The most common line of treatment doctors recommend for knee degenerative disease like osteoarthritis (OA) or meniscal tears is knee arthroscopy. However, a very recent study’s conclusion will surely blow your mind. As per the article published in “The BMJ”, guideline strongly recommends AGAINST arthroscopy for ‘nearly all’ patients with knee OA or meniscal tears.

Historical data review showed that knee arthroscopy is the most common orthopedic procedure performed. This data was reviewed by an international multidisciplinary panel including orthopedic surgeons, a rheumatologist, physiotherapists, a general practitioner, general internists, epidemiologists, methodologists, and people with live experience of degenerative knee disease (including those who had undergone and those who had not undergone arthroscopy) met to discuss the evidence.

The Guideline strongly recommends against arthroscopic surgery in almost all patients with degenerative joint disease of the knee, based on linked systematic reviews. The authors also advise that “further research is unlikely to alter this recommendation”.

They further state that “health care administrators and funders may use the number of arthroscopies performed in patients with degenerative knee disease as an indicator of quality care”. However, the small and short-lived pain reduction and increased function after arthroscopic surgery are greatly outweighed by the financial burden, post-op limitations, and complications (rare).

On the Other hand, conservative treatment is suggested as the best-recommended line of treatment for almost all the patients with knee DJD.

Based on a systemic review in 2016, BMJ published the guidelines on May 10, 2017, indicating that exercise therapy is as effective in patients with degenerative medial meniscus tear, as the outcomes from knee arthroscopic surgery.

Degenerative joint disease of the knee, as considered by the authors, is atraumatic knee pain in patients over age 35, irrespective of radiologic evidence of osteoarthritis, mechanical symptoms, meniscus tear, or acute/subacute symptom onset.

The Conclusion

In conclusion, the authors advised, “Given that there is evidence of harm and no evidence of important lasting benefit in any subgroup, the panel believes that the burden of proof rests with those who suggest benefit for any other particular subgroup before arthroscopic surgery is routinely performed in any subgroup of patients.”