Nutton Richard W
Orthopedics and Trauma at University of Edinburgh, Edinburgh, UK.
Nat Clin Pract Rheumatol. 2009 Mar;5(3):122-3. doi: 10.1038/ncprheum1020.
Considering the high prevalence of knee osteoarthritis and the relatively common use of arthroscopy to treat this condition, few well-designed studies have been published on the effectiveness of arthroscopy for treating knee osteoarthritis. The study by Kirkley et al. is a welcome addition to the literature as it addresses many of the criticisms of previous work by using appropriate exclusion criteria, standardizing treatment in the study groups, using well-validated clinical scores, and providing a period of follow-up exceeding 2 years. The authors conclude that although all patients benefited from active treatment for knee osteoarthritis, comprising rehabilitation and optimized medical treatment, the addition of arthroscopic debridement of the knee did not improve outcomes. These results underline the outcome of a previous prospective, randomized trial, which concluded that the placebo effect of performing knee arthroscopy for osteoarthritis accounted for the main therapeutic benefit observed at follow-up.
考虑到膝关节骨关节炎的高患病率以及关节镜检查在治疗该疾病中的相对普遍应用，关于关节镜检查治疗膝关节骨关节炎有效性的精心设计的研究却很少发表。Kirkley等人的研究是文献中的一个受欢迎的补充，因为它通过使用适当的排除标准、使研究组的治疗标准化、使用经过充分验证的临床评分以及提供超过2年的随访期，解决了先前研究的许多批评。作者得出结论，尽管所有患者都从膝关节骨关节炎的积极治疗中受益，包括康复和优化的药物治疗，但膝关节镜下清创术并未改善治疗结果。这些结果强调了先前一项前瞻性随机试验的结果，该试验得出结论，骨关节炎膝关节镜检查的安慰剂效应是随访时观察到的主要治疗益处的原因。
