[Gonarthrosis--assessment and conservative therapy].

Osteoarthritis of the knee joint is the most prevalent cause of disability in older patients. Isolated medial tibio-femoral compartment disease is by far the most common localization among the various combinations within the knee joint that is affected by osteoarthritis. Interestingly, the risk factors for the disease process in the medial tibio-femoral compartment are not the same for the femoropatellar disease. The diagnosis is not only based on the history and the clinical examination of the knee joint cartilage and bone, but it also includes the clinical assessment of periarticular structures of the knee. Standard radiographic examination should be performed in most cases to confirm the diagnosis. Unfortunately, so far no specific therapy is available that halts or cures the disease process in osteoarthritis. One probable exception are the corrective osteotomies. Conservative treatment strategies include prevention, therapy of established early and late end-stage disease. A proper combination of nonpharmacologic treatment and drug therapy is, together with the seldom indicated joint lavage, the key for satisfied patients. Information and assurance of the patients and their families prevents them from unjustified fears and frustration and is a strong promoter for an excellent compliance in successful programs to improve muscle strength.