New surgical guidelines for knee osteoarthritis: AAOS

The American Academy of Orthopedic Surgeons (AAOS) has introduced new guidelines for patients undergoing surgery for knee osteoarthritis. The new guidelines aim to improve mobility and relieve pain that is associated with knee osteoarthritis. The guidelines are for total knee replacement (TKR), which is a common form of surgery for knee osteoarthritis.

Chair of the AAOS Committee on Evidence-Based Quality and Value, David Jevsevar, M.D., M.B.A., said, “Total knee replacement is a safe and effective technique that benefits patients immensely. Many of the guidelines in the CPG are strongly recommended because the literature and other evidence of good outcomes was very compelling.”

Knee osteoarthritis is known as the “wear and tear” arthritis because it wears down the cartilage, which allows for the bones to rub together and become damaged. Symptoms of knee osteoarthritis include swelling, pain, stiffness and difficulty walking or standing from a seated position.

The AAOS guidelines take into account a patient’s lifestyle and expectations along with the physician’s experience as influence for treatment decisions. The new recommendations suggest the following:

• Reduction of risk factors, such as weight and smoking
• Administration of multi-modal anesthesia, including local anesthetic and nerve blockade around the knee joint to decrease pain and opioid use following TKR
• Treatment with tranexamic acid to decrease postoperative blood loss and transfusions following TKR
• Starting rehabilitation the same day TKR is performed to reduce length of hospital stay