Rheumatic diseases clinics of North America
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The menisci play a critical protective role for the knee joint through shock absorption and load distribution. Currently, the consensus in surgical treatment of meniscal tears is to preserve as much functional meniscal tissue as possible. ⋯ Surgical resection of nonobstructive degenerate lesions may remove only the evidence of the disorder while the osteoarthritis degradation proceeds. Well-designed randomized, controlled clinical trials are needed.
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Rheum. Dis. Clin. North Am. · Aug 2008
ReviewThe symptoms of osteoarthritis and the genesis of pain.
Symptomatic osteoarthritis (OA) causes substantial physical and psychosocial disability. This article delineates the characteristic symptoms and signs associated with OA and how they can be used to make the clinical diagnosis. ⋯ The remainder of the article focuses on what is known about the causes of pain in OA and factors that contribute to its severity. Much has been learned during recent years, but much of this puzzle remains unexplored or inadequately understood.
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The role of surgical treatment in osteoarthritis of the knee continues to evolve. The indications for arthroscopy have narrowed. Orthopedic surgeons continue to explore options less invasive than total knee replacement for isolated unicompartmental arthritis of the knee joint. In addition to arthroscopy, this article discusses the merits and drawbacks of and indications for osteotomy, interpositional arthroscopy, patellofemoral replacements, and emerging technologies for total knee replacements.