Abstract
Introduction This study was conducted in order to evaluate the patterns of utilization of arthroscopic knee debridement for the treatment of degenerative arthritis and the five years outcome following an initial arthroscopic procedure at our institution.
Methods This is a retrospective study on all patients with degenerative arthritis of the knee who had their first arthroscopic debridement between 1992 and 1995, and had a follow-up of at least five years or ended up with total knee replacement (TKR). Patients with other prior surgery to the knee were excluded. The patients were divided into four groups based on the first arthroscopic finding using the Outerbridge grading system (Stage I: Softening, II: Fibrillation, III: Fragmentation, IV: Eburnation). The clinical status following the first arthroscopy and during the last follow-up were evaluated. The duration between the first arthroscopic debridement and TKR were also taken into account. Two hundred and two cases were included in the study which consists of 114 male and 88 female with mean age of 58.7 years. The mean follow-up was 5.4 years. There were 15 cases in stage I, 96 in stage II, 58 in stage III and 33 in stage IV.
Results Following the first arthroscopic debridement, 93.7% of patients in stage I and II became asymptomatic compared to 26.4% in stage III and in IV where 60.4% still presented with recurrent symptoms. On the last follow-up, 18.9% in stage I and II had total knee replacement done compared to 78.0% in stage III and IV. The mean duration between the first arthroscopic debridement and TKR was 8.6 years in stage II, 3.3 years in stage III and 1.5 years in stage IV.
Conclusions This study has shown that given the proper selection of patients and the correct stage of degenerative arthritis, arthroscopic debridement can still be a successful palliative, temporizing treatment for the osteoarthritic knee. It is of utmost importance that the patient’s pre-operative expectations have to be clearly objectified.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
