Hip and Knee Arthroplasty in Osteoarthritis

Osteoarthritis (OA) of the hip and knee continues to increase in prevalence with the increasing age of our population. This condition is characterized by joint pain, stiffness, and limitations in activities of daily living. Management options are initially aimed at preventing the progression of disease and delaying the need for total joint arthroplasty (TJA). This includes nonoperative measures, as well as surgical interventions, including arthroscopy, osteotomy, and arthrodesis. However, once patients fail alternative therapy, TJA is indicated. Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are highly effective procedures at reducing pain and improving functional status. Patients report high satisfaction rates after TJA and experience minimal complications. Moreover, these procedures are cost effective. Significant research into patient-specific implants (PSI) and computer-navigation-assisted surgery shows improved component positioning; however, further research is needed to determine the clinical effect of this innovation. Wear rates in both TKA and THA have improved significantly over the past decade, with highly cross-linked ultra-high molecular-weight polyethylene showing promising results. New minimally invasive surgical techniques are also showing excellent short-term results, but long-term data is still lacking. Overall, hip and knee OA is a debilitating condition that can be effectively managed with TKA or THA. Indications continue to expand for these procedures and innovation continues to aim for improved outcomes.