2015 ISAKOS Biennial Congress ePoster #1508

Arthroscopic Arthroplasty Versus Debridement for Knee Osteoarthritis in Patients Without Malalignment or Mechanical Symptoms

Jinzhong Zhao, MD, Shanghai CHINA
Shanghai Sixth People's Hospital, Shanghai, Shanghai, CHINA

FDA Status Not Applicable

Summary: Arthroscopic arthroplasty, which is different in technique and concept from arthroscopic debridement, can get superior midterm results than arthroscopic debridement when used to treat pure knee OA

Abstract:

Background

The advantages of arthroscopic arthroplasty (AA) over arthroscopic debridement (AD) for the treatment of knee osteoarthritis (OA) in patients without malalignment or mechanical symptoms are currently unknown.

Hypothesis

AA for knee OA in patients without malalignment or mechanical symptoms can result in better clinical results compared with AD.
Study design: Randomized clinical trial. Level of evidence, 1.

Methods

A total of 284 patients with moderate-to-severe knee OA but without malalignment or mechanical symptoms were randomly assigned to undergo either AA or AD.This so-called AA includes bone denervation, synovectomy for hypertrophic or inflamed synovium, notch plasty, patellofemoral joint plasty, osteophyte removal, rather than debridement only. Follow-up examination was performed 12, 24, and 60 months postoperatively. Pain level was evaluated using a visual analog scale (VAS) preoperatively and 1.5, 3, 6, and 12 months postoperatively. The degree of knee function was assessed according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score preoperatively and 12, 24, and 60 months postoperatively.

Results

One-hundred fourteen patients in the AA group and 122 patients in the AD group underwent complete serial functional evaluations for 5 years. Regarding pain level, the AA group had significantly lower VAS scores at 3, 6, and 12 months postoperatively. Functional evaluations revealed significantly superior results in the AA group at 12, 24, and 60 months postoperatively. Compared with the preoperative WOMAC score, the final follow-up scores significantly increased in the AA group and significantly reduced in the AD group. Finally, 1 patient in the AA group and 9 patients in the AD group underwent total knee arthroplasty. The difference in the number of patients in the two groups who underwent TKA was statistically significant.

Conclusions

AA for knee OA in patients without malalignment or mechanical symptoms provides additional benefits compared with AD.