Is there a value in knee arthroscopy?

Is there a value in knee arthroscopy?
Is there a value in knee arthroscopy?

What is arthroscopy?

Knee arthroscopy is a minimally invasive procedure in which surgeons make small incisions to allow surgical tools and a small camera into the knee. The purpose is to trim away and remove loose or torn pieces of cartilage

In theory, arthroscopy should help relieve knee pain and improve function by clearing away loose or disconnected tissue that is interfering with the movement of the knee. However, evidence of its effectiveness has been mixed—and now a new review of studies adds even more doubt on its claims.

The review looked at 9 studies that included 1,270 middle-aged or older patients who had both knee pain and evidence of cartilage or joint degeneration through an MRI scan. In the studies, some received an arthroscopy and others received no treatment or alternate, nonsurgical treatments. The review revealed that those who had an arthroscopy had a little more pain relief than the nonsurgical groups, but only for 3 to 6 months. After 6 months, their results were no better than the others. When it came to knee function, the surgical groups had no significant improvements compared with the control groups.

A better alternative to arthroscopy

If you have knee pain and limited function, you may be wondering what your other treatment options are instead of arthroscopy. This same review found that one other intervention had a substantial impact for improving pain: exercise therapy. Studies in which participants exercised 3 times a week showed a large pain-relieving effect as a result.

I always recommend low-impact aerobic exercise to all my patients. There are also newer injection options available including highly concentrated hyaluronic acid, platelet rich plasma (PRP), and stem cells.

Reference:

Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ. 2015.