Factors influencing clinical outcomes in patients with knee osteoarthritis undergoing arthroscopic treatment

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by pain and limited joint function. Arthroscopic debridement is a commonly used surgical intervention; however, its efficacy remains controversial. This study aimed to identify factors influencing the clinical outcomes of arthroscopic treatment for KOA.

This retrospective cohort study included 169 patients with KOA treated between January 2019 and December 2023. Patients were divided into an observation group (arthroscopic debridement, n=85) and a control group (integrated traditional Chinese and Western medicine conservative treatment, n=84) according to the treatment modality. The visual analog scale (VAS) score, Lysholm knee score, range of motion (ROM), and Kellgren-Lawrence (K-L) grade were assessed preoperatively and at 1, 4, 7, and 24 months postoperatively. Multivariate logistic regression analysis was performed to identify predictors of treatment efficacy, and a nomogram model was constructed for outcome prediction.

The observation group exhibited significantly lower VAS scores and higher Lysholm scores at 1, 4, and 7 months postoperatively compared with the control group (all P < 0.05). Improvements in ROM and K-L grade were also more pronounced in the observation group. Multivariate analysis identified body mass index (BMI) > 26 kg/m², higher K-L grade, and higher Outerbridge grade as significant predictors of worse treatment outcomes. The nomogram demonstrated good predictive performance (concordance index = 0.82, area under the curve = 0.83).

BMI, K-L grade, and Outerbridge grade are key determinants of clinical outcomes following arthroscopic treatment for KOA. The proposed nomogram offers a practical tool for preoperative prediction of surgical efficacy.