Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline

doi:10.1136/bmj.j1982

Practice Guideline

. 2017 May 10:357:j1982.

doi: 10.1136/bmj.j1982.

Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline

Reed A C Siemieniuk^{1

2}, Ian A Harris^{3

4}, Thomas Agoritsas^{5

6}, Rudolf W Poolman⁷, Romina Brignardello-Petersen^{5

8}, Stijn Van de Velde⁹, Rachelle Buchbinder^{10

11}, Martin Englund¹², Lyubov Lytvyn¹³, Casey Quinlan¹⁴, Lise Helsingen¹⁵, Gunnar Knutsen¹⁶, Nina Rydland Olsen¹⁷, Helen Macdonald¹⁸, Louise Hailey¹⁹, Hazel M Wilson²⁰, Anne Lydiatt²¹, Annette Kristiansen^{22

23}

Affiliations

¹ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8 reed.siemieniuk@medportal.ca.
² Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ South Western Sydney Clinical School, UNSW, Australia.
⁴ Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
⁵ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
⁶ Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland.
⁷ Department of Orthopaedic Surgery, Joint Research, OLVG, 1090 HM Amsterdam, The Netherlands.
⁸ Faculty of Dentistry, Universidad de Chile, Independencia, Santiago, Chile.
⁹ Norwegian Institute of Public Health, Nydalen, N-0403 Oslo, Norway.
¹⁰ Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia.
¹¹ Monash Department of Clinical Epidemiology, Cabrini Institute; Suite 41 Cabrini Medical Centre, Malvern Vic, 3144, Australia.
¹² Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden.
¹³ Oslo University Hospital, Blindern 0317 Oslo, Norway.
¹⁴ Richmond, Virginia, USA.
¹⁵ Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Blindern 0317 Oslo, Norway.
¹⁶ University Hospital North Norway, 9038 Tromso, Norway.
¹⁷ Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social sciences, Bergen University College, 5020 Bergen, Norway.
¹⁸ BMJ Editorial, BMA House, London WC1H 9JR, UK.
¹⁹ Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7HE, UK.
²⁰ London, Ontario, Canada.
²¹ Ingersoll, Ontario, Canada N5C 3N1.
²² Department of Health and Science, University of Oslo, Oslo, Norway.
²³ Department of Medicine, Hospital Innlandet Trust, Gjøvik, Norway.

PMID: 28490431
PMCID: PMC5426368
DOI: 10.1136/bmj.j1982

Practice Guideline

Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline

Reed A C Siemieniuk et al. BMJ. 2017.

. 2017 May 10:357:j1982.

doi: 10.1136/bmj.j1982.

Authors

Affiliations

¹ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8 reed.siemieniuk@medportal.ca.
² Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ South Western Sydney Clinical School, UNSW, Australia.
⁴ Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
⁵ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
⁶ Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland.
⁷ Department of Orthopaedic Surgery, Joint Research, OLVG, 1090 HM Amsterdam, The Netherlands.
⁸ Faculty of Dentistry, Universidad de Chile, Independencia, Santiago, Chile.
⁹ Norwegian Institute of Public Health, Nydalen, N-0403 Oslo, Norway.
¹⁰ Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia.
¹¹ Monash Department of Clinical Epidemiology, Cabrini Institute; Suite 41 Cabrini Medical Centre, Malvern Vic, 3144, Australia.
¹² Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden.
¹³ Oslo University Hospital, Blindern 0317 Oslo, Norway.
¹⁴ Richmond, Virginia, USA.
¹⁵ Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Blindern 0317 Oslo, Norway.
¹⁶ University Hospital North Norway, 9038 Tromso, Norway.
¹⁷ Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social sciences, Bergen University College, 5020 Bergen, Norway.
¹⁸ BMJ Editorial, BMA House, London WC1H 9JR, UK.
¹⁹ Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7HE, UK.
²⁰ London, Ontario, Canada.
²¹ Ingersoll, Ontario, Canada N5C 3N1.
²² Department of Health and Science, University of Oslo, Oslo, Norway.
²³ Department of Medicine, Hospital Innlandet Trust, Gjøvik, Norway.

PMID: 28490431
PMCID: PMC5426368
DOI: 10.1136/bmj.j1982

No abstract available

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the BMJ Rapid Recommendations interests disclosure form, and a detailed, contextualised description of all disclosures is reported in appendix 1. As with all BMJ Rapid Recommendations, the executive team and The BMJ judged that no panel member had any financial conflict of interest. Professional and academic interests are minimised as much as possible, while maintaining necessary expertise on the panel to make fully informed decisions.

Figures

None — **Fig 1** Population adjusted trends in frequency of knee arthroscopy; percent. Arthroscopic knee surgery remains common despite accumulating evidence suggesting little benefit

See this image and copyright information in PMC

Comment in

Surgery: Falling out of love with knee arthroscopy.
Järvinen TLN, Guyatt GH. Järvinen TLN, et al. Nat Rev Rheumatol. 2017 Sep;13(9):515-516. doi: 10.1038/nrrheum.2017.106. Epub 2017 Jul 6. Nat Rev Rheumatol. 2017. PMID: 28680134 No abstract available.
Guideline: An expert panel strongly recommends against arthroscopic knee surgery for degenerative knee disease.
Mar CD. Mar CD. Ann Intern Med. 2017 Oct 17;167(8):JC38. doi: 10.7326/ACPJC-2017-167-8-038. Ann Intern Med. 2017. PMID: 29049757 No abstract available.
An Open Letter to the Editor of The BMJ.
Bollen S. Bollen S. Arthroscopy. 2018 Jan;34(1):8-11. doi: 10.1016/j.arthro.2017.11.010. Arthroscopy. 2018. PMID: 29304984 No abstract available.

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References

1. Englund M, Guermazi A, Gale D, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008;359:1108-15. 10.1056/NEJMoa0800777 pmid:18784100. - DOI - PMC - PubMed
1. Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med 2011;155:725-32. 10.7326/0003-4819-155-11-201112060-00004 pmid:22147711. - DOI - PMC - PubMed
1. Turkiewicz A, Gerhardsson de Verdier M, Engström G, et al. Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care. Rheumatology (Oxford) 2015;54:827-35. 10.1093/rheumatology/keu409 pmid:25313145. - DOI - PubMed
1. McGrory B, Weber K, Lynott JA, et al. American Academy of Orthopaedic Surgeons. The American Academy of Orthopaedic Surgeons evidence-based clinical practice guideline on surgical management of osteoarthritis of the knee. J Bone Joint Surg Am 2016;98:688-92. 10.2106/JBJS.15.01311 pmid:27098328. - DOI - PubMed
1. Skou ST, Roos EM, Laursen MB, et al. A randomized, controlled trial of total knee replacement. N Engl J Med 2015;373:1597-606. 10.1056/NEJMoa1505467 pmid:26488691. - DOI - PubMed

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[1] Englund M, Guermazi A, Gale D, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008;359:1108-15. 10.1056/NEJMoa0800777 pmid:18784100. - DOI - PMC - PubMed

[2] Englund M, Guermazi A, Gale D, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008;359:1108-15. 10.1056/NEJMoa0800777 pmid:18784100. - DOI - PMC - PubMed

[3] Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med 2011;155:725-32. 10.7326/0003-4819-155-11-201112060-00004 pmid:22147711. - DOI - PMC - PubMed

[4] Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med 2011;155:725-32. 10.7326/0003-4819-155-11-201112060-00004 pmid:22147711. - DOI - PMC - PubMed

[5] Turkiewicz A, Gerhardsson de Verdier M, Engström G, et al. Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care. Rheumatology (Oxford) 2015;54:827-35. 10.1093/rheumatology/keu409 pmid:25313145. - DOI - PubMed

[6] Turkiewicz A, Gerhardsson de Verdier M, Engström G, et al. Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care. Rheumatology (Oxford) 2015;54:827-35. 10.1093/rheumatology/keu409 pmid:25313145. - DOI - PubMed

[7] McGrory B, Weber K, Lynott JA, et al. American Academy of Orthopaedic Surgeons. The American Academy of Orthopaedic Surgeons evidence-based clinical practice guideline on surgical management of osteoarthritis of the knee. J Bone Joint Surg Am 2016;98:688-92. 10.2106/JBJS.15.01311 pmid:27098328. - DOI - PubMed

[8] McGrory B, Weber K, Lynott JA, et al. American Academy of Orthopaedic Surgeons. The American Academy of Orthopaedic Surgeons evidence-based clinical practice guideline on surgical management of osteoarthritis of the knee. J Bone Joint Surg Am 2016;98:688-92. 10.2106/JBJS.15.01311 pmid:27098328. - DOI - PubMed

[9] Skou ST, Roos EM, Laursen MB, et al. A randomized, controlled trial of total knee replacement. N Engl J Med 2015;373:1597-606. 10.1056/NEJMoa1505467 pmid:26488691. - DOI - PubMed

[10] Skou ST, Roos EM, Laursen MB, et al. A randomized, controlled trial of total knee replacement. N Engl J Med 2015;373:1597-606. 10.1056/NEJMoa1505467 pmid:26488691. - DOI - PubMed

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Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline

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Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline

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