Arthroscopy as a treatment for wear-related changes in the knee

People with wear-related knee problems, such as meniscus injuries or joint wear (osteoarthritis of the knee) are often treated by inpatient or outpatient arthroscopy. This report compares the efficacy, safety and cost-benefit ratio of various treatments.

The aim was to analyse the results after short- and medium-term follow-up observation and after more than seven years. The analysis covered 21 studies involving more than 2,000 participants. None of the studies included long-term data. The studies investigated factors such as pain, function, joint stiffness, quality of life and frequency of full knee replacement. The report’s findings did not reveal any significant differences between arthroscopy and other methods of treatment. Furthermore, it made no difference whether the intervention took place in the inpatient or outpatient setting. The people who had been treated by arthroscopy had slightly less pain than those who had received other treatments during the short follow-up observation period only. In general, the studies were of insufficient quality to provide meaningful information. Furthermore, they rarely reported on side effects. For this reason, it is difficult to assess the clinical efficacy of arthroscopy in terms of benefits and harm. The cost-benefit analysis did not deliver a clear picture since the studies that were reviewed were contradictory and showed evidence of shortcomings.

The report concludes that arthroscopy exhibited no benefits after a short or medium-length post-treatment period. The report was unable to draw any conclusions on the benefits or harm after a lengthy post-treatment period or in connection with possible side effects owing to the lack of data or poor data quality. The very limited data available on the cost-benefit ratio of arthroscopy were insufficient to permit conclusions.