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Invasive Non-Arthroplasty Treatment Options for Knee Osteoarthritis: Review

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Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 08-17 | Rohan G Reddy, YuChia Wang, Ryan Scully, Savyasachi C Thakkar

DOI: :10.13107/jcorth.2023.v08i01.549

Author: Rohan G Reddy [1], YuChia Wang [2], Ryan Scully [3], Savyasachi C Thakkar [4]

[1] Orthopaedic Research Collaborative (ORC); Johns Hopkins University, Baltimore, Maryland, United States, ,
[2] Orthopaedic Research Collaborative (ORC);Department of Orthopaedic Surgery, Eastern Virginia Medical School, Norfolk, Virginia, United States,
[3] Orthopaedic Research Collaborative (ORC); Department of Orthopaedic Surgery, Naval Hospital Camp Pendleton, Oceanside, California, United States,

[4] Orthopaedic Research Collaborative (ORC); Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, United States.

Address of Correspondence
Dr. Rohan G Reddy,

Johns Hopkins University, Baltimore, Maryland, United States.

E-mail: rreddy19@jhu.edu

Abstract

Introduction: Knee osteoarthritis (KOA) is one of the most common joint diseases in the world, such that there exists a variety of treatment methods, ranging from conservative treatments such as physical therapy and weight loss to total replacement of the diseased joint. Invasive non-arthroplasty treatment methods are growing in popularity and this review aims to explore the current literature. Better understanding of these alternatives could allow orthopedic surgeons and primary care providers to offer poor arthroplasty candidates meaningful symptomatic relief.

Materials and Methods: A literature review using PubMed, Google Scholar, and SCOPUS was performed to examine the following invasive non-arthroplasty treatment options: Corticosteroid injections (CS), viscosupplementation, platelet-rich plasma injections, stem cell injections, ozone therapy, prolotherapy, radiofrequency nerve ablation (RFA), arthroscopy, and osteotomy. Articles with complete data on the outcomes following these treatment methods were included in the study.

Results: CSs showed strong efficacy in providing short-term pain relief, while viscosupplementation and platelet-rich plasma have shown to be effective in long-term management as well. Aside from the more common injectable treatment options, newer options such as stem cell injection and ozone therapy have shown clinical efficacy while prolotherapy and RFA are still early-stage treatment options. Still, further studies are required to better assess these emerging therapies. Operatively, arthroscopic surgery has shown to be minimally effective while osteotomy demonstrated effective pain and functional improvement.

Conclusion: Multiple therapeutic options exist for invasive management of KOA to a different degree of effectiveness and efficacy. We have analyzed the outcomes of multiple invasive non-arthroplasty treatment options for KOA. This review can better inform patients and surgeons of the pros and cons of different KOA treatment methods. Newer conservative options may have positive clinical implications but will require further investigation. Operative alternatives to arthroplasty can provide symptomatic relief but may increase the associated risk and complexity should the need for arthroplasty ever arises.

Keywords: Total knee arthroplasty, injections, radiofrequency nerve ablation, arthroscopy, osteotomy.

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How to Cite this article: Reddy RG, Wang Y, Scully R, Thakkar SC. Invasive Non-arthroplasty Treatment Options for Knee Osteoarthritis: Review. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):08-17.

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Ultrasonic Bone Scalpel and Its Role In Spine Surgeries : An Article Review

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Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 20-27| TausifAhmed Shikalgar, Priyank Patel, Abhay Nene, Shubhanshu Bhaladhare, Sanjay Puri, Manojkumar Gaddiker

DOI:10.13107/jcorth.2022.v07i01.461

Author: TausifAhmed Shikalgar [1], Priyank Patel [1], Abhay Nene [1], Shubhanshu Bhaladhare [1], Sanjay Puri [1], Manojkumar Gaddiker [1]

[1] Department of Orthopaedics, Lilavati Hospital and Research Centre, Bandra (W), Mumbai 400050, India

 

Address of Correspondence
Dr. Tausif Ahmed Shikalgar,
Fellow Spine Surgery, Under Dr. Abhay Nene, Lilavati Hospital and Research Centre, Bandra (W), Mumbai – 400 050, Maharashtra, India.
E-mail: Dr.tausifahmedshikalgar@gmail.com

Abstract

The past few decades have seen tremendous improvement in the field of spine surgery. Spine surgery involves a number of procedures from simple laminectomy to deformity correction. This requires high surgical skills and care, which is achieved by a number of instruments, which, in turn, protect surgeons from committing complications. Recent advancements in spine surgery include ultrasonic bone scalpel, which cut bone accurately and precisely. It is a unique surgical device which offers a controlled osteotomy which slices the hard bone while the soft tissues remain largely unaffected. The major benefits of using this modern instrument are the soft-tissue sparing, controlled cutting, reduced bleeding, and thereby increasing the effectiveness. The aim of this article is to summarize its uses in current practice of spine surgeons and to focus on its advantages and complications associated with uses of this device.

Keywords: Ultrasonic bone scalpel, spine surgery, complications, safety, osteotomy

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How to Cite this article: Shikalgar TA, Patel P, Nene A, Bhaladhare S, Puri S, Gaddikeri M. Ultrasonic Bone Scalpel and its Role in Spine Surgeries: An Article Review. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):20-27.

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Current Concepts in High Tibial Osteotomy

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page:24-31 | Vikram Arun Mhaskar, Yogesh Jain, Jitendra Maheshwari

Author: Vikram Arun Mhaskar [1], Yogesh Jain [1], Jitendra Maheshwari [1]

[1] Knee & Shoulder Clinic, New Delhi, Max Superspecilaity Hospital Saket, New Delhi, India

Address of Correspondence
Dr. Vikram Arun Mhaskar,
Knee & Shoulder Clinic, New Delhi, Max Superspecilaity Hospital Saket, New Delhi, India
E-mail: drvikrammhaskar@gmail.com

Abstract

Background: High tibial osteotomy is an effective procedure for the management of medial compartment osteoarthritis. This paper intends to analyze the current indications, contra indications, technique, complications, survival, and recent advances of this procedure.

Method: Literature review was done by searching journals with “High tibial osteotomy,” “Indications of HTO,” “Alignment in HTO,” “Survival and clinical outcomes of HTO,” and “Recent advances in HTO.” A total of 12 articles were found suitable for this study and reviewed.

Outcomes: Indications have largely remained the same except for thrust, which was earlier, a contra indication, Biplanar osteotomy, patient specific instrumentation; 3D printing and computer navigation are the recent technical modifications. The rate of complications is variable in different studies and the 5-year survival is still over 90% in most studies. Rate of serious complications is low but minor complications are high.

Conclusion: HTO is a successful procedure in treating medial compartment OA in isolation or with ligament deficiencies with a good 5 and 10-year survival. Recent advances have focused on improving planning, rehabilitation, and accuracy of alignment.

Keywords: High Tibial Osteotomy, osteotomy, deformity, gene varum, osteoarthritis, knee preservation, deformity correction

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How to Cite this article: Mhaskar VA, Jain Y, Maheshwari J. Current Concepts in High Tibial Osteotomy. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):24-31.

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A Malunited Fibula with raised Lateral Malleolus treated Surgically by Fibular Osteotomy and Plating

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Vol 3 | Issue 2 |  July-Dec 2018 | Page 54-55 | HR Jhunjhunwala.

Authors: HR Jhunjhunwala [1].

[1] Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India.

Address of Correspondence
Dr. HR Jhunjhunwala,
Department of Orthopaedics, Bombay Hospital Postgraduate Institute of Medical Sciences, Marine Lines, Mumbai, India.
Email: drhrj2@gmail.com

Abstract

Isolated fibular fractures are often considered innocuous and treated conservatively. They may malunited and predispose the ankle to severe twisting injuries. We present one such case where the patient presented with twisting injury to the ankle. Radiograph revealed a malunited fibula which was high riding. To prevent future such episodes, fibula was pulled down by doing an osteotomy and was stabilised with a plate. The union was uneventful and at final follow up pf two years the patient is symptom free
Keywords: malunited fibula, Osteotomy

References

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How to Cite this article: Jhunjhunwala HR. A Malunited Fibula with raised Lateral Malleolus treated surgically by Fibular Osteotomy and Plating. Journal of Clinical Orthopaedics July-Dec 2018; 3(2):54-55.

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