The indications for arthroscopy in an arthritic knee is clear cut
sudden onset sharp episodic pain in a patient with mild arthritic pain meaning(dull chronic pain, night pain) which was well tolerated by the patient. Mcmurrys test should be positive.
MRI should demonstrate a meniscal tear usually degenerative tear. MRI would also rule out ostenecrosis of femeoral condyle which again is sudden onset.
the results are even better in patients with medial compartment arthritis with sudden onset lateral meniscal tear.
in such cases partial menisectomy will help. the patient needs to understand that scopy will relieve only the sharp episodic pain at best and one could wash out the knee and consider viscosuplimentation or PRP injection which eve group one believes in.
There is no role for arthroscopic washout in an arthrirtic knee wich at best would relieve symptoms for a few weeks to months.
please not that astenecrosi of medail femoral condyle has been reported rarely post menisectomy and should be investigated in arthritic patients with increasing pain post scopy.
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