Arthroscopy for degenerate meniscal tears of the knee

The NHS performs around 150 000 arthroscopic knee operations a year, with more than half involving resection of the meniscus. Therefore, close scrutiny of this intervention in the United Kingdom is entirely appropriate, particularly in the context of the ongoing drive towards providing evidence based and value based care.

Considering such high rates of surgery, it would be natural to assume that this operation is backed up by adequate evidence. However, unlike knee replacement surgery, which is supported by population based patient reported outcomes (PROMs) data and the National Joint Registry, healthcare commissioners lack the necessary data to allow informed decision making for knee arthroscopy. Detailed indications for its use need further refinement. With this backdrop, any results from high quality randomised controlled trials in this area are welcome.

The recent study by Sihvonen and colleagues therefore makes interesting reading.1 In 2005, when the trial was started, investigators were worried about the increasing numbers of arthroscopic meniscectomies performed for patients with degenerative meniscal tears. At this time it was common …