The effect of arthroscopic debridement and conservative treatment in knee osteoarthritis: Results of a 5-year follow-up and literature review [Die Behandlung moderater Kniegelenksarthrosen durch arthroskopisches Gelenkdebridement: 5-Jahres-Ergebnisse und systematisches Review]

摘要

Purpose: This study is aimed to compare the effects of arthroscopic joint debridement over a 5-year period in a clearly defined patient population (only grade III knee osteoarthritis, history <2 years). Material and Methods: A total of 96 patients (50 male and 46 female) underwent arthroscopic knee debridement for knee OA. The main criteria for inclusion were osteoarthritis grade III (Kellgren-Lawrence score) and a maximal history of 2 years. Results: The subjective complaints and the knee-related quality of life were estimated by the KOOS (knee injury and osteoarthritis outcome score). The score increased significantly within the 1 to 3rd year post operation. After this interval the mean points of the score declined. But after 5 years the KOOS was higher in comparison to the baseline dates. Patients who had undergone conservative treatment at baseline had a significantly different KOOS than patients in the arthroscopy group.Over time, patients in the arthroscopy group had fewer complaints than patients in the conservative treatment group.In both groups, the results decreased over time. A total of 17 patients (17.2%) needed a conversion to total endoprothetic replacement. The mean time-interval between index operation and conversion was 56.6 (95% CI 54.4-58.4) months. Conclusions: In middle stages of knee OA, arthroscopic joint debridement can effectively reduce subjective complaints. Because this treatment does not stop the process of OA, the improvements decrease over time.