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Twenty-nine knees in 23 patients with symptomatic osteoarthritis underwent washout with lactated Ringer's solution. Two arthroscopic cannulas were placed into the knee under local anesthetic. Three liters of fluid were run through the knee using varying inflow and outflow to alternately inflate and deflate the knee. We obtained Hospital for Special Surgery knee scores, Knee Society pain and function ratings, and visual analog pain scales before washout and up to 2 years after washout. At 1 year, the mean Hospital for Special Surgery score increased from 72 to 87, the Knee Society pain rating from 64 to 89, and the Knee Society function rating from 62 to 82. Twenty-five knees had a good or excellent result at 1 year. Twenty-one of these were observed at 2 years; 17 had good or excellent results. This study confirms the value of a fluid washout in an arthritic knee for some patients. This may explain some of the symptom relief seen with arthroscopic procedures in this condition.

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Background: At least 760,000 outpatient meniscectomies are performed in the United States each year, making this the most common musculoskeletal procedure. However, meniscal resection can alter the joint biomechanics and overload the articular cartilage, which may contribute to degenerative changes and the need for knee replacement. Avoiding or delaying knee replacement is particularly important in younger or more active patients. Synthetic meniscal implants have been developed in an attempt to restore the natural joint biomechanics, alleviate pain and disability, and potentially minimize degenerative changes in patients who require meniscectomy. Purpose To evaluate the preliminary results from 2 ongoing trials that are evaluating the safety and effectiveness of a synthetic polymer meniscal implant (NUsurface; Active Implants, LLC). Study Design: Cohort study; Level of evidence, 2. Methods: This was a preliminary analysis of the first 100 patients enrolled across 2 studies for 12 months: a single-arm, intervention-only study and a randomized controlled trial comparing the investigational meniscal implant with nonsurgical therapy. There were 65 patients in the implant group (30 randomized) and 35 in the control group. Outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) and adverse events (AEs) collected at baseline and follow-up visits of 6 weeks, 6 months, and 12 months. Results: No statistically significant differences were found in baseline characteristics between the implant and control groups. At 12 months, follow-up KOOS data were available for 87% of the 100 included patients. Significantly greater improvements from baseline were observed in the implant group compared with controls in all KOOS subcomponents, except for symptoms (119%-177% greater improvement at 12 months). AEs were reported at similar rates between the 2 groups, with 12 AEs among 11 patients in the implant group (16.9%) versus 5 AEs among 5 patients (14.3%) in the control group ( P = .99). Conclusion: These preliminary results suggest significant improvements in pain and function scores with the implant over nonsurgical therapy and a similar adverse event rate.

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