Arthroscopic Management of Osteoarthritis of the Knee

Introduction: The purpose of the study was to prospectively assess patients with osteoarthritis of the knee selected for arthroscopic management (arthroscopic lavage and debridement, abrasion arthroplasty, microfracture, and radiofrequency (RF)-based chondroplasty). Methods: From 2003 to 2005, 108 patients with symptomatic primary osteoarthritis of the knee underwent arthroscopic management after medical treatment failure, of whom 92 were followed for a mean of 25 months (16 lost to follow-up). Pain was assessed using the pain domain, Knee Society Scoring System (Insall modification). Preoperative radiographic assessment was by Kellgren-Lawrence method; intraoperative severity of cartilage lesions were assessed using a modified Noyes grading system. Results: Mean age of 92 enrolled patients (98 knees) was 63 years (range, 22-84) and 56 (60%) were female. The medial compartment was more frequently and severely involved than the lateral compartment and PF joint, and Kellgren-Lawrence grading of arthritis severity profoundly affected outcome. Substantial postoperative pain relief and clinical success were achieved for joints with Kellgren-Lawrence grade Ⅰ and Ⅱ osteoarthritis, but minimal pain relief and no clinical improvement were achieved for those grade Ⅲ and Ⅳ. In cases of mild arthritis, superior outcome was achieved with microfracture compared to debridement alone; however, the short-term outcome was poorer in severe arthritis cases. Conclusions: Arthroscopic management for osteoarthritis of the knee is a viable treatment option in cases of mild arthritis. Level of Evidence: Level Ⅳ.

並列關鍵字

arthroscopic management ； osteoarthritis of knee ； microfracture

國際替代計量

全文下載

主題瀏覽