An arthroscopy is a type of keyhole surgery used both to diagnose and treat problems with joints. It's most commonly used on the knees, ankles, shoulders, elbows, wrists and hips.
An arthroscopy involves the use of a device called an arthroscope to examine the joints. This is a thin, metal tube about the length and width of a drinking straw that contains a light source and a camera. Images are sent from the arthroscope to a video screen or an eyepiece, so the surgeon is able to see inside the joint.
It's also possible for tiny surgical instruments to be used alongside an arthroscope to allow the surgeon to treat certain joint conditions
Proposed revisions to the eligibility criteria
Knee Arthroscopy procedures are categorised as Not Routinely Funded. This means for patients requiring Knee Arthroscopy, the CCG will only fund the treatment if an Individual Funding Request (IFR) application proves exceptional clinical need.
Will only be funded for:
Removal of loose body when there is clear history of locking and reported history of other treatment failing
Repair of cruciate ligament Synovectomy/Symptomatic Plica
Knee “washout” (arthroscopic lavage) for osteoarthritis will not be funded unless there is clear documented history of mechanical locking (not gelling, giving way or x-ray evidence of loose bodies)
Continued diagnostic use following MRI in the following circumstances:
When the MRI report shows significant degree of movement deficit
If the patient has an Anterior Cruciate Ligament reconstruction and the metal screws are affecting the MRI image quality
Patient has a Pacemaker
If there are Red Flag symptoms or signs including: recent trauma, constant progressive non-mechanical pain (particularly at night), previous history of cancer, long term steroid use, history of drug abuse, history of HIV, fever, being systematically unwell, recent unexplained weight loss, persistent severe restriction of joint movement, widespread neurological changes, and structural deformity.
If there are Red Flag conditions: infection, carcinoma, nerve root impingement, bony fracture and avascular necrosis.
Will not be funded and should not be undertaken in any of the following circumstances:
Diagnostic purposes only (note the above exceptions)
Treatment of osteoarthritis (arthroscopic lavage) “washout” and debridement. In line with NICE Guidance CG59/177; this should not be offered as part of a treatment for osteoarthritis unless the person has a clear documented history of mechanical locking (not gelling, giving way or x-ray evidence of loose bodies)
Arthroscopic lavage (“washout” – HRG: HB25B, HB25C) will only be funded as a clinical exceptional case and funding request should be via Individual Funding Request.