The indications for arthroscopic debridement for osteoarthritis of the knee.

The evidence supporting the therapeutic value of arthroscopic debridement of the knee is overwhelming. However, there is a need for better-designed clinical trials comparing arthroscopic debridement to established alternative treatments. The most important factor in determining success is proper patient selection, and many who have osteoarthritis of the knee will not benefit from arthroscopic debridement. Patients who have end-stage osteoarthritis or severe malalignment and those who do not have mechanical symptoms are unlikely to improve. The important considerations are how effective the treatment is and whether the expected benefits justify the risks, potential complications, and cost. An objective analysis of outcome studies in patients who have osteoarthritis of the knee joint clearly shows that properly selected patients will benefit greatly from arthroscopic debridement and many will be saved from the increased morbidity and potential complications of alternative treatments.