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Falling out of love with knee arthroscopy

Knee arthroscopy, the most common orthopaedic procedure, is used to treat middle-aged or elderly patients with knee pain, with over two million patients undergoing this surgery every year worldwide. A new clinical practice guideline advises against the use of arthroscopy in these patients, contradicting the common use of this procedure in clinical practice.

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  1. Siemieniuk, R. A. C. et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ 357, j1982 (2017).

    Article  Google Scholar 

  2. Brignardello-Petersen, R. et al. Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review. BMJ Open 7, e016114 (2017).

    Article  Google Scholar 

  3. Devji, T. et al. Application of minimal important differences in degenerative knee disease outcomes: a systematic review and case study to inform BMJ Rapid Recommendations. BMJ Open 7, e015587 (2017).

    Article  Google Scholar 

  4. Jarvinen, T. L. & Guyatt, G. H. Arthroscopic surgery for knee pain. BMJ 354, i3934 (2016).

    Article  Google Scholar 

  5. Buxton, M. J. Economic forces and hospital technology. A perspective from Europe. Int. J. Technol. Assess. Health Care 3, 241–251 (1987).

    Article  CAS  Google Scholar 

  6. Price, A. & Beard, D. Arthroscopy for degenerate meniscal tears of the knee. BMJ 348, g2382 (2014).

    Article  Google Scholar 

  7. Sihvonen, R. et al. Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial. Ann. Rheum. Dis. (2017).

  8. Thorlund, J. B. et al. Patient reported outcomes in patients undergoing arthroscopic partial meniscectomy for traumatic or degenerative meniscal tears: comparative prospective cohort study. BMJ 356, j356 (2017).

    Article  Google Scholar 

  9. Swedish Agency for Health Technology Assessment and Assessment of Social Services. Arthroscopic surgery is ineffective in knee osteoarthritis and results in high costs. SBU (2014).

  10. Council for Choices in Health Care in Finland. Knee degeneration treatment by keyhole surgery not included in publicly funded healthcare services in Finland. Choices in Health Care (2017).

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The work of T.L.N.J. is supported by grants from the Sigrid Juselius Foundation, Finnish State Funding for Health Research (VTR), the Pirkanmaa and Helsinki University Hospital Districts, the Academy of Finland and the Jane and Aatos Erkko Foundation.

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Correspondence to Teppo L. N. Järvinen.

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Järvinen, T., Guyatt, G. Falling out of love with knee arthroscopy. Nat Rev Rheumatol 13, 515–516 (2017).

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