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Guideline recommendations for surgery |
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| AAOS [10] |
Schnitzer/ACR [7] |
EULAR [6] |
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| Surgery |
Recommended for patients with 12 weeks or more of pain not responding to conservative treatment |
Recommended for patients with severe osteoarthritis limiting their activities of daily living and not responding to nonpharmacologic and pharmacologic treatments |
Recommended (C) for patients with radiographic evidence of osteoarthritis, refractory pain and disability |
| Total knee replacement |
Recommended (A) for patients with bi/tri compartmental arthritis if no response from conservative treatment |
Recommended (C) |
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| Recommended (A) for patients with medial compartment arthritis not candidate for osteotomy or unicompartmental knee replacement |
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| Recommended (A) for patients with lateral compartment arthritis not candidate for osteotomy |
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| Recommended (B) for older patients if magnetic resonance imaging confirms avascular necrosis |
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| Recommended (B) for older or less active patients with isolated patellofemoral arthritis |
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| Recommended (D) if no response from conservative treatment and previous infection |
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| Not recommended (D) if active infection |
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| Unicompartmental knee replacement |
Recommended (B) for less active patients with medial compartment arthritis |
Recommended (C) |
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| Recommended (C) for patients with lateral compartment arthritis not candidate for osteotomy |
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| Osteotomy |
Recommended (A) for young, active patients with medial compartment arthritis and varus alignment if no response from conservative treatment |
Recommended (C) |
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| Recommended (B) for young, active patients with lateral compartment arthritis |
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| Arthroscopy |
Not recommended (A) if no mechanical symptoms |
Recommended (C) |
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| Recommended (B) if degenerative arthritis and mechanical symptoms |
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| Recommended (B) if gross malalignment/instability, cartilage remaining and localized symptoms |
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| Knee fusion |
Recommended (D) if no response from conservative treatment and previous infection, or for young patients with a history of chronic infection |
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| Patellectomy |
Recommended (D) for young, active patients with isolated patellofemoral arthritis |
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AAOS, American Academy of Orthopaedic Surgeons; ACR, American College of Rheumatology; EULAR, European League Against Rheumatism. | |||
Poitras et al. Arthritis Research & Therapy 2007 9:R126 doi:10.1186/ar2339 |
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