In elderly severe knee osteoarthritis, when proceed to early total knee arthroplasty? скачать в хорошем качестве

In elderly severe knee osteoarthritis, when proceed to early total knee arthroplasty?

Elderly patients with severe knee osteoarthritis often present a difficult management decision: continue prolonged conservative therapy or proceed with early total knee arthroplasty. While surgery may offer improved pain relief, it carries a moderate increase in complications and perioperative risk, particularly in adults aged 80 and older or those with significant comorbidities. Conservative management reduces immediate harm but may prolong disability when symptoms are refractory. This discussion outlines a practical framework for defaulting to non-surgical management while identifying appropriate thresholds for escalation. Key considerations include symptom severity, functional limitation, surgical risk assessment (including ASA classification), age, comorbidity burden, and patient preference. The emphasis is on individualized risk–benefit assessment rather than radiographic severity or institutional pressures. Clinical decisions should prioritize safety while remaining responsive to persistent, function-limiting pain. #Orthopedics #Geriatrics #Osteoarthritis #TotalKneeArthroplasty #PrimaryCare