Arthroscopic Debridement of the Knee: An Evidence Update. 2014


BACKGROUND Patients with knee pain as a result of osteoarthritis or degenerative meniscal injury may seek treatment through arthroscopic surgery. How effective arthroscopic debridement with or without meniscectomy is for relieving pain and improving patients' functional outcomes is uncertain. OBJECTIVE To conduct an evidence update of an evidence-based analysis (EBA) conducted in 2005 to determine if arthroscopic debridement for osteoarthritis of the knee or for meniscal injury from degenerative causes improve patient outcomes. METHODS A literature search was performed using Ovid MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, Embase, and all EBM databases, for studies published from January 1, 2005, to February 4, 2014. METHODS A systematic review of the literature was conducted, limited to randomized controlled trials (RCTs) that examined the effectiveness of arthroscopic debridement with or without meniscectomy. Quality assessment of the body of literature was conducted using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS A total of 8 RCTs were identified, 2 from the original EBA plus 6 that were published since that time. The studies included patients with a range of indications for treatment and severity of osteoarthritis. Moderate-quality evidence showed no statistically significant difference in pain or functional status between patients who received arthroscopic treatment versus placebo (e.g., sham surgery). Low-quality evidence showed no statistically significant difference in pain or functional status between patients who received arthroscopic treatment versus usual care (e.g., physical therapy). CONCLUSIONS Heterogeneity across the study populations, interventions, and reported measures limited the ability to calculate a summary effect estimate; however, all studies demonstrated consistency in their findings. CONCLUSIONS The evidence does not show the superiority of arthroscopic debridement with or without meniscectomy in patients with osteoarthritis of the knee or with meniscal injury from degenerative causes.

UI MeSH Term Description Entries
D008592 Menisci, Tibial The interarticular fibrocartilages of the superior surface of the tibia. Lateral Menisci,Medial Menisci,Menisci, Lateral,Menisci, Medial,Semilunar Cartilages,Tibial Menisci,Meniscus, Medial,Meniscus, Tibial,Tibial Meniscus,Cartilage, Semilunar,Cartilages, Semilunar,Lateral Meniscus,Medial Meniscus,Meniscus, Lateral,Semilunar Cartilage
D003646 Debridement The removal of foreign material and devitalized or contaminated tissue from or adjacent to a traumatic or infected lesion until surrounding healthy tissue is exposed. (Dorland, 27th ed) Debridements
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070600 Tibial Meniscus Injuries Injuries to the TIBIAL MENISCUS of the leg. Bucket Handle Tears,Flap Tears,Tibial Meniscus Tears,Torn Tibial Meniscus,Bucket Handle Tear,Flap Tear,Injuries, Tibial Meniscus,Injury, Tibial Meniscus,Meniscus Injuries, Tibial,Meniscus Injury, Tibial,Meniscus Tear, Tibial,Meniscus Tears, Tibial,Meniscus, Torn Tibial,Tear, Tibial Meniscus,Tears, Flap,Tears, Tibial Meniscus,Tibial Meniscus Injury,Tibial Meniscus Tear,Tibial Meniscus, Torn
D001182 Arthroscopy Endoscopic examination, therapy and surgery of the joint. Arthroscopic Surgical Procedures,Surgical Procedures, Arthroscopic,Arthroscopic Surgery,Surgery, Arthroscopic,Arthroscopic Surgeries,Arthroscopic Surgical Procedure,Arthroscopies,Procedure, Arthroscopic Surgical,Procedures, Arthroscopic Surgical,Surgeries, Arthroscopic,Surgical Procedure, Arthroscopic
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D018771 Arthralgia Pain in the joint. Joint Pain,Polyarthralgia,Arthralgias,Joint Pains,Pain, Joint,Pains, Joint,Polyarthralgias
D020370 Osteoarthritis, Knee Noninflammatory degenerative disease of the knee joint consisting of three large categories: conditions that block normal synchronous movement, conditions that produce abnormal pathways of motion, and conditions that cause stress concentration resulting in changes to articular cartilage. (Crenshaw, Campbell's Operative Orthopaedics, 8th ed, p2019) Osteoarthritis of Knee,Osteoarthritis of the Knee,Knee Osteoarthritides,Knee Osteoarthritis

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