Knee pain is a phenomenon that occurs in many middle-aged and elderly people, especially when going up and down the stairs, the pain is especially obvious, and in severe cases, it may even limit the patient’s activities. With the improvement of health consciousness, middle-aged and elderly people pay more and more attention to it, but due to the lack of scientific awareness, there are often misunderstandings in the understanding. Myth one, osteophytes is osteoarthritis? The imaging description of “osteophytes” seems to be more popular than the name “osteoarthritis”, in fact, osteophytes is a secondary change of osteoarthritis, the main pathological change of osteoarthritis is the wear and tear of the cartilage, and osteophytes is the body tries to repair the cartilage destruction secondary changes. The main pathological change in osteoarthritis is wear and tear of the cartilage, while osteophytes are secondary changes in the body’s attempt to repair cartilage destruction. Many older people have only minor cartilage destruction in their joints, with very small bone spurs, unrestricted joint function, and mild pain. With proper maintenance, this type of osteophyte usually does not progress to osteoarthritis. If the articular cartilage is progressive degeneration, obvious osteophytes, osteosclerosis ivory change and bone cysts, joint pain affecting walking, activities are obviously limited, can be diagnosed as osteoarthritis. It can be said that osteophytes are not equal to osteoarthritis, and doctors must combine history, physical examination and film reading to make a correct diagnosis. Middle-aged and elderly people who are found to have mild osteoarthritis need not be overly nervous, and there is no need for special treatment if joint degeneration and osteoarthritis are controlled within the range that does not affect daily life through exercise and maintenance. Myth 2: Removing bone spurs will make it painless? Many patients in the clinic will strongly request the physician to remove the bone spurs in the knee, thinking that as long as the bone spurs are removed, osteoarthritis will be cured. Is this really true? Bone spurs are secondary changes in cartilage degeneration, and in most cases do not cause pain. The real culprit is the impingement of proliferating bone spurs with ligaments and other soft tissues, for example, spurs in the intercondylar fossa of the femur impinge on the anterior and posterior cruciate ligaments, and spurs in the medial condyle of the femur and the tibia can press up on the medial collateral ligament, etc. In fact, bone spurs have a certain degree of impact on the knee, which can cause pain. In fact, bone spurs are helpful in stabilizing the knee joint to some extent, so if the worn cartilage is not dealt with and the spurs are simply removed, not only will it not improve the knee pain and function, but it may even aggravate the pain and dysfunction. Therefore, patients who are bothered by bone spurs should focus on how to deal with the worn cartilage while seeking a doctor to remove the bone spurs. Myth 3: Only a “three-step program” can treat osteoarthritis? Many patients who have been diagnosed with osteoarthritis are often given the opinion that conservative treatment should be given for a period of time to alleviate the symptoms, and if that doesn’t work, then minimally invasive arthroscopic surgery should be done to clean up the joints, and if that doesn’t work, then the only thing that can be done is to replace the joints. We used to call them the “trilogy” of treatment for osteoarthritis. Each person’s physical condition, living habits are different, the onset of osteoarthritis process and symptoms also vary from person to person, which determines the scientific knee osteoarthritis treatment program should be individualized. For example, some patients just squatting or up and down the stairs, climbing the mountain when the knee pain, walking on a flat road and no obvious symptoms, such patients should help him to do more patellar push, quadriceps muscle strength exercises, reduce climbing, stair climbing and other activities to increase the friction of the patellofemoral joint, and according to the patient’s physical conditions supplemented with drug therapy. For patients whose conservative treatment is ineffective, proximal tibial osteotomy or unicondylar replacement surgery can be considered, and knee joint surface replacement has been proved to be a more mature and effective treatment method for advanced patients. In short, the treatment of osteoarthritis of the knee, need to professional doctors according to the patient’s osteoarthritis disease degree, systemic conditions, lifestyle and even family, economic and other circumstances of the comprehensive individualized consideration, never mechanical follow the “trilogy”. Myth 4: Can anyone do minimally invasive arthroscopic surgery? Many patients with osteoarthritis of the knee joint are still unable to get effective relief after conservative treatment, but they are afraid of joint replacement surgery, and then focus their attention on minimally invasive arthroscopic surgery. As a matter of fact, arthroscopic surgery has its own indications for people, and it needs to be judged by a professional doctor before deciding whether it is suitable or not, and it should not be carried out arbitrarily by listening to some unsupported propaganda. For early osteoarthritis confined to a single compartment, especially the patellofemoral joint, unicompartmental tibiofemoral joint osteoarthritis, young patients or those who refuse to accept artificial joint replacement surgery, arthroscopic cleanup and arthroplasty can be performed. However, for patients with abnormal joint force lines, i.e., severe type 0, type X leg or patellar subluxation, it is necessary to combine with osteotomy or patellar trajectory adjustment surgery to restore the normal force lines of the knee joint in order to achieve better results. Chondrocyte transplantation is an emerging surgical technique in recent years, which is characterized by taking autologous cartilage through arthroscopy to the test chamber in the tissue engineering scaffolds for culture and expansion, and then transplanting the prepared tissue-engineered cartilage scaffolds to the defective parts after 1-2 weeks. It is believed that this technique is expected to solve the regeneration of cartilage in the future, which is the fundamental problem of osteoarthritis treatment. Myth 5: Replacement joints do not last long? Is surgery for the elderly more risky? Many middle-aged and elderly people with chronic diseases are often worried that chronic diseases will aggravate their surgical risk, and the life span of artificial joints is limited, such as replacing a joint in a few years will have to be replaced again. In fact, joint replacement surgery is currently the development of more mature surgical techniques, in general, as long as the patient’s systemic function is still good, take chronic disease medication on time, the indicators will be controlled in a reasonable range, safe to accept the operation. Data show that more than 90% of patients can normally use the implanted prosthesis for more than 10 years, and more than 80% of patients can use it for more than 20 years. Therefore, the majority of elderly people who have an artificial joint can use it for the rest of their lives. It should be emphasized that patients should closely cooperate with the doctor to do functional exercises after surgery and follow the doctor’s instructions on time in order to minimize the chance of complications.