Surgical management of osteoarthritis.

The surgical management of osteoarthritis has progressed greatly in the past 30 years and often is indicated when noninvasive measures can no longer provide sufficient pain relief and maintenance of function. Physicians can choose from a variety of surgical procedures, depending on patient age, the joint involved, functional expectations, patient activity demands, and degree of cartilaginous loss. Surgical procedures for arthritic joints can be classified in two broad categories: those that are cartilage-sparing, such as osteotomy, and those that are cartilage-sacrificing, such as arthroplasty. This article discusses those procedures most commonly used for the major weightbearing joints of the lower extremities (hip, knee, ankle) as well as the large joints of the upper extremity (shoulder, elbow).