Arthroscopic resection, debridement for knee OA may not affect progression to TKA
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Key takeaways:
- Arthroscopic surgery for patients with knee osteoarthritis did not delay or hasten progression to total knee arthroplasty.
- Patients with vs. without arthroscopy had similar long-term incidences of arthroplasty.
Published results showed arthroscopic resection or debridement of degenerative knee tissue in patients with osteoarthritis was not associated with delayed or hastened progression to total knee arthroplasty at long-term follow-up.
Researchers performed a secondary analysis of a single-center, assessor-blinded randomized clinical trial that analyzed long-term outcomes of 178 patients presenting with knee OA between Jan. 1, 1999, to Aug. 31, 2007.
According to the study, 92 patients (mean age, 58.1 years) underwent arthroscopic resection or debridement of degenerative tears of the meniscus, fragments of articular cartilage, or chondral flaps and osteophytes. A control cohort of 86 patients (mean age, 59.9 years) continued with nonoperative management. The primary outcome measure was cumulative incidence of TKA at a mean follow-up of 13.8 years, with a maximum follow-up of 20 years.
At final follow-up, researchers found 31 patients (33.7%) in the arthroscopy cohort and 36 patients (41.9%) in the control cohort underwent TKA (adjusted HR = 0.85). They noted a similar incidence of TKA for the 13 patients in the control cohort who ultimately received arthroscopic surgery (aHR = 0.88).
At 5-year follow-up, the cumulative incidence of TKA was 10.2% in the arthroscopy cohort and 9.3% in the control cohort. At 10-year follow-up, the cumulative incidence of TKA was 23.3% in the arthroscopy cohort and 21.4% in the control cohort.
“These findings suggest the addition of arthroscopic surgery to nonoperative management for patients with OA of the knee did not delay or hasten TKA,” the researchers wrote in the study.
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