This flowchart will help to put the various interventions for knee arthritis into perspective.

Flowchart created in 2018 and page updated August 2023 by Dr Sheila Strover (Clinical Editor)

The image resolution is quite high - there is just a lot of information there - so you should be able to re-size to navigate and see everything or download the image onto your computer by either right-clicking or ctrl+click.

Flowchart of interventions in knee arthritis

Normal gradual age-related deterioration in the joint cartilage with no specific focal defect

This is the common pattern of age-related knee joint deterioration. The chart offers a progression of relatively simple interventions, with total knee replacement as the final solution if the articular cartilage wear is simply too great.


Focal cartilage damage where the rest of the cartilage might be alright

This is where OATS, mosaicplasty, focal implants and focal resurfacing may play an important role.


Damage limited to one side of the joint because of atypical forces going through the limb

In this group of people, the focus is on correcting the alignment or balancing the forces going through the joint - via procedures appropriate to the alteration of the forces, eg meniscal transplant or osteotomy, and then the cartilage repair procedures follow that. There is no use seeing to the articular cartilage damage if the poor balance of forces is simply going to lead to destruction again. If the cartilage is too far gone, then correcting the forces may precede a partial knee replacement.

Quick links:


Knee arthritis interventions when you are too young for a total knee replacement - ebook