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Surgical procedures are usually reserved for patients who have noted no improvement with medications or procedures.

Arthroscopy

During an arthroscopy, several tiny incisions are made on the sides of your knee. A small lighted camera is inserted through one incision. The view inside your knee can be broadcasted onto a large monitor in the operating room. Operating instruments are passed through a second incision. These instruments are used to clean out shards of bone and cartilage that might be causing your pain and interfering with movement. The procedure usually takes less than an hour and is done as an outpatient surgery.

It takes 4-6 weeks for the affected joint to recover. You can probably return to work or resume daily activities within a few days. A specific activity and rehabilitation program may be suggested to speed your recovery and protect future joint function.

Osteotomy

In this procedure, a deformed joint, usually of the knee, thigh bone, or leg bone (femur and tibia), is realigned to redistribute body weight on the joint. By doing this, the healthy joint cartilage, usually on the outside of the knee, is aligned to bear more weight and thus alleviate pressure on the damaged tissue.

You will need to walk with crutches for 1-3 months. Next, you will begin rehabilitative leg strengthening and walking exercises. With a successful osteotomy, you will probably be able to resume your full activities after 4-6 months.

Arthroplasty

This is a joint replacement surgery. The joint is usually replaced with a synthetic joint, usually made from metal, plastic, or ceramics. Knee replacements and hip replacements are particularly common.

Hip Replacement
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The surgeon makes an incision along the joint, moves aside muscles, and removes the damaged bone and cartilage. The remaining bone is prepared to receive the prosthesis, and the new artificial joint is placed in position. Depending upon the type of prosthesis, the surgeon may use bone cement to hold one or both parts of the artificial hip. The incision is closed with stitches or staples, which will be removed in about 2 weeks. The procedure will take a few hours and may require a blood transfusion.

Within 6 weeks, you should be able to resume light activities. To speed your recovery and protect future joint function, follow the recommended activity and rehabilitation program.

Knee Prosthesis
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Arthrodesis

This procedure is a last resort for patients who have not had good pain relief from other efforts. In this procedure, the two bones making up a joint are permanently fused together. While this can greatly improve pain, it also means that the joint is permanently nonfunctional.

Revision Information

  • Osteoarthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/conditions-treatments/disease-center/osteoarthritis. Accessed July 23, 2013.

  • Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Osteoarthritis/default.asp. Updated July 2010. Accessed July 23, 2013.

  • Sinusas, K. Osteoarthritis: Diagnosis and treatment. Am Fam Physician. 2012;85(1):49-56.