Medium-term efficacy of arthroscopic debridement vs conservative treatment for knee osteoarthritis of Kellgren-Lawrence grades I-III.

Abstract

BACKGROUNDArthroscopic debridement is a mature treatment for knee osteoarthritis (KOA). Due to the differences in the research subjects, methods, and efficacy evaluation indexes, there are great differences in the surgical efficacy reported in the literature.AIMTo compare the medium-term efficacy of arthroscopic debridement and conservative treatment for KOA of Kellgren-Lawrence grades I-III.METHODSPatients with KOA of Kellgren-Lawrence grades I-III who were admitted to the orthopedic clinic of our hospital from July 2018 to December 2018 and agreed to undergo arthroscopic surgery were included in an arthroscopic debridement group, and those who refused surgical treatment were included in a conservative treatment group. Gender, age, body mass index (BMI), side of KOA, American hospital for special surgery knee score (HSS score) before treatment, visual analogue scale (VAS) score during walking and rest before treatment, conservative treatment content, and surgical procedure were recorded. Outpatient visits were conducted at the 1st, 3rd, 6th, 12th, and 24th mo after treatment in the two groups. The changes of HSS score and VAS score in each group before and after treatment were statistically analyzed, and the differences of HSS score and VAS score in different treatment stages between the two groups were also compared.RESULTSIn the conservative treatment group, there were 80 patients with complete follow-up data, including 20 males and 60 females, aged 58.75 ± 14.66 years old. And in the knee arthroscopic debridement group, there were 98 patients with complete follow-up data, including 24 males and 74 females, aged 59.27 ± 14.48 years old. There was no statistically significant difference in the general data (gender, age, BMI, side of KOA, Kellgren-Lawrence grade distribution, HSS score, and VAS score) between the two groups before treatment. The HSS scores of the conservative treatment group at the 1st, 3rd, 6th, 12th, and 24th mo after treatment were significantly higher than that before treatment (P < 0.05). There was no statistical difference in HSS score of the conservative treatment group among the 1st, 3rd, 6th, 12th, and 24th mo (P > 0.05). The HSS score of the knee arthroscopic debridement group at the 1st mo after surgery was significantly higher than that before surgery (P < 0.05). HSS scores of the knee arthroscopic debridement group at the 3rd, 6th, 12th, and 24th mo were significantly higher than those before surgery and at the 1st mo after surgery (P < 0.05). There were no statistically significant differences in HSS scores at the 3rd, 6th, 12th, and 24th mo after surgery (P > 0.05). HSS scores at the 3rd, 6th, 12th, and 24th mo were significantly higher in the arthroscopic debridement group than in the conservative treatment group (P < 0.05). There was no statistical difference in HSS scores between the two groups before treatment and at the 1st mo of follow-up (P > 0.05). VAS scores during walking and rest were significantly decreased in both groups, and the VAS score during rest was significantly lower in the arthroscopic debridement group than in the conservative treatment group, but there was no significant difference in the VAS score during walking between the two groups after treatment.CONCLUSIONCompared with conservative treatment, arthroscopic debridement can significantly improve the knee resting pain and knee functional status of patients with KOA of Kellgren-Lawrence grades I-III within 2 years after treatment.