Nonoperative and Arthroscopic Approaches to the Postmeniscectomy Arthritic Knee

Management of the unicompartmental osteoarthritic knee is challenging. Recent treatment modalities, including NSAIDs, supplements, and injectable HA, have provided clinically effective adjuncts. Supplements seem to be most effective in treating mild to moderate OA. Wide product variability mandates familiarization by healthcare providers. The widely advertised "chondroprotective" benefit has not been convincingly proven and awaits further outcome studies. Hyaluronic acid seems to be clinically effective in patients with mild to moderate osteoarthritis and has a low complication rate. Its effectiveness, however, is probably not achieved through its marketed "viscosupplementation" mechanism. Further research will allow us to better determine its exact placement in the treatment of osteoarthritis. In the future, the treatment of osteoarthritis will most likely focus on prevention, and biologic manipulation such as gene therapy may eventually render even today's "advanced" therapeutic alternatives obsolete.