Surgical Treatment of Degenerative Arthritis of the Knee Joint

Haggart, G. Edmund

doi:10.1056/nejm194706262362603

Cited by 34 publications

(10 citation statements)

References 2 publications

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“…For many years, open debridement, the "house cleaning" operation, was the only possible surgical procedure for moderate degenerative arthritis of the knee [8,9,13,18,19]. Both Magnuson and Haggart described methods of wide joint exposure, shaving of fibrillated cartilage, removal of torn menisci and loose bodies, trimming of osteophytes, patellectomy if needed, and rarely synovectomy.…”

Section: Discussionmentioning

confidence: 99%

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A prospective review of arthroscopic debridement for degenerative joint disease of the knee

Aichroth

Patel

Moyes

1991

International Orthopaedics

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A prospective review of 254 patients with moderate or severe knee pain due to degenerative joint disease, treated by arthroscopic debridement of menisci, articular cartilage, osteophytes and loose bodies has been made 24 to 140 months (average of 44 months) after surgery. Patients ranged in age from 28 to 82 years with an average of 49 years. At review, 75% had minimal discomfort and improved function and 85% were satisfied with the treatment. Those with less radiographic arthritis, less severe involvement of articular cartilage at operation and of younger age had more worthwhile improvement. This procedure allows worthwhile relief of symptoms, and only 14% had a subsequent operation after an average period of four years.

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Section: Discussionmentioning

confidence: 99%

“…O p e n d e b r i d e m e n t o f the knee has been f o u n d useful [8,9,18,19]. A d v a n c e s in a r t h r o s c o p i c t e c h n i q u e a n d i n s t r u m e n t a t i o n has m a d e it possible to debride the knee t h r o u g h small incisions [2, 4 -7 , 16, 17, 23-28].…”

mentioning

confidence: 99%

A prospective review of arthroscopic debridement for degenerative joint disease of the knee

Aichroth

Patel

Moyes

1991

International Orthopaedics

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“…Abrasion arthroplasty was described in the treatment of osteoarthritic knees prior to the development of total knee replacement13 but recent studies have shown conflicting conclusions,1415 and more recently a Cochrane review has confirmed that it is not effective in the treatment of OA 16. Symptomatic and functional outcome improvement has been shown for five years post-treatment of medial femoral condylar articular cartilage defects, with significant decline afterwards 17.…”

Section: Methodsmentioning

confidence: 99%

Cartilage repair: A review of Stanmore experience in the treatment of osteochondral defects in the knee with various surgical techniques

Vijayan

Bentley

Briggs

et al. 2010

IJOO

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Articular cartilage damage in the young adult knee, if left untreated, it may proceed to degenerative osteoarthritis and is a serious cause of disability and loss of function. Surgical cartilage repair of an osteochondral defect can give the patient significant relief from symptoms and preserve the functional life of the joint. Several techniques including bone marrow stimulation, cartilage tissue based therapy, cartilage cell seeded therapies and osteotomies have been described in the literature with varying results. Established techniques rely mainly on the formation of fibro-cartilage, which has been shown to degenerate over time due to shear forces. The implantation of autologous cultured chondrocytes into an osteochondral defect, may replace damaged cartilage with hyaline or hyaline-like cartilage. This clinical review assesses current surgical techniques and makes recommendations on the most appropriate method of cartilage repair when managing symptomatic osteochondral defects of the knee. We also discuss the experience with the technique of autologous chondrocyte implantation at our institution over the past 11 years.

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“…It gave good results in the early stages of wear (Haggart 1940;Magnuson 1941). Pridie (1959) described an articular drilling technique which was not primarily a debridement procedure, although removal of loose degenerate articular cartilage was included.…”

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confidence: 96%

Articular Debridement Versus Washout for Degeneration of the Medial Femoral Condyle

Hubbard

1996

The Journal of Bone and Joint Surgery. British volume

202

104

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In a prospective randomised trial 76 knees with isolated degenerative changes in the medial femoral condyle of grades 3 or 4 were treated by either arthroscopic debridement (40) or washout (36).All knees were followed up for at least one year and 58 for five years. The mean follow-up time was 4.5 years in the debridement group and 4.3 years in the washout group.At one year 32 of the debridement group and five of the washout group were painfree and at five years 19 of a total of 32 survivors in the debridement group and three of the 26 in the washout group were also free from pain. The mean improvement in a modified Lysholm score was 28 for the debridement group at one year and 21 at five years. In the washout group it was only 5 at one year and 4 at five years.For knees with lesions of the medial femoral condyle of grades 3 or 4, arthroscopic debridement appears to be the treatment of choice with over half the patients free from pain after five years.

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Surgical Treatment of Degenerative Arthritis of the Knee Joint

Cited by 34 publications

References 2 publications

A prospective review of arthroscopic debridement for degenerative joint disease of the knee

A prospective review of arthroscopic debridement for degenerative joint disease of the knee

Cartilage repair: A review of Stanmore experience in the treatment of osteochondral defects in the knee with various surgical techniques

Articular Debridement Versus Washout for Degeneration of the Medial Femoral Condyle

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