Osteoarthritis of the Knee

To the Editor: The comprehensive discussion of the medical management of osteoarthritis by Felson (Feb. 23 issue) 1 made no mention of the role of surgery, particularly when the disease is severe. Conclusions from the 2003 National Institutes of Health (NIH) consensus statement on total knee replacement 2 identified operative interventions as perhaps the most effective treatments for osteoarthritic knees. An evidence compendium published by the American Academy of Orthopaedic Surgeons (AAOS) 3 and AAOS practice guidelines 4 summarize both surgical and nonsurgical options for managing this prevalent health problem. Effective surgical options for management of osteoarthritis include arthroscopy (not for purposes of joint . . .