A Strategic Approach to Knee Arthritis Treatment: From Non-Pharmacologic Management to Surgery

408 Pages·2021·20.272 MB·English

by  Seung-Suk Seo

A Strategic
Approach to Knee
Arthritis Treatment
From Non-Pharmacologic
Management to Surgery
Seung-Suk Seo
Editor
123
A Strategic Approach to Knee
Arthritis Treatment
Seung-Suk Seo
Editor
A Strategic Approach
to Knee Arthritis
Treatment
From Non-Pharmacologic
Management to Surgery
Editor
Seung-Suk Seo
Department of Orthopedics
Haeundae Bumin Hospital
Busan
South Korea
ISBN 978-981-16-4216-6 ISBN 978-981-16-4217-3 (eBook)
https://doi.org/10.1007/978-981-16-4217-3
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Singapore Pte Ltd. 2021
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Dedicated to those I cherish the most, my wife Da-Hyun,
my mother Hu-Bun, and two my sons.
Foreword
It is a great challenge and hard to write a book in English for Korean scholars.
I sincerely congratulate Dr. Seung-Suk Seo on the publication of this book
through continuous research and efforts with a passion for academics, even in
the midst of being busy treating patients.
The knee joint is one of the most studied and mentioned topics in orthope-
dic surgery. The knee joint is a specialized structure that supports repetitive
loads and enables joint movement by reducing friction. It is built by the phys-
iological conditions of articular cartilage and cellular matrix. Also, the knee
joint is a complex and complicated structure, and is the structure with the
most to do.
This book deals with osteoarthritis of the knee joint that is one of the most
common and important knee joint disease. Due to the gradual aging of the
population, osteoarthritis of the knee joint is more frequent, especially in
developed countries. Therefore, proper diagnosis and treatment of knee
osteoarthritis is an important responsibility for general physicians, rheuma-
tologists, and orthopedic surgeons. Many books on knee arthritis have already
been published. This book contains all the basic and practical, up-to-date
knowledge of knee osteoarthritis, from the basics of the knee, such as the
anatomy and biomechanics of the knee, the structure and function of articular
cartilage and meniscus, to the diagnosis and various treatments of arthritis. In
particular, a number of visual illustrations were added appropriately to com-
plement the text and enhance understanding. In addition, in order to provide
the evidence-based and most modern view on knee arthritis, the author’s
opinion and many influential references have been reviewed.
This book was made with continuous inspection and efforts for many
days, with the dedication of well-versed authorities and competent young
doctors in the field of knee joints. Thanks to all the doctors who have contrib-
uted to this book. Their dedication will be a good guide for the numerous
trainees, clinicians studying, and treating knee osteoarthritis. Special thanks
to Dr. Seung-Suk Seo for collecting and revising all the texts. He is one of the
best, most delicate, and academically outstanding doctors of many orthopedic
surgeons I have ever seen. His leadership has undoubtedly led to the publica-
tion of a great book.
The medicine is advancing day by day. The knee joint is no exception. I
am sure this book will be a good guide to treating osteoarthritis in the knee
and will be a stable and lasting reference for the next few years. I hope this
book will be of great help to all doctors who treat knee arthritis.
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viii Foreword
Finally, if the book does not flow like water, it rots and disappears. Do not
settle for this. I hope that a more complete revision comes out by supplement-
ing any missing or updated parts.
Jin Hwan Ahn, MD, PhD
Department of Orthopedics, Sae Um Hospital
Seoul, South Korea
Department of Orthopedics, College of Medicine
Sungkyunkwan University
Seoul, South Korea
Foreword
The diagnosis and treatment of arthritis of the knee has various treatment
methods as well as a long history. Now, when the world’s knowledge is con-
nected through the Internet, many of these treatment methods are introduced
through papers or books. The pace of development of treatment has acceler-
ated over time, and a vast amount of research is being updated even now.
Knowledge of these treatment methods is also open to patients, so patients
who search for a treatment for their disease ask a doctor for the treatment they
searched for or ask more deeply about the treatment. Mastering all of the new
treatments is practically difficult and the selection of treatment is hard. In
order to choose the right treatment, it is necessary to understand the pathol-
ogy and progression of degenerative arthritis of the knee and to classify the
mechanisms and effects of various treatment methods.
The editor of this book, whom I have known for a long time, is an ortho-
pedic specialist who has been treating patients with knee joint disease for
more than 30 years while actively conducting academic activities such as
serving as president of the Korean Knee Society. He is probably one of those
who can explain the diagnosis and treatment of degenerative knee arthritis
well. This book goes beyond simply recording the author’s experiences and
observations and is the result of organizing them on a theoretical basis con-
cretely and systematically. This book provides comprehensive information
about knee arthritis as well as the latest knowledge on the effects of each of
the non-surgical and various surgical treatments. Along with this latest knowl-
edge, the pros and cons of the technique based on the editor’s extensive clini-
cal experience are clearly described. In addition, detailed illustrations help to
understand the anatomy of the knee, the pathology of osteoarthritis, and its
exacerbation process.
Knee osteoarthritis has been studied for a long time with various treat-
ments; however, there is still a need for improvement of more effective treat-
ments and basic research. Even treatments within the same category have
varying results depending on the dose, technique, and approach, and adverse
events have been reported that cannot be ignored. These unorganized variable
results may rather confuse doctors trying to treat patients. In this respect, this
book, which summarizes the existing knowledge of knee arthritis that is com-
prehensive and up-to-date, is a very valuable resource for improving the diag-
nosis and treatment of knee arthritis. In addition, it is believed that various
knee treatment mechanisms, techniques, and tips are organized in an easy-to-
understand manner in this book, helping doctors who do not major in knee
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x Foreword
but want to access knee disease treatment to broaden their understanding of
knee arthritis. I do not doubt that this book will make it easier for many
patients suffering from knee arthritis and doctors who treat it, and wish the
editors great success.
Dae Kyung Bae, MD, PhD
Department of Orthopedics, Seoul Sacred Heart Hospital
Seoul, South Korea
Department of Orthopaedics, College of Medicine
Kyung Hee University
Seoul, South Korea
Preface
Osteoarthritis is one of the most common diseases that occur in humans. In
particular, knee osteoarthritis exacts a tremendous socioeconomic burden
upon those who suffer from it due to the hardship it places upon an individu-
al’s personal and professional activities. As a young man, while completing
my medical studies and residency I understood osteoarthritis to be a disease
of articular cartilage that progressed naturally through daily “wear and tear.”
However, as medical knowledge has advanced over the last several decades,
many breakthroughs have been made with regard to the etiology, pathogene-
sis, diagnosis, and treatment of osteoarthritis. My knowledge too has grown
right alongside these advances as I have been an orthopedic surgeon special-
izing in knee joint surgery for the past 30 years.
In my practice, I have encountered countless patients with knee osteoar-
thritis who have been referred to my clinic for surgery. However, only a few
of the patients I treat are provided with surgical treatment and most patients
are treated non-surgically. My thoughts, as a practicing surgeon, while var-
ied, have often focused on my belief that many healthcare providers, includ-
ing myself, have failed to provide appropriate medical care to patients with
knee osteoarthritis. Despite many academic societies and government regu-
lators having drafted therapeutic guidelines for osteoarthritis, in my opin-
ion, in practice, many patients have not been properly treated with the
established guidelines in clinics. While varied, reasons for this include
social and environmental factors, including the healthcare systems in many
countries, the education provided to healthcare providers, and various
patient-related factors. Among the issues I have outlined here, I believe the
education provided to healthcare providers is of critical importance. One of
the key reasons, I believe that educational practices are lacking, is that
despite the abundance of knowledge regarding osteoarthritis that has been
introduced in textbooks, journals, and web-based articles, it is difficult to
find texts specific to knee osteoarthritis. Additionally, of the texts that exist
focused on knee osteoarthritis, most focus almost exclusively on surgical
techniques. Knee osteoarthritis is treated not only by orthopedic surgeons,
but also by rheumatologists, general physicians, and family medical doc-
tors, so I believe it requires a textbook that provides integrated knowledge
with a focus on both non-surgical treatment and surgery-specific knowl-
edge. Osteoarthritis is caused by a variety of etiologies and is characterized
by gradual destruction of the joints that progresses through a variety of
disease stages. Osteoarthritis has a variety of causes and disease progres-
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