Arthroscopy, Meniscal Surgery and Lavage

About

Arthroscopy is a term that comes from two Greek words; ‘arthro’, meaning joint; and ‘skopein’, meaning to examine. It involves small incisions and the insertion of a small camera and special instruments to perform minor procedures. This replaces the need for larger incisions and allows for faster healing, a more rapid recovery, and less scarring. Arthroscopic surgical procedures are often performed in day-surgery and the patient is able to return home that evening.

Arthroscopy is often used to repair structures that have been torn or broken in recent acute trauma, such as the breaking of a ligament or tearing of a meniscus. Meniscal repair and cruciate ligament repair for acute injuries are two of the most common and effective arthroscopic procedures.

Osteoarthritis (OA), or ‘wear and tear arthritis’, is primarily caused by overloading the joint, having a genetic pre-disposition to cartilage wear, and cumulative injury over the course of a lifetime. Over recent years, it has become common practice to perform an arthroscopic ‘lavage’, or washing-out and cleaning-up the painful joint with OA. It is of appeal to the patient because it makes logical sense and it seems like a quick-fix.

However, recent strong scientific evidence has been published stating that arthroscopic lavage and clean-up procedures for knee OA patients achieve the same or worse results as placebo or ‘sham’ surgery. Considering the risks and costs of surgical procedure, arthroscopy cannot be recommended for the knee OA patient unless there is significant functional impairment such as severe catching/locking of the knee.

Be Aware

Arthroscopy and surgery are very effective placebos, due to the way the human mind perceives the severity of this medical intervention. Although many doctors and surgeons still practice arthroscopies for knee OA, and some patients may perceive the procedure has helped them, the recent data against this treatment’s effectiveness is strong.

Due to this recent scientific data, some health funds may choose not to reimburse costs for arthroscopic lavage for OA.

As far as surgeries go, arthroscopy holds less infection and post-surgery complication risk than more invasive surgeries, however the risk is still a significant consideration for the patient.