A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
New England Journal of MedicinePublished 11 July 2002Open access
J. Bruce Moseley, Kimberly J. OʼMalley, Nancy J. Petersen, Terri Menke, Baruch A. Brody, David H. Kuykendall
Citations2,113
SJR quartileQ1
SJR score19.08
SNIP13.47
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TL;DR
In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthro scopic débridement were no better than those after a placebo procedure.
Abstract
In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure.
Keywords
Medicine
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Source Citation Moseley JB, O’Malley K, Petersen NJ, et al.
