Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review

BMJ Open
Romina Brignardello-PetersenPer Olav Vandvik

Abstract

To determine the effects and complications of arthroscopic surgery compared with conservative management strategies in patients with degenerative knee disease. Systematic review. Pain, function, adverse events. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and Open Grey up to August 2016. For effects, randomised clinical trials (RCTs) comparing arthroscopic surgery with a conservative management strategy (including sham surgery) in patients with degenerative knee disease. For complications, RCTs and observational studies. Two reviewers independently extracted data and assessed risk of bias for patient-important outcomes. A parallel guideline committee (BMJ Rapid Recommendations) provided input on the design and interpretation of the systematic review, including selection of patient-important outcomes. We used the GRADE approach to rate the certainty (quality) of the evidence. We included 13 RCTs and 12 observational studies. With respect to pain, the review identified high-certainty evidence that knee arthroscopy results in a very small reduction in pain up to 3 months (mean difference =5.4 on a 100-point scale, 95% CI 2.0 to 8.8) and very small or no pain reduction up to 2 years ...Continue Reading

Citations

Jul 7, 2017·Nature Reviews. Rheumatology·Teppo L N Järvinen, Gordon H Guyatt
Jan 31, 2018·ANZ Journal of Surgery·Rachelle Buchbinder, Allison Bourne
Mar 6, 2018·Acta Orthopaedica·Søren T SkouJonas Bloch Thorlund
Feb 17, 2018·British Journal of Sports Medicine·Reed A C SiemieniukAnnette Kristiansen
Apr 11, 2019·Annual Review of Biomedical Engineering·Caroline A MurphyMaurice N Collins
Jul 20, 2019·The Cochrane Database of Systematic Reviews·Jonathan S PalmerAndrew J Price
Jan 30, 2019·Internal Medicine Journal·Charlotte BlacketerCatherine Hill
Nov 15, 2019·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Ali KiadaliriMartin Englund
Jan 18, 2018·The Journal of Bone and Joint Surgery. American Volume·Gwo-Chin Lee
Feb 24, 2019·British Journal of Sports Medicine·Simon G F AbramAndrew J Price
Aug 29, 2020·British Journal of Sports Medicine·Raine SihvonenUNKNOWN FIDELITY (Finnish Degenerative Meniscus Lesion Study) Investigators
Jul 6, 2018·Archives of Orthopaedic and Trauma Surgery·Dong-Yeong LeeDong-Geun Kang
Sep 27, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·T RietbergenL van Bodegom-Vos
Jan 7, 2021·The New England Journal of Medicine·Leena Sharma
Dec 16, 2020·Journal of Clinical Epidemiology·Alonso Carrasco-LabraGordon H Guyatt
Jan 1, 2021·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Jourdan M CancienneBrian C Werner
Nov 3, 2020·The Journal of Orthopaedic and Sports Physical Therapy·Zoe A MichaleffSimon Décary
Jan 16, 2021·ANZ Journal of Surgery·Julian A Feller
Feb 22, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Chetan KhatriTimothy Barlow
Nov 12, 2020·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Ian A HarrisRachelle Buchbinder
Feb 3, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Tengjiao ZhuKe Zhang
Jun 20, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·T RietbergenUNKNOWN SMART study group
Sep 21, 2021·Archives of Orthopaedic and Trauma Surgery·Tarun GoyalSouvik Paul

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Methods Mentioned

BETA
lavage

Software Mentioned

Methodological Index for Non Studies ( MINORS )
Google Scholar
R Foundation for Statistical Computing
MAGICapp
Open Grey
R
Cochrane

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