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Position Statement from the Australian Knee Society on ArthroscopicTue, 29 Sep 2015

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Position Statement from the Australian Knee Society on Arthroscopic Surgery of the Knee, with particular reference to the presence of Osteoarthritis.

In preparing the following evidence based document, the Australian Knee Society, on behalf of the Australian Orthopaedic Association, has combined the individual clinical expertise of its members with the best available external clinical evidence from a systematic review of the literature. (references listed at end of document)

Position Statement

Arthroscopic debridement, and / or lavage, has been shown to have no beneficial effect on the natural history of osteoarthritis, nor is it indicated as a primary treatment in the management of osteoarthritis. However, this does not preclude the use of arthroscopic surgery, where indicated, to manage symptomatic coexisting pathology, in the presence of osteoarthritis.

Explanatory Footnotes

Arthroscopic Surgery in the Presence of Osteoarthritis
There are certain clinical scenarios in which arthroscopic surgery, in the presence of osteoarthritis, may be appropriate - albeit after considered discussion with the patient. These include, but are not necessarily limited to, the following:

Definition of Osteoarthritis

Osteoarthritis, or degenerative joint disease, is a progressive disorder of joints characterized by gradual diffuse loss of articular cartilage, effects on the underlying bone, and secondary compromise of joint function. This should be distinguished from focal articular cartilage pathology in an otherwise normal joint, occurring more commonly in younger people. There is a spectrum of severity of osteoarthritis from minor partial thickness articular cartilage abnormalities to large areas of full thickness loss. Clinical decision making requires careful assessment of the degree of arthritis, its likely contribution to the symptoms, and the potential contribution of additional pathology to those symptoms.

Assessment and Interpretation of MRI Scanning

MRI is an excellent adjunct both to clinical decision making, and to guiding the use of surgery. In particular, it can be used to more accurately assess the degree of arthritis, and to look for and assess additional pathology that may correlate with a patient’s symptoms. MRI reports should be interpreted carefully by the treating surgeon, in combination with direct review of the imaging, when determining the clinical relevance of the findings.

Arthroscopic Surgery in the Presence of Osteoarthritis

The decision to proceed with arthroscopic surgery in the presence of osteoarthritis should be made by the treating orthopaedic surgeon:

Reference List

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