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Local GI effects (gastric mucosal protection, intestinal barrier restoration) are well-documented in IBD and ulcer models

Where this category of medication is approved and available, its potential role as part of a wider pre-operative medical plan is something I will discuss with the patient and their broader medical team

For patients who dont respond to 3-6 months of conservative treatment, correction of extensor mechanism alignment problems (medial plication/lateral release, tibial tubercle osteotomy) and cartilage-oriented surgeries (arthroscopic patellar shaving, drilling of the defect that reaches subchondral bone, facetectomy, tibial tubercle proximal relocation, patellectomy, patellofemoral surface arthroplasty) may be needed.

& Daley, G

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