Evidence map›Paper›PMID 28495819›Full record

SynthesisBMJ open2017

Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review.

Romina Brignardello-Petersen, Gordon H Guyatt, Rachelle Buchbinder, Rudolf W Poolman, Stefan Schandelmaier, Yaping Chang, Behnam Sadeghirad, Nathan Evaniew, Per O Vandvik

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04370678 (Changes in Preference for Surgery of Patients Signed up for Arthroscopic Procedures), which is not on this map. Cited by 63 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 11 pooled it
14.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04370678 completednot on this mapstarted 2020, after this paper: background citation

Changes in Preference for Surgery of Patients Signed up for Arthroscopic Procedures: COVID-19 Effect on Arthroscopic Patients in a University Hospital in Denmark

TypeobservationalSponsorRegion ZealandRan2020 to 2020Enrolled79ConditionsArthroscopyArmsChange in preference to surgery under COVID-19 pandemic.
3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 11 syntheses or guidelines pooled it, 141 citations in OpenAlex.

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  7. Surgical interventions for symptomatic mild to moderate knee osteoarthritis.The Cochrane database of systematic reviews · 2019
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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 7 countries.

Romina Brignardello-PetersenDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Gordon H GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Rachelle BuchbinderDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Rudolf W PoolmanDepartment of Orthopedic Surgery and Traumatology, Joint Research, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands.
Stefan SchandelmaierDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-8429-0337
Yaping ChangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Behnam SadeghiradDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Nathan EvaniewDivision of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Per O VandvikDepartment of Medicine, Innlandet Hospital Trust-Division Gjøvik, Gjøvik, Norway.
Impact · CACabrini Hospital · AUKerman University of Medical Sciences · IRMcMaster University · CAOLVG · NLUniversity Hospital of Basel · CHUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the effects and complications of arthroscopic surgery compared with conservative management strategies in patients with degenerative knee disease.

designSystematic review.

main outcome measuresPain, function, adverse events. DATA SOURCES: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and Open Grey up to August 2016. ELIGIBILITY CRITERIA: For effects, randomised clinical trials (RCTs) comparing arthroscopic surgery with a conservative management strategy (including sham surgery) in patients with degenerative knee disease. For complications, RCTs and observational studies. REVIEW

methodsTwo reviewers independently extracted data and assessed risk of bias for patient-important outcomes. A parallel guideline committee (

resultsWe included 13 RCTs and 12 observational studies. With respect to pain, the review identified high-certainty evidence that knee arthroscopy results in a very small reduction in pain up to 3 months (mean difference =5.4 on a 100-point scale, 95% CI 2.0 to 8.8) and very small or no pain reduction up to 2 years (mean difference =3.1, 95% CI -0.2 to 6.4) when compared with conservative management. With respect to function, the review identified moderate-certainty evidence that knee arthroscopy results in a very small improvement in the short term (mean difference =4.9 on a 100-point scale, 95% CI 1.5 to 8.4) and very small or no improved function up to 2 years (mean difference =3.2, 95% CI -0.5 to 6.8). Alternative presentations of magnitude of effect, and associated sensitivity analyses, were consistent with the findings of the primary analysis. Low-quality evidence suggested a very low probability of serious complications after knee arthroscopy.

conclusionsOver the long term, patients who undergo knee arthroscopy versus those who receive conservative management strategies do not have important benefits in pain or function. TRIAL REGISTRATION NUMBER: PROSPERO CRD42016046242.

Indexed as

Conservative TreatmentArthroscopyHumansKnee JointObservational Studies as TopicOsteoarthritis, KneePractice Guidelines as TopicQuality of LifeRandomized Controlled Trials as TopicSeverity of Illness IndexTreatment OutcomearthritisGRADEknee painmeniscus tearOsteoarthritis

Identifiers

PMID28495819
PMCPMC5541494
OpenAlexW2612540102

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.