![]() Further clinical study of this subset of patients within the context of a randomised controlled trial would be helpful. Delaying inevitable joint replacement is particularly desirable in these patients. For this reason we believe that arthroscopic debridement should principally be used in younger patients with osteoarthritis, with meniscal lesions or chondral flaps amenable to debridement. The presence of limb malalignment is associated with a less successful outcome. 8, 9 Factors correlating with a better outcome include the presence of mechanical symptoms of painful locking or catching of the knee, mild to moderate radiographic evidence of arthritis, and a younger age at the time of surgery. Some studies do suggest that arthroscopic treatment used in a more selective manner can control symptoms of osteoarthritis of the knee for up to five years. 7 Prospective randomised controlled trials looking at subsets of patients with differing levels of symptoms and disease are scarce. It has been shown that improvement of symptoms in an unselected cohort of patients allocated to either washout or washout and debridement could be attributed to a placebo effect. The role of arthroscopic debridement for degenerative arthritis of the knee is controversial. ![]() This article concentrates on the interventions and surgical options used by orthopaedic surgeons for the treatment of this disease, indications for their use, and likely outcomes. Non-surgical treatment of osteoarthritis of the knee is primarily carried out in the community. Moreover, whereas most patients are past retirement, a major proportion is of working age, leading to difficulties with work and presenting an important economic cost to society. ![]() Classically the pain depends on activity, and in severe cases not only limits the distance patients can walk and their daily activities, but also disrupts sleep. Most patients with osteoarthritis of the knee are able to manage their symptoms without medical treatment, but a large proportion of those referred to orthopaedic surgeons have debilitating disease, presenting chiefly with pain and stiffness. 1 This proportion is likely to increase with extended longevity and a bigger body mass index. Osteoarthritis of the knee is common, affecting almost a tenth of the population aged over 55.
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