Arthritic knees remain painful after arthroscop...( Trimming damaged tissue through arth...),Health

Trimming damaged tissue through arthroscopic surgery does not relieve pain and swelling in arthritic knees any better than simply flushing loose debris from the joint, according to a new review of evidence.

However, these findings come from studies on a broad range of patients. The technique, known as arthroscopic debridement (AD), might still improve comfort and mobility in some subsets of patients with the most common form of arthritis, the review authors say.

Surgeons should make a careful decision about using AD for the treatment of knee osteoarthritis, said lead author Wiroon Laupattarakasem, M.D., of Khon Kaen University in Thailand. It should by no means be regarded as inappropriate for every knee.

Osteoarthritis is typically a progressive disease that affects the hands, hips, shoulders and knees, especially in older people. The condition causes cartilage which cushions the ends of bones in these joints to break down. Loose bits of tissue can then cause pain, swelling and poor joint function.

Arthroscopic surgery for knee osteoarthritis can include a number of different procedures. These range from lavage, which is flushing and suctioning debris from the joint, to methods like debridement for trimming damaged cartilage and bone spurs. Surgeons might also treat the bone itself with abrasion or microfracture to stimulate the growth of new cartilage.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The reviewers base the latest findings on three randomized controlled studies with 271 patients. The largest and most reliable of these studies compares arthroscopic debridement with lavage and sham surgery. The three trea
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