Question

A 65-year-old lady presented with a swollen and painful knee. On examination, she was found to have grade III osteoarthritic changes. What is the best treatment option?

• A. Conservative management
• B. Arthroscopic washing
• C. Partial knee replacement
• D. Total knee replacement

Hint:

Advanced (grade III to IV) osteoarthritis in an elderly patient calls for arthroplasty.

Answer 1

The Correct Option is D

Step 1: We are given a 65-year-old woman with a painful, swollen knee and radiological grade III osteoarthritic (Kellgren-Lawrence) changes, and asked for the best treatment.
Step 2: Osteoarthritis severity guides treatment. Early disease (grade I to II) is managed conservatively with analgesics, weight reduction, physiotherapy, and intra-articular injections. Advanced disease with severe pain and joint destruction needs surgical replacement.
Step 3: Grade III to IV changes in a symptomatic 65-year-old with significant cartilage loss and deformity are best treated with total knee replacement (arthroplasty), which reliably relieves pain and restores function.
Step 4: Reviewing other options: conservative management is for early or mild disease. Arthroscopic washout has not been shown to benefit established osteoarthritis. Partial (unicompartmental) replacement is reserved for disease limited to one compartment, not for diffuse grade III changes. Therefore the best option is Total knee replacement.