Surgical treatment of osteoarthritis of the knee: With the advent of an aging population in China, more and more elderly people are suffering from osteoarthritis of the knee, resulting in limited mobility and reduced quality of life. It is the trend to treat osteoarthritis by giving standard stepwise and precise treatment according to the different degrees of osteoarthritis progression. Last time we gave some introduction to the conservative treatment of early and mid-stage osteoarthritis of the knee. This time, we will focus on the stepped treatment plan for the middle and late stages of knee. Nowadays, the stepwise and precise treatment of knee osteoarthritis has formed a stepwise treatment with the characteristics of arthroscopy, high tibial osteotomy and artificial joint replacement. Stepwise treatment of knee osteoarthritis I. Minimally invasive arthroscopy Arthroscopy is a minimally invasive surgical procedure for the treatment of osteoarthritis, which has the advantages of minimally invasive, less complications and faster recovery, but there are clear indications for minimally invasive arthroscopic treatment of osteoarthritis, namely 1, there are free bodies in the joint (joint rats) 2, meniscal injury-based osteoarthritis 3, some of the relatively young people with articular cartilage damage 2, knee preservation surgery divided into osteotomy orthopedic surgery and unicondylar replacement surgery 1, through the adjustment of the lower limb force line to treat osteoarthritis ~ ~ osteotomy deformity correction Many patients with osteoarthritis legs are not straight, O or K-shaped, that is, inversion or valgus. Since inversion is the cause or aggravation, well, osteotomy orthopedic surgery, this surgical method because of the preservation of the ligamentous structure within the joint, in suitable patients after reasonable treatment has a better postoperative patient feeling, suitable for younger patients. It is mainly suitable for patients with mild to moderate degree of joint degeneration, especially for patients with pronounced inversion or valgus deformity, with better surgical results. The purpose of knee preservation is far-reaching in clinical treatment. 2. Partial arthroplasty (unicondylar arthroplasty) ~~ unicondylar surface replacement The knee has three compartments (chambers), medial, lateral, and anterior. In many advanced osteoarthritis, there are not problems in all three compartments, but often the medial side is more common, so there is no need to perform multi-chamber arthroplasty when there is a problem in the unicondylar compartment. Unicondylar arthroplasty is also a less traumatic procedure because the ligamentous structures in the knee are preserved, and the patient is relatively satisfied with the postoperative experience. It is primarily indicated for patients with moderate to severe unicondylar joint wear, but the wear is still limited to the anteromedial compartment of the tibiofemoral joint, patients with mild deformity and functional integrity of the ligaments of the knee, or patients with unilateral condylar collapse due to trauma, unicondylar surface replacement is a relatively minor procedure, but requires strict control of the indications for surgery. Total knee arthroplasty When osteoarthritis reaches an advanced stage, the cartilage is fully damaged and there is no way out, and the quality of life is seriously reduced, it is time to consider total knee arthroplasty. Total knee arthroplasty is a very mature surgical technique for patients with severe joint wear and severe joint deformities, and it is only a joint surface replacement, so there is no need to be overly afraid of surgery. Total knee surface replacement remains the gold standard for the treatment of end-stage osteoarthritis and rheumatoid arthritis and other knee joint insufficiencies.