caa a22 4500 605457700 CHVBK 20210128100224.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00167-014-3220-1 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3220-1 Arthroscopy for mechanical symptoms in osteoarthritis: a cost-effective procedure [Elektronische Daten] [Jonathan Hutt, Johnathan Craik, Joideep Phadnis, Andrew Cobb] Purpose: The place of knee arthroscopy as a therapeutic option for osteoarthritis (OA) has been the subject of some debate. The hypothesis for this study was that arthroscopic debridement is beneficial in patients with OA who have significant mechanical symptoms. Methods: Forty-three patients with radiological OA on plain radiographs and mechanical symptoms were prospectively followed. No further imaging was obtained. They were assessed pre- and postoperatively with an Oxford Knee Score (OKS) and pain visual analogue score (VAS). Postoperative patient satisfaction was measured with a VAS. A cost-benefit analysis was performed using a transformed OKS to generate a quality-adjusted life year (QALY) measurement. Results: At a mean of 1.5years, seven patients (16%) had undergone total knee arthroplasty at a mean of 8.2months postarthroscopy. For the remaining 35 patients, there were significant improvements in pain (median 7-5, p<0.05) and OKS (median 24-36.5, p<0.05). Satisfaction was a median 6.2 for all patients. The mean calculated EQ-5D improved from 0.43 (SD 0.16) to 0.79 (SD 0.23), which gave a gain of 0.52 QALYs in the study period. This generated a cost per QALY of £2,088, well below the threshold of £30,000 quoted by the UK National Institute for Health and Care Excellence as demonstration of cost-effective treatment. Conclusions: This prospective study demonstrates that although not universally effective, arthroscopic debridement for patients with knee OA and mechanical symptoms can result in significant improvements in pain and function. The procedure gave good patient satisfaction, and even at an early follow-up period proves to be cost-effective. Level of evidence: IV. Springer-Verlag Berlin Heidelberg, 2014 Arthroscopy nationallicence Knee nationallicence Osteoarthritis nationallicence Debridement nationallicence Hutt Jonathan Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut Craik Johnathan Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut Phadnis Joideep Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut Cobb Andrew Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3545-3549 0942-2056 23:12<3545 2015 23 167 https://doi.org/10.1007/s00167-014-3220-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3220-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hutt Jonathan Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut NATIONALLICENCE 700 1- Craik Johnathan Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut NATIONALLICENCE 700 1- Phadnis Joideep Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut NATIONALLICENCE 700 1- Cobb Andrew Epsom General Hospital, Dorking Road, KT18 7EG, Epsom, Surrey, UK aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3545-3549 0942-2056 23:12<3545 2015 23 167