In this secondary analysis, nearly 80% of patients with knee osteoarthritis did not require total knee replacement within 10 years of nonoperative care with or without knee arthroscopic surgery.
Some case series show that arthroscopic surgery for knee OA may delay more invasive procedures, such as TKA or osteotomy, while longitudinal cohort studies often contradict this. Current OA guidelines are yet to address this issue.
This secondary analysis of a randomized trial compared the long-term incidence of TKA in 178 patients with knee OA who were referred for potential arthroscopic surgery at a tertiary care center in Canada.Patients in the arthroscopic surgery group had specific knee procedures along with nonoperative management , while the control group received nonoperative management alone.
The primary outcome was TKA on the knee being studied, and the secondary outcome was TKA or osteotomy on either knee.During a median follow-up of 13.8 years, 37.6% of patients underwent TKA, with comparable proportions of patients in the arthroscopic surgery and control groups undergoing TKA .A time-stratified analysis done for 0-5 years, 5-10 years, and beyond 10 years of follow-up also showed a consistent interpretation.
When patients with crossover to arthroscopic surgery during the follow-up were included, the results remained similar for both the primary and secondary outcomes."Our study findings do not support the use of arthroscopic surgery for OA of the knee.""Arthroscopic surgery does not provide additional benefit to nonoperative management for improving pain, stiffness, and function and is likely not cost-effective at 2 years of follow-up," the authors wrote.
Generalized Osteoarthritis OA - Osteoarthritis DJD - Degenerative Joint Disease Degenerative Arthritis Generalised Osteoarthritis Osteoarthritis (OA) Arthroscopy Arthroscopic Surgery Surgery Arthroplasty Knee Osteoarthritis Total Knee Arthroplasty TKA - Total Knee Arthroplasty Total Knee Replacement Osteotomy Grant Sports Medicine
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