The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Arthroscopic radiofrequency chondroplasty for discrete chondral defects of the knee in June 2014.
Discrete chondral defects in articular cartilage usually occur as a result of trauma. The rough, irregular edges of a defect may cause inflammation, swelling, pain and difficulty walking. Progressive degeneration of a chondraldefect can expose the underlying bone and lead to arthritis. If pieces of cartilage break off from the edges of a chondral defect, this may cause cartilage damage elsewhere in the knee and lead to further arthritic changes.
Treatment options depend on the size and site of the chondral defect. The condition is usually chronic and different treatment strategies may be needed at different stages. Conservative treatment includes analgesics to relieve pain and inflammation. Physiotherapy and/or prescribed exercise may be used to improve knee function and mobility.
W83.5 Endoscopic articular thermal chondroplasty
Y13.4 Radiofrequency controlled thermal destruction of lesion of organ NOC
Z84.6 Knee joint
Z94.- Laterality of operation
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.