Status quo

The multiple use of this operation has long been viewed critically. In a new 2022 Systematic Review, an updated comparison was made with placebo surgery (2105 participants). The results were really exciting.

Conclusion of the authors

Knee arthroscopy offers little or no clinically meaningful benefit in terms of pain and function and probably offers no benefit in terms of knee-specific quality of life. In other words, the effects of placebo surgery were quite similar

That’s not it yet

Another Systematic Review from 2017 compared knee arthroscopy with conservative treatment. In the short & long term, there were no or very little benefits in terms of pain & function.

It’s science

Thorlund et al. concluded in their 2015 review that these surgeries have only a small benefit in a degnerative knee, and that this benefit is also limited in time and virtually nonexistent 1-2 years after surgery.

Conclusion

Arthroscopic knee surgery for degenerative changes of the knee joint remains a common treatment, although guidelines strongly advise against its use. The results just shown have again underscored that the current use of knee arthroscopies is not purposeful and their relevance should be reevaluated.
The fact that patients are suggested/recommended such an operation without first discussing all other treatment options, and in some cases on the basis of MRI findings alone, is grossly negligent in my opinion. In this regard, a big shout-out to all physicians who go through all treatment options with their patients, maintain open communication, and base their expertise on the findings of science. Keep up the good work!

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Source list:
O’Connor, D., Johnston, R. V., Brignardello-Petersen, R., Poolman, R. W., Cyril, S., Vandvik, P. O., & Buchbinder, R. (2022). Arthroscopic surgery for degenerative knee disease (osteoarthritis including degenerative meniscal tears). Cochrane Database of Systematic Reviews, 3(3), CD014328. https://doi.org/10.1002/14651858.CD014328

Brignardello-Petersen, R., Guyatt, G. H., Buchbinder, R., Poolman, R. W., Schandelmaier, S., Chang, Y., Sadeghirad, B., Evaniew, N., & Vandvik, P. O. (2017). Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review. BMJ Open, 7(5), e016114. https://doi.org/10.1136/bmjopen-2017-016114

Thorlund, J. B., Juhl, C. B., Roos, E. M., & Lohmander, L. S. (2015). Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ (Clinical Research Ed.), 350(jun16 3), h2747. https://doi.org/10.1136/bmj.h2747

Muheim, L. L. S., Senn, O., Früh, M., Reich, O., Rosemann, T., & Neuner-Jehle, S. M. (2017). Inappropriate use of arthroscopic meniscal surgery in degenerative knee disease: An observational study from Switzerland. Acta Orthopaedica, 88(5), 550-555. https://doi.org/10.1080/17453674.2017.1344915