Arthroscopy for Osteoarthritis: Is It Worth It?

Arthroscopy 

Professor David Hunter, rheumatologist

There are a lot of common treatments that are used for osteoarthritis that either have poor evidence to support their efficacy and/or have side effects and a cost that don't necessarily warrant or justify their continued use. A which is commonly used for the management of osteoarthritis of the knee and has no evidence to support its efficacy and similarly has a relatively high rate of adverse effects and costs substantially. So, in rare instances arthroscopy for the management of knee osteoarthritis may be suitable if a person cannot move their knee, it’s locked or blocked in one position. In that context which is about 1 to 2 percent of people with osteoarthritis it may be appropriate the remainder of the time it's not appropriate for the management of osteoarthritis. 

Research around arthroscopy 

Professor Rachelle Buchbinder, rheumatologist

There is compelling evidence based on high-quality trials that have been performed in the last decade that really shows that arthroscopy for people with osteoarthritis is not effective. So, arthroscopy might involve cleaning out the joint or washing it out and in carefully conducted studies where this is compared to a sham surgical procedure there's been no difference in the outcome so this really can't be recommended for people with osteoarthritis. 

Last year there was another study that compared the effects of arthroscopy for people who had osteoarthritis in their knee with a meniscal tear and found that having surgery was no better than a period of rehabilitation for relieving the symptoms of this condition either. So, really if people are offered an arthroscopy to clean out their osteoarthritic joint, I think the best approach would be to perhaps get a second opinion and also ask the surgeon what the evidence is that this is going to be a value for them. Arthroscopy for hip pain has also been increasingly promoted and used and like stem cell therapy there isn't enough evidence to say one way or another whether or not it is effective and nor do we know about any potential harms