[Efficiency of arthroscopic treatment in the knee osteoarthritis]

Abstract

THE AIM OF THE STUDY was to estimate the effectiveness of arthroscopic operations for patients suffering from knee osteoarthritis; to determine if it is possible to decrease pain, increase range of motions and mobility function.

Material and methods: The subjects of the study were patients with grade III and grade IV with knee osteoarthritis (Outerbridge classification), who underwent arthroscopic operations at Kaunas Red Cross Hospital in 1993-2000. They were followed after arthroscopic operations: debridement, partial synovectomy, meniscus resection and elimination of free bodies. Two hundred eighteen patients were examined by questionnaire; 137 (62.8%) were females and 81 (37.2%) were males. The age range was from 19 till 77 years (average 53.09 years). Follow-up was 1-8 years (average 2.56 years). We estimated knee score and function score pre-op and 0.5 year, 1 year, 3 years and more than 3 years post-op.

Results: Six months post-op 58.3% of patients were satisfied, 41.7% had no changes or even worsened. One year post-op 77.5% of patients were satisfied; 3 years post-op 64 patients were followed, 78.1% were satisfied; more than 3 years post-op 45 patients were followed, 82.2% were satisfied. The results six months post-op are as following: 33.9% very good, 38.1% good, 22.9% satisfactory and 5.1% bad. One year post-op the very good and good results increased. Only 64 patients were followed-up three years post-op; 64.1% had very good results and 25.0% had good results, satisfactory and bad results were in the range of 10.9%. The shorter time till arthroscopic intervention and performing arthroscopic debridement gave positive influence on good and very good results. Instability due to ACL rupture, big osteophytes, subchondral sclerosis, valgus deformation and grade III-IV patellofemoral cartilage changes gave worse results. Synovectomy had no influence on the results.

Conclusions: Arthroscopy is a minimally invasive palliative intervention for the patients with the knee osteoarthritis.