Clinical Editor
Dr Sheila Strover is the Founder and previous Clinical Editor of the KNEEguru website.Her medical studies were completed at the University of the Witwatersrand in South Africa - BSc(Hons) (1968) and MBBCh (1974). She emigrated to the United Kingdom in 1983 and worked as an anaesthetist (anaesthesio…
A simple flowchart with links to show the possible interventions in cases of knee arthritis.
Flowchart created in 2018 and page updated August 2023 by Dr Sheila Strover (Clinical Editor)
The image resolution is quite high - there is just a lot of information there - so you should be able to re-size to navigate and see everything or download the image onto your computer by either right-clicking or ctrl+click.
This is the common pattern of age-related knee joint deterioration. The chart offers a progression of relatively simple interventions, with total knee replacement as the final solution if the articular cartilage wear is simply too great.
This is where OATS, mosaicplasty, focal implants and focal resurfacing may play an important role.
In this group of people, the focus is on correcting the alignment or balancing the forces going through the joint - via procedures appropriate to the alteration of the forces, eg meniscal transplant or osteotomy, and then the cartilage repair procedures follow that. There is no use seeing to the articular cartilage damage if the poor balance of forces is simply going to lead to destruction again. If the cartilage is too far gone, then correcting the forces may precede a partial knee replacement.