Arthroscopic debridement for the treatment of osteoarthritis of the knee: 2-and 5-year results

Purpose: The purpose of this study was to evaluate the effect that arthroscopic debridement in osteoarthritic knees has on patient satisfaction and function. Type of Study: Cohort observational study. Methods: Thirty-six patients (mean age, 64.8 years) were available for 2- and 5-year follow-up after undergoing knee arthroscopy to treat arthritic symptoms refractory to conservative treatment. Surgical treatment included debridement of meniscal lesions, stabilization of chondral defects, removal of impinging osteophytes, and notchplasty. Age, symptoms, preoperative and postoperative Hospital for Special Surgery (HSS) scores, compartments involved, motion, impinging lesions, and level of satisfaction were evaluated. Results: At 2 years, 32 of 36 patients were satisfied. Mean HSS scores improved from 29.2 to 48.0. All 4 early failures had tricompartment disease (mean preoperative HSS scores, 21.5; preoperative flexion contractures, 15.6degrees). At 5 years, 25 of the 36 patients were satisfied with good to excellent results. Mean HSS scores decreased slightly to 43.2. Three patients had some deterioration and were rated fair, and 8 were considered failures requiring further surgery. The 25 of 36 with satisfactory results had a mean preoperative flexion contracture of 7.3degrees and average HSS scores of 33.2, whereas the other 11 of 36 had mean contractures of 15.0degrees and average HSS scores of 20.1. Poor results were associated with contractures greater than 10degrees (P = .05) and lower preoperative HSS scores (P = .05). Conclusions: Arthroscopic debridement of osteoarthritic knees has a favorable outcome in selected patients. Those patients with preoperative flexion contractures less than 10degrees and preoperative HSS scores greater than 22 beneficially responded to this method of treatment.