The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee

Abstract

Background: Osteoarthritis is the most common joint disease of adults worldwide. Its incidence rises with age. Both intrinsic and extrinsic risk factors promote its development. In men aged 60 to 64, the right knee is more commonly affected; in women, the right and left knees are affected with nearly equal frequency.

Methods: The PubMed, Medline, Embase and Cochrane Library databases were selectively searched for current studies (up to September 2009; case reports excluded) on the epidemiology, etiology, diagnosis, staging, and treatment of osteoarthritis of the knee. The search terms were "gonarthrosis," "prevention," "conservative treatment," "joint preservation," "physical activity," "arthroscopy," "osteotomy," "braces," "orthoses," and "osteoarthritis knee joint."

Results and conclusion: Osteoarthritis is not yet a curable disease, and its pathogenesis remains unclear. The best treatment for osteoarthritis of the knee is prevention. The goal of therapy is to alleviate clinical manifestations. The therapeutic spectrum ranges from physiotherapy and orthopedic aids to pharmacotherapy and surgery.

Figures

Figure 1

Plain x-rays of the left knee in Kellgren and Lawrence stage 4: a) AP view, b) lateral view

Figure 2

The pathogenesis of osteoarthritis (modified from e14)

Figure 3

The treatment algorithm for clinically significant osteoarthritis of the knee in use at the Department of Orthopaedic and Trauma Surgery, University of Cologne

Figure 1

Radial tear of the medial meniscus

Figure 2

Medial cartilaginous damage of the tibia, stage 4

Figure 3

Microfracturing of the medial tibial plateau and partial resection of the medial meniscus