[Results of arthroscopic debridement and lavage in patients with knee osteoarthritis]

Knee osteoarthritis (OA) is a degenerative process that affects people over 50 years old and is an important cause of disability. Treatment options include non-operative and operative modalities. Arthroscopic lavage and debridement may be the first choice to consider in patients between 45 and 65 years with early OA.

We conducted a self-controlled clinical trial with deliberate maneuver assignment. Thirty nine patients between 38 and 68 year of age with clinical and radiographic knee OA were included. Patients underwent arthroscopic lavage and debridement between January of 2001 and December 2003. Preoperative and postoperative evaluation was performed using the HSS knee score as well as questions that evaluated patient satisfaction and subjective function. Statistical analysis using one tailed Student's t-test was performed. Significance was considered with ap value of < 0.0001.

Thirty-three patients completed the evaluation. Six patients were lost to follow-up. Mean age of patients was 53 (38 to 68). Mean preoperative HSS score was 54.9 and average postoperative score was 74.8. Thirty-one out of 33 patients (93%) were satisfied and reported good subjective function after the operation. Twenty five of these patients presented Outerbridge grade II-III cartilage defects and 6 patients presented grade IV lesions. Twenty nine of the 33 patients (87.8%) referred improvement to perform their daily-living activities and 4 patients did not improve. Thirty two out of 33 patients would recommend the operation.

Arthroscopic debridement and lavage improves function and satisfaction in patients with grade II and III of OA. Patients with severe chondral lesions (grade IV) also improved to a lesser extent. Thus, arthroscopic debridement and lavage is a good treatment alternative in young patients with early OA.