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Arthroscopic Debridement of the Knee: An Evidence Update
#MMPMID26330895
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Ont Health Technol Assess Ser
2014[]; 14
(13
): 1-43
PMID26330895
show ga
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. OBJECTIVES: 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. DATA SOURCES:
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. REVIEW 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). LIMITATIONS:
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.
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