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Evidence to Improve Care

Arthroscopic Debridement of the Knee

Ontario Health Technology Advisory Committee Recommendation

  • The Ontario Health Technology Advisory Committee recommends against arthroscopic debridement for patients with uncomplicated (without meniscal tears) osteoarthritis of the knee.

Read the full OHTAC Recommendation report

The soft tissues of the knee joint can wear away and cause pain, limiting quality of life and the ability to participate in day-to-day activities. It’s estimated that about 16,000 persons have osteoarthritis of the knee in Ontario. Most arthroscopies (68.4 percent) currently conducted in Ontario are for osteoarthritis or degenerative knee injury. An arthroscopy is a procedure in which a fibre-optic camera is inserted through a small incision and allows a surgeon to see and even repair some types of joint damage.

Health Quality Ontario Reviews Arthroscopic Debridement

Arthroscopic debridement is a surgical treatment that extracts any loose material in the knee joint and can smooth the surfaces inside the knee. It is more accessible when comparted to total knee replacements or alternatives such as physical therapy for patients who live far from cities or have little time or money. There are ethical concerns with providing surgery that is not proven to be better than less invasive alternatives. However, there are also ethical concerns about not giving patients an alternative treatment that might be effective.

Arthroscopic Debridement of the Knee: An Evidence Update
November 2014 (PDF)

Related Resources

Quality-Based Procedures: Clinical Handbook for Knee Arthroscopy
August 2014 (PDF)

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The Ministry of Health and Long-Term Care endorses these recommendations.

The Ministry of Health and Long-Term Care has provided the following response: Although the Ministry is not aware of a field evaluation having taken place, arthroscopic meniscectomy is an insured service in Ontario and these recommendations are included in the Ministry and Health Quality Ontario's clinical handbook on knee arthroscopy, which is a publicly funded quality-based procedure.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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