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Systematic review is the highest level of evidence for knee osteoarthritis injection options, not expert society guidelines
  1. John W Orchard
  1. Correspondence to Dr John Orchard, University of Sydney, School of Public Health, Sydney, NSW 2006, Australia; john.orchard{at}

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It was pleasing to read the BMJ-reprinted article of Buchbinder et al1 in the BJSM. Key recommendations from the article1 which are consistent with systematic review (SR) evidence include that knee arthroscopy is not superior to less invasive treatment for knee osteoarthritis (OA) (or degenerative meniscal tear); that degenerative meniscal tears are common in asymptomatic knees in the middle-aged and elderly; and that moderate level exercise is an effective treatment for knee OA.

Based on expert society guidelines only2 (not SRs), the authors make recommendations …

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.