Study: Knee arthritis surgery neither delays nor hastens total replacement

Editor's Note

Arthroscopic surgery for arthritis patients does not impact long-term incidence of total knee arthroplasty (TKA), according to a study published April 18 in Jama Network Open.

The secondary analysis of a randomized clinical trial focused on 178 adults diagnosed with osteoarthritis (OA) of the knee and referred for potential arthroscopic surgery, including resection or debridement of degenerative tears of the menisci, fragments of articular cartilage, or chondral flaps and osteophytes that prevented full extension. During a median follow-up of 13.8 years, 33.7 percent of patients in the arthroscopic surgery group underwent TKA, as opposed to 41.9 percent in the group that underwent nonoperative management (medication and physical therapy).

Results reportedly were similar when accounting for crossovers to arthroscopic surgery during follow-up. Within five years, the cumulative incidence of TKA was 10.2% in the arthroscopic surgery group versus 9.3% in the nonoperative management group. Within 10 years, these figures were 23.3 and 21.4%, respectively.

“Approximately 80 percent of patients did not undergo TKA within 10 years of nonoperative management with or without additional knee arthroscopic surgery,” the researchers conclude.