Royal College of Surgeons respond to new research on the effectiveness of knee arthroscopy surgery

Knee arthroscopy should not be performed in almost all patients with degenerative knee disease, a panel of international experts have said in The BMJ today. The experts say that the surgery does not, on average, result in a lasting improvement in pain or function - and they say further research is unlikely to alter this advice.

In response to the research, Mrs Scarlett McNally, council member for the Royal College of Surgeons said:

“This review applies to a particular type of knee surgery which orthopaedic surgeons are already moving away from for people with arthritis. Following the Cochrane review in 2008[1], and the subsequent revision of NICE guidance[2], surgeons now only consider knee arthroscopy as a suitable course of action for patients that have issues with their knee unexpectedly catching or giving way. Surgeons also only offer it to patients that have not responded well to non-surgical treatment, particularly weight loss and strengthening exercises, after at least 3 months. That said, any new research is always welcome and it is important that surgeons use this as an opportunity to remind themselves that they should only offer this procedure in very particular circumstances.  

“This research also highlights the importance of patients being fully informed of the care options open to them. Patients should, in discussions with their surgeon, decide what is the most suitable surgical or non-surgical solution for their problem. It is then a medical professional’s duty to make patients aware of all potential outcomes of any type of surgery or medical care.” 

Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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¹ Laupattarakasem W, Laopaiboon M, Laupattarakasem P, Sumananont C. Arthroscopic debridement for knee osteoarthritis. Cochrane Database Syst Rev. 2008; Issue 1. Art. No.: CD005118. doi:10.1002/14651858.CD005118.pub2.

²  Royal College of Surgeons, Commissioning guide:Painful osteoarthritis of the knee,  01 July 201, Royal College of Surgeons of England (RCS), https://www.evidence.nhs.uk/Search?om=%5B%7B%22srn%22:%5B%22Royal%20College%20of%20Surgeons%20-%20RCS%22%5D%7D%5D&q=guidelines+knee+arthroscopy