Skip to main content

Safer Care Victoria’s Best Care resources support patients and healthcare providers to have conversations and make decisions together about the most appropriate pathways for care.

This resource, developed for clinicians, details a specific elective surgery procedure that should now only be done for specific indications. Evidence-based recommendations that detail ‘best care’ pathways should be discussed with your patient to determine the most appropriate pathway of care.

Advice

Arthroscopic knee procedures, including lavage, debridement and partial meniscectomy, should not be used to treat a patient with uncomplicated knee osteoarthritis because it does not alter the natural history of knee osteoarthritis.

When is the procedure indicated?

Knee arthroscopy, in the presence of osteoarthritis, may be appropriate in the following circumstances:

  • suspected or confirmed septic arthritis
  • symptomatic loose bodies
  • locked or locking knees
  • meniscal tears that require repair, such as due to recurrent effusions or mechanical dysfunction, after appropriate trial of physiotherapy/rehabilitation
  • need for synovectomy in the case of inflammatory arthropathy
  • need for resection or biopsy in the case of synovial pathology
  • in conjunction with other surgical procedures such as high tibial osteotomy
  • for diagnostic purposes where MRI results are unclear or imaging is not possible, and the symptoms are not characteristic of osteoarthritis.

Best care recommendations

Treatment options for uncomplicated knee osteoarthritis include:

  • physiotherapy/exercise
  • education and self-management
  • weight loss if indicated
  • pharmacological treatments
  • joint replacement surgery where conservative management has failed to control pain or maintain function.

Evidence

Australian Commission on Safety and Quality in Health Care. Osteoarthritis of the knee clinical care standard. Sydney (NSW): Australian Commission on Safety and Quality in Health Care; 2017 [cited 2020 Jun 13]. 

Australian Commission on Safety and Quality in Health Care. The first Australian atlas of healthcare variation.  Sydney (NSW): Australian Commission on Safety and Quality in Health Care; 2015 [cited 2020 Jun 13]. 

Australian Orthopaedic Association. Position statement from the Australian Knee Society on arthroscopic surgery of the knee, including reference to the presence of osteoarthritis or degenerative joint disease. Sydney (NSW): Australian Orthopaedic Association; 2016 [cited 2020 Jun 13]. 

Hunter DJ, Felson DT. Osteoarthritis. BMJ. 2006;332(7542):639-42. 

Safer Care Victoria. Osteoarthritis. Melbourne (VIC): Safer Care Victoria. 2019 [cited 2020 Jun 13]. 

Thorlund JB, Juhl CB, Roos EM, Lohmander LS. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ. 2015 Jun 16;350:h2747. 

Page last updated: 23 Dec 2020

Was this content helpful to you?