Arthroscopic Surgery in Primary Osteoarthritis of the Knee

Kim, Jung Man; Chang, Han; Shin, Jang Chul

Abstract

Between sept. 1982 and June 1985, the authors have performed arthroscopic debridement on 32 knees of 30 patients with primary osteoarthritis of the knee. Operative procedures including lavage, partial meniscectomy, excision of shelf, partial or total synovectomy of the anterior compartment, debridement of the articular cartilage, removal of loose bodies and multiple drilling of the articular cartilage were variously combined case by case. The follow-up period was between 18 and 52 months, with on average of 30.6 months. Clinical results were evaluated with the modified method of Sprague, III and were classified "Excellent". "Good", "Fair" and "Poor". The data were analyzed by Fishers exact test to clarify the relationship between clinical results and various preoperative factors. The results were as follows: l. Of the total 32 knees, results were "excellent" in 17(53.1%), "good" in 9(28.1%), "fair" in 3 (9.4%) and "poor" in 3(9.4%) knees respectively. Satisfactory results, including "excellent" and good, were achieved in more than 3/4 cases(81.2%) . 2. Of the 3 "poor" cases, 2 cases seemed to be affected by major depression and the other one case had no specific cause to be considered. 3. The unsatisfactory cases, including "fair" and "poor" cases, commonly had degenerative changes of patellofemoral joint arthroscopically although the correlation between it and the results were not significantly proved statistically(P>0.05). 4. The correlation between amount of effusion, degree of degeneration of articular cartilage and amount of fibrinoid debris were not significantly proved statistically(P>0.05). 5. The correlation between clinical results and amout of effusion. degreq or site of degeneration of articular cartilage, degree of flexion contracture, meniscal tear, synovectomy, debridement of articular cartilage and number of operative procedures could not be significanly proved statistically. In conclusion, arthroscopic treatment of the primary osteoarthritis of the knee shows relatively satisfactory results in most cases with fewcomplications and a short rehabilitation period, and the procedure could be recommended as a process inbetween conservative treatment and definitive treatment such as total knee replacement. But any specific relationship between clinical results and various preoperative factors could not be proved statistically. The clinical results seemed to be attected by individual unknown factors and further precise analysis and long term follow-up will be necessary to clarify them.