Arthroscopy of the knee in elderly patients: cartilage lesions and their influence on short term outcome. A retrospective follow-up of 183 patients.

We reviewed all patients of 65 years and older (n=183), who underwent a knee arthroscopy between 2004 and 2005. The purpose of our study was to determine the frequency and severity of cartilage lesions and their influence on short-term clinical outcome. Signs of osteoarthritis (OA) were absent or minor on pre operative plain radiographs in 30.5% of patients, but only 5.3% of patients were found during arthroscopy to have no obvious cartilage lesions. WOMAC and KOOS scores did not clearly correlate with severity of cartilage damage, but some WOMAC and KOOS subscales scored significantly lower when cartilage lesions were located on the lateral side. Forty-one patients eventually underwent TKA after a mean period of 14 months. In conclusion, cartilage lesions were visualized in almost every case even when pre-operative radiographs suggested differently. The higher the Kellgren-Lawrence grade of cartilage lesions on preoperative radiographs, the higher the risk for a TKA in the short term. Forty-seven percent of patients with Kellgren-Lawrence grade 4 lesions needed a TKA during the time period of the study.