Optimising treatment of younger, active knee osteoarthritis patients: Surgical options and functional outcomes

The main objective of this thesis is to facilitate the shared-decision making for the best surgical treatment strategy in relatively young and active knee osteoarthritis (OA) patients, based on their individual expectations and activity goals. We investigated three topics: I) current functional outcomes, including participation in sports and work, of joint preserving alternatives to knee arthroplasty (KA), II) prognostic factors for patient relevant outcomes, such as return to sport and work, after knee osteotomy and KA, and III) strategies to optimize outcomes like goal attainment and patient satisfaction in this relatively young and active group of KA patients. The results reported in this thesis support the use of knee joint sparing alternatives to KA in the treatment of relatively young, active patients. Individual activity goals, and prognostic factors for patient relevant outcomes, such as preoperative sports participation and being the family’s breadwinner, should be taken into account when deciding which treatment option is best for each specific patient. Finally, if patients go on to require a knee arthroplasty, goal-oriented and personalized rehabilitation should be offered.