Mini Arthrotomy in the Management of Primary Osteoarthritis of the Knee Joint: A Literature Review

Abstract

Aims: This literature review aims to evaluate the possible role and limitations of mini arthrotomy in the management of primary knee osteoarthritis (OA), with attention to patient selection, clinical rationale, available evidence, and comparison with conservative, arthroscopic, and arthroplasty-based strategies. Study Design: Narrative literature review. Methodology: A narrative search of PubMed, Google Scholar, ScienceDirect, and guideline sources was performed using keywords related to knee osteoarthritis, mini arthrotomy, arthroscopy, debridement, loose bodies, osteophytes, and surgical treatment. English-language articles, guidelines, reviews, and clinically relevant comparative studies published mainly from 2000 to 2024 were considered. Evidence was synthesised descriptively because direct studies of mini arthrotomy for primary knee OA are limited. Results: Knee OA is a major cause of pain, disability, and reduced mobility. Conservative treatment remains the first-line approach, while surgery is considered for persistent symptoms or structural pathology. The available literature does not support mini arthrotomy as a disease-modifying procedure. Its potential role is limited to selected patients with mild to moderate OA, preserved joint space, and clear mechanical symptoms caused by loose bodies, focal osteophytes, or localised synovial pathology. Evidence for mini arthrotomy in primary knee OA is indirect and mostly extrapolated from minimally invasive open procedures, arthroscopy, debridement, and guideline recommendations. Therefore, claims of effectiveness should be interpreted cautiously. Conclusion: Mini arthrotomy may be considered only as a targeted symptomatic procedure in carefully selected patients with localised mechanical pathology, particularly where arthroscopy is unavailable or costly. It should not be presented as a routine treatment for primary knee OA or as an alternative to arthroplasty in advanced disease. Further prospective comparative studies are required to define its indications, outcomes, complications, durability, and cost-effectiveness.