International Orthopaedics

, Volume 37, Issue 7, pp 1263–1271

Indications for and results of arthroscopy in the arthritic knee: a European survey

Authors

    • Department of Orthopedic and Trauma SurgeryAlbert Ludwig University of Freiburg
  • Matthias Rueschenschmidt
    • Department of Orthopedic and Trauma SurgeryAlbert Ludwig University of Freiburg
  • Romain Seil
    • Sports Medicine Research LaboratoryPublic Research Center for Health
  • David Dejour
    • Lyon-Ortho-Clinic Clinique de la Sauvegarde
  • Anke Bernstein
    • Department of Orthopedic and Trauma SurgeryAlbert Ludwig University of Freiburg
  • Norbert Suedkamp
    • Department of Orthopedic and Trauma SurgeryAlbert Ludwig University of Freiburg
  • Amelie Stoehr
    • OCM Clinic for Orthopedic and Trauma Surgery
Original Paper

DOI: 10.1007/s00264-013-1896-3

Cite this article as:
Mayr, H.O., Rueschenschmidt, M., Seil, R. et al. International Orthopaedics (SICOT) (2013) 37: 1263. doi:10.1007/s00264-013-1896-3

Abstract

Purpose

The place of arthroscopic treatment in osteoarthritis of the knee has generated much controversy. A survey was initiated to collect the opinion of experienced surgeons.

Methods

Of the 211 surgeons interviewed, 170 (80.6 %) replied to the electronic questionnaire. Respondents had at least ten years of experience in arthroscopy and currently perform more than 100 arthroscopies per year. Various indications and treatment modalities for arthroscopy in osteoarthritis of the knee had to be evaluated on a scale from “excellent” to “no indication”.

Results

The respondents generally believe that an improvement is more likely in low-grade osteoarthritis (p < 0.001) and in neutral leg axis (p < 0.001). The outcome was rated better if symptoms had persisted for less than six months (p < 0.001) and for patients that were younger than 60 years (p < 0.001). Partial meniscectomy and notchplasty in cases of extension deficit were considered as successful treatment options. Debridement was an accepted indication, with an outcome mainly rated as fair. A majority saw no indication for joint lavage, arthroscopic treatment of arthrofibrosis and removal of osteophytes. The outcome appears to be poor if a bone edema is diagnosed on magnetic resonance imaging prior to arthroscopy. Only 55.9 % of respondents were comfortable with the current definition of osteoarthritis.

Conclusions

Experienced arthroscopic surgeons all over Europe believe arthroscopy in osteoarthritis is appropriate, under certain conditions. The major task for surgeons is to select the right patients who are likely to benefit from this intervention.

Copyright information

© Springer-Verlag Berlin Heidelberg 2013