Comparison of Arthroscopic and Conservative Treatments for Knee Osteoarthritis: A 5-Year Retrospective Comparative Study

Purpose To compare the effectiveness of arthroscopic and conservative treatments in patients with knee osteoarthritis (KOA) with 5 years of follow-up. Methods Patients diagnosed with Kellgren-Lawrence grade 2 to 4 KOA who underwent arthroscopic or conservative treatment from May 2005 to May 2012 were included. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score was collected 1, 2, 3, 4, and 5 years after the initial treatment, and the number of patients who underwent total knee arthroplasty (TKA) at every time point was recorded. Results Three hundred eighty-two patients (168 in the conservative group and 214 in the arthroscopy group) were included. Five years after the initial treatment, 32 of the 214 patients who underwent arthroscopy (15.0%) compared with 30 of the 168 patients in the conservative treatment group (17.9%) ultimately underwent TKA, with no statistically significant difference between groups ( P  = .20). The WOMAC score was significantly lower in the arthroscopy group than in the conservative group at year 1 (24.33 ± 21.56 vs 36.43 ± 16.22, respectively) and year 2 (26.31 ± 17.84 vs 35.41 ± 19.21, respectively). There were no significant between-group differences at years 3, 4, and 5. Conclusions Compared with conservative treatment, arthroscopy provided no benefit in decreasing or delaying arthroplasty surgery. However, arthroscopy had a greater ability to relieve symptoms at 1 and 2 years. Our results suggest that arthroscopy can relieve symptoms up to 2 years without elevating the risk of arthroplasty. Level of Evidence Level III, retrospective comparative study.