequence of an imbalance between the load applied to a joint and the surface available to support that load. Therefore, conservative treatments will either tend to decrease the load exerted on the joint, such as in a tibial valgus osteotomy for instance, or to improve the articular surface supporting that load. Sometimes, both can be provided at the same time; the peri-acetabular osteotomy for hip dysplasia is an example of such a procedure. Conservative treatments are usually offered to young patients in order to delay, if not avoid, the need for a joint prosthesis. They are usually performed before osteoarthritis appears or at an early stage. Joint arthroplasties have overwhelmingly excellent functional results and today's research is directed towards providing rapid recovery, very long-term stability, and the assurance of a good functionality in extreme conditions. However, complications with joint arthroplasties can be serious with little, if any, reasonable salvage solution. Therefore, these procedures are offered to patients who have failed adequate medical treatment measures.
authors.affiliation: Service de chirurgie orthopédique et oncologique, hôpital Cochin, AP-HP, 75014 Paris, France. Electronic address: ndelescalopier@gmail.com.
authors.forename: Nicolas
authors.initials: N
authors.lastname: de l'Escalopier
authors.affiliation: Service de chirurgie orthopédique et oncologique, hôpital Cochin, AP-HP, 75014 Paris, France; Université Paris-Descartes, 75000 Paris, France; Inserm U1153, 75000 France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Anract
authors.affiliation: Service de chirurgie orthopédique et oncologique, hôpital Cochin, AP-HP, 75014 Paris, France; Université Paris-Descartes, 75000 Paris, France; Inserm U1153, 75000 France.
authors.forename: David
authors.initials: D
authors.lastname: Biau
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D001178:Arthroplasty / Q000379:methods*; D006801:Humans; D010003:Osteoarthritis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D018579:Patient Selection
keywords: Conservative surgery; Hip; Joint arthroplasty; Knee; Osteoarthritis; Shoulder