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Do sports medicine clinicians have credible alternatives to knee arthroscopy for the degenerative knee?
  1. Kay M Crossley1,
  2. Joanne L Kemp2,
  3. Adam G Culvenor3,4,
  4. Christian J Barton2,5
  1. 1School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
  2. 2Latrobe Sports Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
  3. 3Paracelsus Medical University, Institute of Anatomy, Salzburg, Austria
  4. 4La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, vic, Australia
  5. 5Complete Sports Care, Hawthorn, Victoria, Australia
  1. Correspondence to Professor Kay M Crossley, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne 3086, Victoria, Australia; k.crossley{at}latrobe.edu.au

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The evidence refuting arthroscopy to treat meniscal degeneration and knee osteoarthritis (OA) is clear and compelling.1–3 At least 10 randomised controlled trials and a systematic review attribute knee arthroscopy with a clinically insignificant benefit (approximately 2.4 mm out of 100 mm for improved pain).1 2 Furthermore, knee arthroscopy confers no benefit when compared head to head with a cost-effective, supervised exercise therapy programme.4

Sports medicine clinicians are key providers of care for middle-aged patients with painful knees. If we ‘abandon ship’, abandon arthroscopy as a treatment option for our patients,3 what can we offer them? What can we say when a patient walks into our practice/clinic hoping for an arthroscopic ‘clean up’? What alternatives do we have?

The answer should be simple, but sadly, it is not. Current evidence and clinical guidelines recommend supervised exercise therapy and education.5 However, our recent unpublished survey of 116 physiotherapists (Australia and Canada) who regularly treat knee …

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