Open Access Technical advance

Arthroscopic cartilage regeneration facilitating procedure for osteoarthritic knee

Shaw-Ruey Lyu13*, Chia-Chen Hsu1 and Chih-Wen Lin23

Author Affiliations

1 Joint Center, Buddhist Dalin Tzu Chi General Hospital, 2, Min-Shen Road, Chiayi, 62247, Taiwan

2 Department of Medical Imaging, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

3 Tzu Chi University, Hualien, Taiwan

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BMC Musculoskeletal Disorders 2012, 13:226  doi:10.1186/1471-2474-13-226

Published: 21 November 2012

Abstract

Background

The effectiveness of arthroscopic treatment for osteoarthritic knee is a controversy. This study presents the technique of a novel concept of arthroscopic procedure and investigates its clinical outcome.

Method

An arthroscopic procedure targeted on elimination of focal abrasion phenomenon and regaining soft tissue balance around patello-femoral joint was applied to treat osteoarthritis knees. Five hundred and seventy-one knees of 367 patients with osteoarthritis received this procedure. There were 70 (19%) male and 297 (81%) female and the mean age was 60 years (SD 10). The Knee Society score (KSS) and the knee injury and osteoarthritis outcome score (KOOS) were used for subjective outcome study. The roentgenographic changes of femoral-tibial angle and joint space width were evaluated for objective outcomes. The mean follow-up period was 38 months (SD 3).

Results

There were 505 knees in 326 patients available with more than 3 years follow-up and the mean follow-up period was 38 months (SD 3). The subjective satisfactory rate for the whole series was 85.5%. For 134 knees with comprehensive follow-up evaluation, the KSS and all subscales of the KOOS improved statistically. The femoral-tibial angle improved from 1.57 degrees (SD 3.92) to 1.93 degrees (SD 4.12) (mean difference: 0.35, SD 0.17). The joint space width increased from 2.02 millimeters (SD 1.24) to 2.17 millimeters (SD 1.17) (mean difference: 0.13, SD 0.05). The degeneration process of the medial compartment was found being reversed in 82.1% of these knees by radiographic evaluation.

Conclusions

Based on these observations arthroscopic cartilage regeneration facilitating procedure is an effective treatment for osteoarthritis of the knee joint and can be expected to satisfy the majority of patients and reverse the degenerative process of their knees.

Keywords:
Osteoarthritis; Knee; Medial plica; Arthroscopy; Cartilage; Regeneration