Inclusion: Adults with knee osteoarthritis; follow up of at least three months
Exclusion: Children (aged under 18 years)
Intervention(s), exposure(s)
Arthroscopic debridement of knee osteoarthritis. This excluded joint lavage, where the aim was soley lavage of the joint, and not any debridement of tissues.
Comparator(s)/ control
Non-surgical treatment - this includes, but is not limited to, physical therapy, steroid injection, synovial fluid substitute, joint lavage, and sham surgery.
Context
It is expected that all studies will be completed within specialist orthopaedic units. This, however, will not necessarily exclude a study.
Outcome(s)
Primary outcomes
- Reduction of knee pain.
- Improvement of knee function (including Patient reported outcome measures)
- Adverse events
There are multiple outcome measures that have been established in Knee OA including the Oxford Knee Score, the Lysholm Knee Scores, the International Knee Documentation Committee (IKDC) Scores, the Hospital for Special Surgery (HSS) Score, and the Western Ontario and McMaster Universities (WOMAC) OA Index. Also standardized measures of pain (e.g. the Visual Analogue Scale) will be included. Different analgesic regimes will be included in the data synthesis. Follow-up of at least three months is required.
Secondary outcomes
Time to next major intervention (e.g., TKA) indicating failure of the treatment or censoring due to end of the study or dropout.
Amount (doses, frequencies and types) of NSAIDs and/or analgesics used as rescue therapies in parallel with the treatment and control.
Other outcomes according to the authors' reports.
Data extraction, (selection and coding)
Titles and/or abstracts of studies retrieved using the search strategy and those from additional sources will be screened independently by two review authors to identify studies that potentially meet the inclusion criteria outlined above. The full text of these potentially eligible studies will be retrieved and independently assessed for eligibility by two review team members. Any disagreement between them over the eligibility of particular studies will be resolved through discussion with a third reviewer.
A standardised form will be used to extract data from the included studies for assessment of study quality and evidence synthesis. Extracted information will include: study population; details of the intervention; details of the comparitor; study methodology; outcomes and times of measurement; information for assessment of the risk of bias. Two review authors will extract data independently, discrepancies will be identified and resolved through discussion (with a third author where necessary).
Risk of bias (quality) assessment
The JADAD scale will be used to quality assess the included studies. This process will be completed by two independent reviewers and any discrepancies will be resolved by discussion (witha a third author where necessary).
Strategy for data synthesis
A narrative synthesis is planned.
Analysis of subgroups or subsets
Patients with either meniscal symptoms, or who have degenerative miniscal disease will be discussed as a subgroup within the review, if the necessary data is available.
Dissemination plans
To aid dissemination in the orthopaedic community this review will be submitted for publication to an internationally recognised journal, and to international conference(s).
Contact details for further information
Timothy Barlow
38 Charter Approach
Warwick
CV34 6AE
timbarlow@doctors.org.uk
Organisational affiliation of the review
Warwick Medical School
Review team
Mr Timothy Barlow, Warwick Medical School Mr Christopher Downham, University hospitals of Coventry and Warwickshire Professor Damian Griffin, Warwick Medical School
Anticipated or actual start date
26 July 2012
Anticipated completion date
31 October 2012
Funding sources/sponsors
n/a
Conflicts of interest
None known
Other registration details
Not applicable
Language
English
Country
England
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Arthroscopy; Humans; Osteoarthritis, Knee
Date of registration in PROSPERO
20 September 2012
Date of publication of this revision
20 September 2012
Stage of review at time of this submission
Started
Completed
Preliminary searches
No
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Data extraction
Risk of bias (quality) assessment
Data analysis
Prospective meta-analysis
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.
