THE FRONTIERS OF THE PATHOPHYSIOLOGY, DIAGNOSIS, AND TREATMENT OF KNEE OSTEOARTHRITIS

Abstract

Locomotive syndrome refers to conditions under which the elderly receive care services, or have high-risk conditions under which they may soon require care services, due to locomotive organ disorders. Knee osteoarthritis (OA) is one of the representative diseases strongly associated with locomotive syndrome. While OA is a disease that primarily results in the degeneration and destruction of articular cartilage, other joint structures, such as the meniscus, subchondral bone, and synovium, are also affected, which results in disability in the activities of daily living. Although the gold standard for assessing joint damage is still plain radiography, biomarkers and magnetic resonance imaging (MRI) are candidates that can detect and monitor joint structures precisely. Given the lack of disease-modifying drugs (DMORDs) for the treatment of knee OA, there is a strong need for treatments of knee pain. Recently, opioids have become available for the treatment of knee OA. For surgical treatment, while endoscopic surgery should be performed for limited cases with meniscal catching or rocking, joint replacement surgeries (TAK or UKA) are associated with excellent long-term outcomes. In addition, high tibial osteotomy (HTO) is also recommended because of the development of a fixation device with stable mid-term outcomes. Therefore, surgical treatment should be considered positively for patients with end-stage knee OA. Owing to the lack of systematic treatment guidelines for knee OA, evidence-based systematic treatment guidelines for knee OA are required.