RAG rating
Document type
Clinical policy
Hertfordshire and West Essex ICB
Output type
Clinical Policies & Evidence-based Interventions

Knee Arthroscopy – local supplement

July 2022 v1.0

This is a local EBI policy supplement to the national EBI guidance (list 1) on debridement and lavage (washout) and list 2 (meniscal tears, MRI in suspected osteoarthritis and MRI in suspected meniscal tear). 

Knee arthroscopy will be funded for: 

  • Surgery for osteochondral lesions 
  • Repair of cruciate ligament reconstruction 
  • Patella tracking/anterior knee pain including lateral release 
  • Synovectomy/symptomatic plica 
  • Diagnostic uncertainty where:

oMRI is contraindicated (e.g., due to patient’s specific type of implanted cardiac pacemaker or defribillator)

oMRI image cannot be interpreted due to low quality and it is clear that obtaining a high-quality MRI image would be unfeasible (e.g., patient has had an Anterior Cruciate Ligament reconstruction and the metal screws are affecting the image quality.

Knee arthroscopy will not be funded for: 

  • Diagnostic purposes only (noting the above exception) 
  • Investigation of knee pain (MRI is a less invasive alternative for the investigation of knee pain) 
  • Lavage and debridement as a treatment for osteoarthritis with no history of mechanical locking 
  • The use of autologous chondrocyte implantation for the treatment of cartilage defects in the knee joints – NICE TA477 (Oct 2017). 
  • Arthroscopic radiofrequency chondroplasty for discrete chondral defects of the knee - NICE IPG 493 (May 2014). 
  • Microstructural scaffold (patch) insertion without autologous cell implantation for repairing symptomatic chondrol knee defects - NICE IPG 560 (June 2016). 
  • Partial replacement of the meniscus of the knee using a biodegradable scaffold - NICE IPG 430 (July 2012). 
  • Mosaicplasty for knee cartilage defects – NICE IPG162 (March 2006)