Dutch Guideline on Knee Arthroscopy Part 1, the meniscus: a multidisciplinary review by the Dutch Orthopaedic Association

Abstract

Background and purpose — A guideline committee of medical specialists and a physiotherapist was formed on the initiative of the Dutch Orthopedic Association (NOV) to update the guideline Arthroscopy of the Knee: Indications and Treatment 2010. This next guideline was developed between June 2017 and December 2019. In this Part 1 we focus on the meniscus, in Part 2 on all other aspects of knee arthroscopy.

Methods — The guideline was developed in accordance with the criteria of the AGREE instrument (AGREE II: Appraisal of Guidelines for Research and Evaluation II) with support of a professional methodologist from the Dutch Knowledge Institute of Medical Specialists. The scientific literature was searched and systematically analyzed. Conclusions and recommendations were formulated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. Recommendations were developed considering the balance of benefits and harms, the type and quality of evidence, the values and preferences of the people involved, and the costs. Here in Part 1 we focus on the diagnosis of meniscal pathology, treatment of meniscal injuries, and persistent pain after meniscal repair and after treatment. In this guideline, the importance of nonoperative treatment of degenerative meniscal tears, the potential for spontaneous healing of traumatic meniscal tears, and encouragement to repair rather than resect meniscal tears when possible are highlighted. The guideline is published online, in Dutch, and is available from the Dutch Guideline Database (https://richtlijnendatabase.nl/?query=Artroscopie+van+de+knie+&specialism=)