SURGICAL intervention for severe osteoarthritis continues to be a critical decision point in orthopedics. A new review explores the complex landscape of operative treatments, providing an updated perspective on best practices for healthcare professionals navigating this debilitating condition.
The study by Aabedi A et al. evaluates total joint arthroplasty (TJA), including total knee arthroplasty (TKA) and total hip arthroplasty (THA), as the gold standard for managing severe osteoarthritis. The procedure consistently offers significant pain relief, functional restoration, and quality-of-life improvement. Leading authorities such as the American College of Rheumatology and the American Association of Hip and Knee Surgeons now endorse timely TJA for patients unresponsive to conservative therapy.
While TJA is highly effective and cost-efficient, the authors caution that it is not without risk. Postoperative complications, reoperations, and revision surgeries remain considerations, especially in patients with obesity or multiple comorbidities. Thoughtful patient selection is therefore essential to optimize outcomes.
In contrast, other surgical options receive less favorable assessments. Osteotomies and cartilage repair procedures show limited long-term benefit in slowing disease progression. Arthroscopic interventions like lavage and debridement do not impact disease trajectory and are no longer recommended as standard care for osteoarthritis.
The review calls for adherence to evidence-based guidelines and emphasizes that TJA should not be delayed in appropriately selected cases. As healthcare systems grapple with increasing OA burden, these findings support a focused approach to surgical decision-making—one grounded in patient-specific factors and robust clinical evidence.
Reference:
Aabedi A et al. Surgical interventions in Severe Osteoarthritis: Pros and Cons. J Orthop Sports Med. 2025;7(1):169-178.
