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 awareness, middle-aged and elderly people pay more attention to it, but due to the lack of scientific awareness, often in the understanding of the misunderstanding. Today summarizes the five major misconceptions about the diagnosis and treatment of osteoarthritis of the knee with readers for analysis. Misconception 1: osteophytes is osteoarthritis, their treatment is the same “osteophytes” this imaging description seems to be more than the “osteoarthritis” the name of the disease more in-depth, in fact, osteophytes is osteoarthritis secondary changes in osteoarthritis, osteoarthritis is the main pathological change is the wear and tear of cartilage, osteoarthritis. The main pathological change in osteoarthritis is the wear and tear of cartilage, while osteophytes are secondary changes in the body’s attempt to repair cartilage damage. Many elderly people have only minor cartilage destruction in their joints, with small bone spurs, unrestricted joint function and mild pain. With proper maintenance, this type of osteophyte usually does not progress to osteoarthritis. If the joint 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 after taking radiographs do not need to be overly nervous, and there is no need for special treatment if the joint degeneration and osteoarthritis are controlled to a level that does not affect daily life through exercise and maintenance. Myth 2: Bone spurs are the root cause of pain, as long as the removal of the natural will not hurt Many patients in the clinic will strongly urge the physician to remove the bone spurs in the knee, thinking that as long as the removal of bone spurs osteoarthritis will be good. Is this really the case? Bone spurs are secondary changes after the degeneration of cartilage, in most cases does not cause pain, bone spurs are covered with cartilage, cartilage, no nerve distribution, feel no pain; but cartilage degeneration will lead to exposed subchondral bone, bone marrow edema, cystic degeneration and other lesions, triggered by the subchondral bone source of pain, and at the same time, the synovial membrane of the edema and inflammation will also trigger synovial source of pain. The real culprit is the impingement of proliferating bone spurs against soft tissues such as ligaments, for example, bone spurs in the intercondylar fossa of the femur impinge on the anterior and posterior cruciate ligaments, and bone spurs in the medial condyles of the femur and tibia jack up and compress the medial collateral ligaments, and so on. In fact, bone spurs are helpful in stabilizing the knee joint to some extent, so if you simply remove the bone spurs without dealing with the worn out cartilage, not only will it not improve the pain and function of the knee joint, but it may even aggravate the pain and dysfunction. Therefore, patients who are troubled by bone spurs are advised to focus on how to deal with the worn cartilage while seeking a doctor to remove the bone spurs. Myth 3: Treatment of osteoarthritis, only a fixed “trilogy” Many patients in the diagnosis of osteoarthritis, often get this advice: first conservative treatment for a period of time to reduce symptoms, if not on a minimally invasive arthroscopic surgery to clean up the joints, or failing that, there is only a joint replacement. 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 with ineffective conservative treatment, arthroscopic patellofemoral arthroplasty can be considered to improve patellar trajectory and reduce patellofemoral joint wear. In some patients, the pain is heavier on the medial side of the knee, and the X-ray shows narrowing of the medial joint space, osteophytes, and in severe cases, inversion of the knee, which is also known as O-shaped leg. These patients should control their weight, walk with crutches, strengthen the lateral femoral muscles, or walk with orthopedic braces for O-legs to reduce the pressure on the medial joints and relieve pain. Patients who fail to receive conservative treatment can consider undergoing proximal tibial osteotomy or unicondylar replacement surgery, and knee joint surface replacement has been proved to be a more mature and effective treatment for patients with advanced osteoarthritis of the knee. In short, the treatment of osteoarthritis of the knee requires professional doctors to consider the patient’s osteoarthritis according to the degree of disease, general condition, lifestyle and even family, economy and other circumstances of the comprehensive individualized, never mechanical follow the “trilogy”. Myth 4: Arthroscopic minimally invasive surgery is omnipotent, anyone can do Many patients with osteoarthritis of the knee joint after conservative treatment, still can not be effectively relieved, but the fear of joint replacement surgery, and then focus on the minimally invasive arthroscopic surgery. As a matter of fact, arthroscopic surgery has its own indications for people, and professional doctors need to make a comprehensive judgment before deciding whether it is suitable or not, and should not listen to some unfounded propaganda and carry out the surgery arbitrarily. 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, a combination of osteotomy or patellar trajectory adjustment surgery is needed to restore the normal force lines of the knee joint in order to achieve a better outcome. 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 problem of cartilage regeneration, which is the fundamental problem in the treatment of osteoarthritis, in the future. Myth 5: Replacement joints can only be used for 7 or 8 years, the elderly surgical risk A lot of chronic diseases of the elderly and middle-aged population, often worried about chronic diseases will aggravate the risk of their surgery, and artificial joints have a limited lifespan, such as the replacement of a few years after a change again. In fact, joint replacement surgery is 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, the safety of the surgery can be accepted. 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, most elderly people who have their artificial joints replaced will be able to use them for the rest of their lives. It should be emphasized that patients should closely cooperate with doctors to do functional exercises after the operation and follow the doctor’s instructions on time in order to minimize the chance of complications. The Department of Joint and Orthopedic Surgery of Changhai Hospital emphasizes on providing individualized treatment plans for patients’ conditions and specific situations in the treatment of osteoarthritis, aiming to alleviate patients’ pain and pain at minimal cost and risk, and to return patients to a flexible joint and a normal life.