A MODERN PERSPECTIVE ON ARTHROSCOPIC PARTIAL MENISCECTOMY AS A TREATMENT FOR EARLY KNEE OSTEOARTHRITIS – Evidence-Based Medicine or Clinical Guidelines?

Background. High-quality evidence-based research have led orthopedic surgeons to abandon lavage and debridement in patients with knee osteoarthritis (OA). However, the issue of the advisability of arthroscopic partial meniscectomy (APM) in such patients remains unresolved, which explains the continued high number of such procedures worldwide. The aim of the study - to conduct a systematic review of current randomized clinical trials (RCTs) on APM in patients with knee OA and compare them with recent clinical guidelines from the perspective of evidence-based medicine. Methods. We analyzed 45 publications (34 RCTs and 11 meta-analyses of RCTs) from domestic and international databases, along with the current clinical guidelines of 10 leading professional societies regarding APM in patients with knee OA over the last 15 years. Results. The majority of publications on this topic (91,3%) consistently reported no significant differences in clinical outcomes between arthroscopic treatment and conservative therapy beyond 12 months. When a positive effect was present, it lasted from 6 to 12 months. Nevertheless, half (48%) of clinical guidelines still recommend this procedure. Conclusion. Recent high-level evidence studies on APM in early knee OA demonstrate no sustained clinical benefit compared to nonoperative treatment. This should be considered in future updates of national clinical guidelines.