Minos Ε. Tyllianakis MD, PhD

Idiopathic osteoarthritis is a disease of unknown aetiology diagnosed in adult life, that affects some of the major joints of the lower (usually) limbs. It affects cartilage, synovial membrane, menisci.

Pain is characterized by short or long-standing flare-ups and remissions. Using the stairs and keeping an upright position are sometimes intolerable. Nocturnal pain is noted at late stages.

There are no drugs aiming at the cause. A lot of factors are on the market presumably halting or repairing the degenerative process, administered orally or intraarticularly. Their scientific value and superiority over long standing conservative methods of treatment is questionable. Intermittent use of anti-inflammatory drugs and physiotherapy are used with variable success.

When patient’s daily activities become limited surgery is indicated. In selected cases in young adults with knee osteoarthritis, tibial osteotomy can be performed. However, in most cases arthroplasty of various types is indicated for both hip and knee. Pain relief is dramatic and some improvement in motion is expected.

I use navigated assisted technique that provides better control of intraoperative osteotomies thus ensuring better results.

Various types of anaesthesia are used. Patients are allowed partial weight bearing and are discharged after a couple of days. There are 2 major postoperative concerns regarding arthroplasties:

1. Infections (1%-2%)– acute or low-grade – requiring long standing intravenous antibiotics and surgical debridement or exchange of implants.
2. Loosening of the implants due to wear of the articulated parts. This is usually detected years after implantation and revision of the arthroplasty is required.