Surgical treatment of the middle-aged patient with arthritic knees.

Arthritic knee disease is increasingly more common in the active aging population. The pathology seen in this patient group can run a spectrum of localized degenerative change through tricompartmental arthritis. Nonsurgical options to treat early symptoms are well known and often are effective. When nonsurgical management has failed, surgical intervention often is warranted. Arthroscopic debridement is considered in select patients with mechanical symptoms. Osteotomy continues to have a role in the treatment of young, active patients and may be particularly appropriate in combination with articular cartilage procedures. Unicompartmental and total knee arthroplasty are reliable treatments for patients with advanced stages of degenerative arthritis.