Abstract
The potential benefit of arthroscopy as a treatment for knee osteoarthritis is contentious,
with National Institute for Health and Care Excellence stating that, “There is uncertainty
regarding the efficacy of the procedure.” This is a study of a consecutive series
of patients with osteoarthritis of the knee, suffering from mechanical symptoms, such
as giving way, catching, and locking, and undergoing arthroscopic debridement, including
chondroplasty and meniscectomy where appropriate. A total of 33 patients were reviewed
at a mean period of 24 months (standard deviation 3 months) and follow-up data were
obtained for 28 of these patients. Primary outcomes measured were: number of mechanical
symptom episodes per week and visual analog scores for pain. Secondary outcomes measured
were: Oxford, Lysholm, and Tegner knee scores together with arc of motion of the joint.
Seven patients went on to have a knee replacement within 2 years. In the patient subgroup
who did not require further surgery, there was statistically significant improvement
in giving way (p = 0.0184) and marginally significant improvement in catching and locking (p = 0.1105 and p = 0.087, respectively). There were statistically significant improvements found in
the Oxford and Lysholm scores (p < 0.0001). An average decrease of 1.9 in the VAS pain score was observed that was
also statistically significant (p < 0.0007) and an average improvement of 10 degrees in the arc of motion was noted,
which was marginally significant (p = 0.0687). To our knowledge, this is the first study with a primary outcome measure
of mechanical symptoms experienced by patients. The results overall suggest that patient
symptoms improved following arthroscopic treatment. As a result, episodes of mechanical
symptoms should be important criteria for clinicians in determining the patient suitability
for arthroscopic debridement.
Keywords
mechanical - arthroscopy - knee - osteoarthritis
