This page is about arthroscopy only. You may wish to look at our page on “Knee Pain – Adults”. Find it by clicking on the A-Z list at the top of this page.
Diagnostic arthroscopy of the knee
Is NOT commissioned or funded for the investigation of knee pain.
Therapeutic arthroscopy of the knee
Arthroscopy of the knee can be undertaken where a competent history and clinical examination has demonstrated:
- Clear evidence of an internal joint derangement (meniscal tear, ligament rupture or loose body)
- Conservative treatment has failed or where it is clear that conservative treatment will not be effective
Occasionally MRI would be required but this would normally be requested by secondary care.
Knee arthroscopy can therefore be carried out for:
- Removal of loose body.
- Meniscal surgery (repair or resection).
- Ligament reconstruction/repair (including lateral relapse).
- Treatment of articular defects e.g. micro-fracture.
- Treatment of osteoarthritis (only in line with NICE guideline (CG177).
A proportion of knee arthroscopies may not lead to the anticipated therapeutic intervention, and therefore will be coded as diagnostic arthroscopies.
Surgeons are asked to ensure that coding of the arthroscopy is undertaken after the procedure has taken place.
Knee Arthroscopy for Osteoarthritis
Knee Arthroscopy for Osteoarthritis is NOT routinely funded.
Arthroscopic knee washout (lavage and debridement) should NOT be used as a treatment for osteoarthritis because it is clinically ineffective.
Referral for arthroscopic lavage and debridement should NOT be offered as part of treatment for osteoarthritis, unless the person has knee osteoarthritis with a clear history of mechanical locking.
More effective treatment includes exercise programmes (e.g. ESCAPE pain), losing weight (if necessary) and managing pain. Osteoarthritis is relatively common in older age groups.
Where symptoms do not resolve after non-operative treatment, referral for consideration of knee replacement, or joint preserving surgery such as osteotomy is appropriate.
Occasionally MRI would be required but this would normally be requested by secondary care
Prior Approval Form (usually completed by Secondary Care Clinician)