Knee arthroscopy has been a very popular operation for treating painful knees for more than 30 years. Unfortunately it doesn’t always work. Over the last few years a lot of research has been looking at which patients it works well in and which it doesn’t. From this we have figured out that there are two groups of patients with painful knees who get little or no benefit from knee arthroscopy. The first group is patients with osteoarthritis and the second group are atraumatic meniscal tears. I’ll go over both groups.
If you have osteoarthritis this means that the firm cartilage surface covering the bone in the knee has worn away. There may also be a torn meniscus cartilage in your knee (the meniscus is a softer cushion that sits between the surfaces). There may also be loose fragments of surface cartilage which have come loose and are floating inside your knee. The evidence tells us that performing a knee arthroscopy to remove the torn meniscus and loose fragments does not lead to a lasting benefit. This is because the cartilage covering the surface will still be missing and the pain comes from the exposed bone. There is no way to arthroscopically put a new surface over the exposed bone.
