Reconstructive surgical approaches can help delay endoprosthetic joint replacement in patients with osteoarthritis. Henning Madry and coauthors introduce such procedures in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2011; 108[40]: 669-77).
Articular cartilage defects often develop subsequent to injury or osteoarthritis. The authors in their article provide an overview of currently available medical and surgical therapeutic options. Medical therapy aims to preserve articular function for as long as possible and to delay surgical intervention. Further to the primarily pain-relieving symptomatic medication, causal treatment with glucosamine and chondroitin aims to improve the joint itself. However, no medical drugs are currently available that can slow down or reverse the process of cartilage degeneration. Surgical measures aim to trigger formation of repair tissue or partially relieve the weight placed on the joint. These procedures include debridement of cartilaginous fragments, marrow-stimulating techniques, transplantation of cartilaginous cells or stem cells, and weight relief by means of osteotomy.
Madry H, Grün UW, Knutsen G: Cartilage repair and joint preservation: medical and surgical treatment options. Dtsch Arztebl Int 2011; 108(40): 669-77.