The effects of arthroscopic joint debridement in the knee osteoarthritis: results of a meta-analysis
Purpose Knee osteoarthritis is one of the most common orthopaedic diseases. Therapeutic options for this disease include conservative treatments and arthroscopic debridement and partial or complete replacement. This meta-analysis aimed to collect and analyse the available information on the effects...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2013-07, Vol.21 (7), p.1553-1561 |
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| creator | Spahn, Gunter Hofmann, Gunther O. Klinger, Hans M. |
| description | Purpose
Knee osteoarthritis is one of the most common orthopaedic diseases. Therapeutic options for this disease include conservative treatments and arthroscopic debridement and partial or complete replacement. This meta-analysis aimed to collect and analyse the available information on the effects of arthroscopic joint debridement related to the clinical outcomes, the required conversion to replacement and the factors for patient selection.
Methods
A search for publications was performed in the PubMed, Cochrane and EMBASE medical databases. The primary search resulted in a total of 1,512 citations. The results from 30 papers were included in this study. The extracted dates were listed in a standardised protocol. The statistical evaluation was performed using Comprehensive Meta-analysis software (V2 Biostat, Englewood, NJ, USA).
Results
No randomised study that compared conservative and arthroscopic treatments for knee osteoarthritis was found. Most studies reported middle-term results after arthroscopic operations. The results of these studies showed excellent or good outcomes in more than 60 % of all patients. These results were correlated with a significant increase in the knee scores from baseline to follow-up; the standardised difference in means was 2.3 (CI 95 % 1.5–3.0,
p
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| doi_str_mv | 10.1007/s00167-012-2169-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1399916589</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1399916589</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-300ac49ebd5cb820c297cf51d15768d764d72b1e4e1951bdf2efcf223569b56e3</originalsourceid><addsrcrecordid>eNqFkU9v1DAQxS0EotstH4ALssSFS6jH8Z-YG6qgIFXqpZyjxB5TL0m82M6h377e7oIQEuI0I83vvdHMI-Q1sPfAmL7MjIHSDQPecFCmgWdkA6JtG90K_ZxsmBF1wqQ6I-c57xirrTAvyRnnnWm56jbE3d0jRe_Rlkyjp0Mq9ylmG_fB0l0MS6EOxxQczlj7sNBSBT8WRBpzwfjEhxLyB5owr9PJhc5YhmZYhukhh3xBXvhhyvjqVLfk2-dPd1dfmpvb669XH28aK5gsTcvYYIXB0Uk7dpxZbrT1EhxIrTqnlXCaj4ACwUgYneforee8lcqMUmG7Je-OvvsUf66YSz-HbHGahgXjmntojTGgZD3-_6iub1XMqIq-_QvdxTXV0w6UMtApkKJScKRsfV9O6Pt9CvOQHnpg_SGt_phWX237Q1pVvCVvTs7rOKP7rfgVTwX4Ech1tHzH9Mfqf7o-Ap1Un0M</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1369186154</pqid></control><display><type>article</type><title>The effects of arthroscopic joint debridement in the knee osteoarthritis: results of a meta-analysis</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>SpringerLink</source><creator>Spahn, Gunter ; Hofmann, Gunther O. ; Klinger, Hans M.</creator><creatorcontrib>Spahn, Gunter ; Hofmann, Gunther O. ; Klinger, Hans M.</creatorcontrib><description>Purpose
Knee osteoarthritis is one of the most common orthopaedic diseases. Therapeutic options for this disease include conservative treatments and arthroscopic debridement and partial or complete replacement. This meta-analysis aimed to collect and analyse the available information on the effects of arthroscopic joint debridement related to the clinical outcomes, the required conversion to replacement and the factors for patient selection.
Methods
A search for publications was performed in the PubMed, Cochrane and EMBASE medical databases. The primary search resulted in a total of 1,512 citations. The results from 30 papers were included in this study. The extracted dates were listed in a standardised protocol. The statistical evaluation was performed using Comprehensive Meta-analysis software (V2 Biostat, Englewood, NJ, USA).
Results
No randomised study that compared conservative and arthroscopic treatments for knee osteoarthritis was found. Most studies reported middle-term results after arthroscopic operations. The results of these studies showed excellent or good outcomes in more than 60 % of all patients. These results were correlated with a significant increase in the knee scores from baseline to follow-up; the standardised difference in means was 2.3 (CI 95 % 1.5–3.0,
p
< 0.001). The required conversion rate to replacement increased as the follow-up interval increased. The rates were as follows: 1 year—6.1 % (CI 95 %, 2.1–16.6 %), 2 years—16.8 % (CI 95 %, 10.2–26.3 %), 3 years—21.7 % (CI 95 %, 15.5–29.1 %) and 4 years—34.1 % (CI 95 %, 22.8–47.6 %). The mean survival time was 42.7 (CI 95 %, 14.5–71.1) months. Numerous factors influenced the outcome, including the radiological stage of the osteoarthritis and individual patient factors (e.g. time of history of osteoarthritis, weight and smoking). The local knee findings, such as axial dysalignment, missing effusion and massive crepitus, were also correlated with patient outcome.
Conclusion
Arthroscopic joint debridement is a potential and sufficient treatment for knee osteoarthritis in a middle-term time interval. This procedure results in an excellent or good outcome in approximately 60 % of patients in approximately 5 years.
Level of evidence
Systematic review of studies, Level III.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-012-2169-1</identifier><identifier>PMID: 22893268</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Arthritis ; Arthroscopy ; Cartilage ; Debridement ; Humans ; Knee ; Literature reviews ; Medicine ; Medicine & Public Health ; Meta-analysis ; Orthopedics ; Osteoarthritis ; Osteoarthritis, Knee - surgery ; Quality of life ; Software ; Systematic review</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2013-07, Vol.21 (7), p.1553-1561</ispartof><rights>Springer-Verlag 2012</rights><rights>Springer-Verlag Berlin Heidelberg 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-300ac49ebd5cb820c297cf51d15768d764d72b1e4e1951bdf2efcf223569b56e3</citedby><cites>FETCH-LOGICAL-c405t-300ac49ebd5cb820c297cf51d15768d764d72b1e4e1951bdf2efcf223569b56e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-012-2169-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-012-2169-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22893268$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spahn, Gunter</creatorcontrib><creatorcontrib>Hofmann, Gunther O.</creatorcontrib><creatorcontrib>Klinger, Hans M.</creatorcontrib><title>The effects of arthroscopic joint debridement in the knee osteoarthritis: results of a meta-analysis</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
Knee osteoarthritis is one of the most common orthopaedic diseases. Therapeutic options for this disease include conservative treatments and arthroscopic debridement and partial or complete replacement. This meta-analysis aimed to collect and analyse the available information on the effects of arthroscopic joint debridement related to the clinical outcomes, the required conversion to replacement and the factors for patient selection.
Methods
A search for publications was performed in the PubMed, Cochrane and EMBASE medical databases. The primary search resulted in a total of 1,512 citations. The results from 30 papers were included in this study. The extracted dates were listed in a standardised protocol. The statistical evaluation was performed using Comprehensive Meta-analysis software (V2 Biostat, Englewood, NJ, USA).
Results
No randomised study that compared conservative and arthroscopic treatments for knee osteoarthritis was found. Most studies reported middle-term results after arthroscopic operations. The results of these studies showed excellent or good outcomes in more than 60 % of all patients. These results were correlated with a significant increase in the knee scores from baseline to follow-up; the standardised difference in means was 2.3 (CI 95 % 1.5–3.0,
p
< 0.001). The required conversion rate to replacement increased as the follow-up interval increased. The rates were as follows: 1 year—6.1 % (CI 95 %, 2.1–16.6 %), 2 years—16.8 % (CI 95 %, 10.2–26.3 %), 3 years—21.7 % (CI 95 %, 15.5–29.1 %) and 4 years—34.1 % (CI 95 %, 22.8–47.6 %). The mean survival time was 42.7 (CI 95 %, 14.5–71.1) months. Numerous factors influenced the outcome, including the radiological stage of the osteoarthritis and individual patient factors (e.g. time of history of osteoarthritis, weight and smoking). The local knee findings, such as axial dysalignment, missing effusion and massive crepitus, were also correlated with patient outcome.
Conclusion
Arthroscopic joint debridement is a potential and sufficient treatment for knee osteoarthritis in a middle-term time interval. This procedure results in an excellent or good outcome in approximately 60 % of patients in approximately 5 years.
Level of evidence
Systematic review of studies, Level III.</description><subject>Arthritis</subject><subject>Arthroscopy</subject><subject>Cartilage</subject><subject>Debridement</subject><subject>Humans</subject><subject>Knee</subject><subject>Literature reviews</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Quality of life</subject><subject>Software</subject><subject>Systematic review</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU9v1DAQxS0EotstH4ALssSFS6jH8Z-YG6qgIFXqpZyjxB5TL0m82M6h377e7oIQEuI0I83vvdHMI-Q1sPfAmL7MjIHSDQPecFCmgWdkA6JtG90K_ZxsmBF1wqQ6I-c57xirrTAvyRnnnWm56jbE3d0jRe_Rlkyjp0Mq9ylmG_fB0l0MS6EOxxQczlj7sNBSBT8WRBpzwfjEhxLyB5owr9PJhc5YhmZYhukhh3xBXvhhyvjqVLfk2-dPd1dfmpvb669XH28aK5gsTcvYYIXB0Uk7dpxZbrT1EhxIrTqnlXCaj4ACwUgYneforee8lcqMUmG7Je-OvvsUf66YSz-HbHGahgXjmntojTGgZD3-_6iub1XMqIq-_QvdxTXV0w6UMtApkKJScKRsfV9O6Pt9CvOQHnpg_SGt_phWX237Q1pVvCVvTs7rOKP7rfgVTwX4Ech1tHzH9Mfqf7o-Ap1Un0M</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Spahn, Gunter</creator><creator>Hofmann, Gunther O.</creator><creator>Klinger, Hans M.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QP</scope></search><sort><creationdate>20130701</creationdate><title>The effects of arthroscopic joint debridement in the knee osteoarthritis: results of a meta-analysis</title><author>Spahn, Gunter ; Hofmann, Gunther O. ; Klinger, Hans M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-300ac49ebd5cb820c297cf51d15768d764d72b1e4e1951bdf2efcf223569b56e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Arthritis</topic><topic>Arthroscopy</topic><topic>Cartilage</topic><topic>Debridement</topic><topic>Humans</topic><topic>Knee</topic><topic>Literature reviews</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Quality of life</topic><topic>Software</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spahn, Gunter</creatorcontrib><creatorcontrib>Hofmann, Gunther O.</creatorcontrib><creatorcontrib>Klinger, Hans M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Physical Education Index</collection><collection>Health & Medicine (ProQuest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spahn, Gunter</au><au>Hofmann, Gunther O.</au><au>Klinger, Hans M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effects of arthroscopic joint debridement in the knee osteoarthritis: results of a meta-analysis</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>21</volume><issue>7</issue><spage>1553</spage><epage>1561</epage><pages>1553-1561</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
Knee osteoarthritis is one of the most common orthopaedic diseases. Therapeutic options for this disease include conservative treatments and arthroscopic debridement and partial or complete replacement. This meta-analysis aimed to collect and analyse the available information on the effects of arthroscopic joint debridement related to the clinical outcomes, the required conversion to replacement and the factors for patient selection.
Methods
A search for publications was performed in the PubMed, Cochrane and EMBASE medical databases. The primary search resulted in a total of 1,512 citations. The results from 30 papers were included in this study. The extracted dates were listed in a standardised protocol. The statistical evaluation was performed using Comprehensive Meta-analysis software (V2 Biostat, Englewood, NJ, USA).
Results
No randomised study that compared conservative and arthroscopic treatments for knee osteoarthritis was found. Most studies reported middle-term results after arthroscopic operations. The results of these studies showed excellent or good outcomes in more than 60 % of all patients. These results were correlated with a significant increase in the knee scores from baseline to follow-up; the standardised difference in means was 2.3 (CI 95 % 1.5–3.0,
p
< 0.001). The required conversion rate to replacement increased as the follow-up interval increased. The rates were as follows: 1 year—6.1 % (CI 95 %, 2.1–16.6 %), 2 years—16.8 % (CI 95 %, 10.2–26.3 %), 3 years—21.7 % (CI 95 %, 15.5–29.1 %) and 4 years—34.1 % (CI 95 %, 22.8–47.6 %). The mean survival time was 42.7 (CI 95 %, 14.5–71.1) months. Numerous factors influenced the outcome, including the radiological stage of the osteoarthritis and individual patient factors (e.g. time of history of osteoarthritis, weight and smoking). The local knee findings, such as axial dysalignment, missing effusion and massive crepitus, were also correlated with patient outcome.
Conclusion
Arthroscopic joint debridement is a potential and sufficient treatment for knee osteoarthritis in a middle-term time interval. This procedure results in an excellent or good outcome in approximately 60 % of patients in approximately 5 years.
Level of evidence
Systematic review of studies, Level III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22893268</pmid><doi>10.1007/s00167-012-2169-1</doi><tpages>9</tpages></addata></record> |
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| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2013-07, Vol.21 (7), p.1553-1561 |
| issn | 0942-2056 1433-7347 |
| language | eng |
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| source | Wiley-Blackwell Journals; MEDLINE; SpringerLink |
| subjects | Arthritis Arthroscopy Cartilage Debridement Humans Knee Literature reviews Medicine Medicine & Public Health Meta-analysis Orthopedics Osteoarthritis Osteoarthritis, Knee - surgery Quality of life Software Systematic review |
| title | The effects of arthroscopic joint debridement in the knee osteoarthritis: results of a meta-analysis |
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