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Evidence summaries

Arthroscopic Debridement for Knee Osteoarthritis

Arthroscopic debridement appears to have no benefit for undiscriminated knee osteoarthritis. Level of evidence: "B"

According to a BMJ RapidRecs guideline, arthroscopic surgery for degenerative knee osteoarthritis and meniscal tear is not recommended.

BMJ RapidReds http://www.bmj.com/content/357/bmj.j1982

A Cochrane review [Abstract] 1 included 3 studies with a total of 271 subjects. The studies had different comparison groups and a moderate risk of bias. One study compared AD with lavage and with sham surgery. Compared to lavage the study found no significant difference. Compared to sham surgery placebo, the study found worse outcomes for AD at two weeks (WMD for pain 8.7, 95% CI 1.7 to 15.8, and function 7.7, 95% CI 1.1 to 14.3; NNTH=5) and no significant difference at two years. The second trial, at higher risk of bias, compared AD and arthroscopic washout, and found that AD significantly reduced knee pain compared to washout at five years (RR 5.5, 95% CI 1.7 to 15.5; NNTB=3). The third trial, also at higher risk of bias, compared AD to closed-needle lavage, and found no significant difference.

Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment and blinding).

References

  • Laupattarakasem W, Laopaiboon M, Laupattarakasem P, Sumananont C. Arthroscopic debridement for knee osteoarthritis. Cochrane Database Syst Rev 2008 Jan 23;(1):CD005118. [PubMed]

Primary/Secondary Keywords