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Orthopedic

Gonarthrosis

Open pathway

A major cause of disability in the elderly

Knee osteoarthritis is highly prevalent among people above 50 years of age, affecting more than 250 million people worldwide, and accounts for almost four fifths of the burden of osteoarthritis.
Although there is variation between countries, gonarthrosis’ burden is increasing in most countries, especially among women. This trend is expected to continue as the ageing of the global population is rising.

Critical actions

  • Perform anamnesis and physical exam
  • Request exams that lead to a decision about appropriateness of surgical treatment

Phases

  1. 1st Medical consultation
  2. Follow-up consultation
  3. Treatment
  4. Follow-up
  5. Referral
  6. Patient education
  7. Emergency
  8. Inpatient

References

  • Brown GA. AAOS clinical practice guideline: treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg. 2013;21(9):577–9.
  • McGrory BJ, Weber KL, Jevsevar DS, Sevarino K. Surgical management of osteoarthritis of the knee: Evidence-based guideline: Evidence-based guideline. J Am Acad Orthop Surg. 2016;24(8):e87-93.
  • Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–89.
  • Miller LE, Fredericson M, Altman RD. Hyaluronic acid injections or oral nonsteroidal anti-inflammatory drugs for knee osteoarthritis: Systematic review and meta-analysis of randomized trials. Orthop J Sports Med. 2020;8(1):232596711989790.
  • Brignardello-Petersen R, Guyatt GH, Buchbinder R, Poolman RW, Schandelmaier S, Chang Y, et al. Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review. BMJ Open. 2017;7(5):e016114.
  • Palmer JS, Monk AP, Hopewell S, Bayliss LE, Jackson W, Beard DJ, et al. Surgical interventions for symptomatic mild to moderate knee osteoarthritis. Cochrane Database Syst Rev. 2019;7:CD012128.
  • Odgaard A, Madsen F, Kristensen PW, Kappel A, Fabrin J. The Mark Coventry award: Patellofemoral arthroplasty results in better range of movement and early patient-reported outcomes than TKA: Patellofemoral arthroplasty results in better range of movement and early patient-reported outcomes than TKA. Clin Orthop Relat Res. 2018;476(1):87–100.
  • Newman JM, Sodhi N, Dekis JC, Khlopas A, Piuzzi NS, Sultan AA, et al. Survivorship and functional outcomes of cementless versus cemented total knee arthroplasty: A meta-analysis. J Knee Surg. 2020;33(3):270–8.
  • Coory JA, Tan KG, Whitehouse SL, Hatton A, Graves SE, Crawford RW. The outcome of total knee arthroplasty with and without patellar resurfacing up to 17 years: A report from the Australian orthopaedic association national joint replacement registry. J Arthroplasty. 2020;35(1):132–8.
  • Büttner M, Mayer AM, Büchler B, Betz U, Drees P, Susanne S. Economic analyses of fast-track total hip and knee arthroplasty: a systematic review. Eur J Orthop Surg Traumatol. 2020;30(1):67–74.
  • Ripollés-Melchor J, Abad-Motos A, Díez-Remesal Y, Aseguinolaza-Pagola M, Padin-Barreiro L, Sánchez-Martín R, et al. Association between use of Enhanced Recovery After Surgery protocol and postoperative complications in total hip and knee arthroplasty in the postoperative outcomes within Enhanced Recovery After Surgery protocol in elective total hip and knee arthroplasty study (POWER2). JAMA Surg. 2020;155(4):e196024.

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