"What's most important," says David, "is how long have they had their symptoms, whether the arthritis has become chronic, whether too much of the cartilage has worn away. Science has not given us a way to regenerate cartilage, at least at this point." For those patients -- as well as people who have had previous surgery of the knee -- knee replacement surgery is typically the only solution.
When asked for an objective assessment of the study, John D. Kelley IV, MD, assistant professor of orthopaedic surgery at Philadelphia's Temple University, tells WebMD, "It's a nice, comprehensive review." In 10 years of practice, says Kelley, "I've seen many patients do remarkably well with arthroscopic surgery. ... I think you have to be very, very careful about choosing your patients and not be overly aggressive."
However, the paper didn't mention a new technology -- the bipolar electrothermal energy "shrinkage wand" -- that can help stabilize arthritis lesions, says Kelley. "Cartilage doesn't deteriorate as rapidly. It's been shown with a microscope that it can make the very rough surface very smooth," he says. "The idea is, with lifestyle modifications [and] weight loss, maybe we can give patients a few more years [without having knee replacement surgery]."
- For patients who experience sudden knee injury, the best treatment is generally arthroscopy, a minimally invasive surgery with a low cost and short recovery time.
- Symptoms of this type of knee injury include locking, popping sounds, pain, and swelling.
- In patients over age 50 who also have some arthritis of the knee, arthroscopy may not be the best choice.