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Osteoarthritis is a condition that mostly affects the elderly population and tends to be localized to the knee joint. At old age, active treatment options are limited by co-morbidities and a higher risk for surgical complications. Therefore, the search for strategies that could become a temporary alternative to knee replacement is a pressing concern. The aim of this study was to analyze how justifiable is total knee replacement in elderly patients with knee osteoarthritis and to propose a less aggressive therapeutic alternative to this surgery. The study included 178 patients over 60 years of age with clinically established knee osteoarthritis who had been previously recommended knee replacement but chosen not to undergo it. The choice of a treatment strategy tested in the study was based on the original grading scale for the evaluation of the knee joint dislocation syndrome. The treatment consisted of therapeutic arthroscopy and intraarticular injections of hyaluronic acid and platelet-rich plasma (PRP). The data were processed in Statistica 12. Data analysis revealed that 39.3% of the participants did not have compelling indications for knee replacement. The proposed combination therapy with intraarticular PRP injections and arthroscopy allowed all the patients to delay knee replacement for at least a year; unaided by arthroscopy, intraarticular injections worked well for only 40%.

Osteoarthritis of the knee in the elderly: is knee replacement always justified?