The current role of arthroscopy in the treatment of osteoarthritis of the knee

Purpose of review The treatment of the osteoarthritic knee in young and middle-aged patients is still a difficult and challenging problem. Arthroscopic surgery has been developed significantly during the past three decades. Its use for the treatment of the knee arthritis is controversial and has recently come under dispute because of the result of a clinical study that showed a possible placebo effect. Recent findings Despite the controversy, good results have been reported for a selected group of patients. Young patients with a short duration of symptoms, mild osteoarthritic changes, good range of motion, mild osteoarthritic changes on radiograph, normal alignment, and mechanical type of symptoms have had a successful outcome. Arthroscopy has been overused in elderly people with only a short-term benefit, for whom it is justified only for those who do not wish to undergo a major procedure. Summary Prospective, randomized, double-blind clinical studies with control groups are needed to explore further the efficacy of arthroscopic surgery for the management of knee osteoarthritis. The inclusion of sham surgery in clinical studies remains a difficult task. It is the surgeon's responsibility to carefully select the patients who will undergo arthroscopic surgery, so that better results can be obtained and unnecessary operations will be avoided.