The Alleviation Of Clinical Symptom After Arthroscopic Debridement For Knee Osteoarthritis(KOA): A Meta-analysis

Objective To systematically evaluate the effectiveness of arthroscopic debridement for KOA in the middle and late stage and I、Ⅱ、Ⅲ grade KOA that graded by Kellgren-Lawrance(K-L)Grade based on the Lysholm score. Methods Databases including CNKI、Pub Med、Cochrane、Wei Pu and Wan Fang Data base were searched from 2006 to 2014, so as to collect randomized controlledtrials(RCTs) or retrospective study of the Lysholm score before and after arthroscopic debridementin treating KOA. Two reviewers independently screened literature according to inclusion criteria and exclusion criteria, evaluated quality, and extracted data.Then the meta-analysis was conducted using Rev Man5.0 software and Stata SE12.0 software.Results Atotal of 23 studies were included. The results of meta-analyses showed that there was significant difference on the Lysholm score at the end of the first[MD=4.53,95%CI(3.65,5.42),P<0.00001],third[MD=4.53,95%CI(3.65,5.42),P<0.00001] and the sixth[MD=6.05,95%CI(4.23,7.87),P<0.00001] month after the arthroscopic debridement compared to that before the surgery. And the difference on the Lysholm score at the end of the third and the sixth month is of no significance[MD=0.26,95%CI(-1.09,1.60),P<0.00001],however, compared to the Lysholm score at the end of the first month, the treatment effect at the end of the third and the sixth month is more obvious[MD3=2.60,95%CI3(0.17,5.02),P3<0.00001 MD6=2.67,95%CI6(0.13,5.20), P6<0.00001]. The arthroscopic debridement has therapeutical effect on I、Ⅱ、Ⅲ grade KOA that graded by K-LGrade. Due to the disease progress continue, the difference on the Lysholm score between preoperation and postoperation fades. Conclusion Arthroscopic debridement has therapeutic effects on KOA.The best treatment was performed after 3 months,and then the treatment effect weekened along with the time goes on,so the arthroscopic debridement can be a cure for the early and middle stage of KOA and to improve the quality of lifeAs the the disease deteriorates,the treatment for Clinical symptoms caused by unstable and Mechanical noose fades.