Abstract
BACKGROUND: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by pain and limited joint function. Arthroscopic debridement is a commonly used surgical intervention; however, its efficacy remains controversial. This study aimed to identify factors influencing the clinical outcomes of arthroscopic treatment for KOA. METHODS: This retrospective cohort study included 169 patients with KOA treated between January 2019 and December 2023. Patients were divided into an observation group (arthroscopic debridement, n=85) and a control group (integrated traditional Chinese and Western medicine conservative treatment, n=84) according to the treatment modality. The visual analog scale (VAS) score, Lysholm knee score, range of motion (ROM), and Kellgren-Lawrence (K-L) grade were assessed preoperatively and at 1, 4, 7, and 24 months postoperatively. Multivariate logistic regression analysis was performed to identify predictors of treatment efficacy, and a nomogram model was constructed for outcome prediction. RESULTS: The observation group exhibited significantly lower VAS scores and higher Lysholm scores at 1, 4, and 7 months postoperatively compared with the control group (all P < 0.05). Improvements in ROM and K-L grade were also more pronounced in the observation group. Multivariate analysis identified body mass index (BMI) > 26 kg/m(2), higher K-L grade, and higher Outerbridge grade as significant predictors of worse treatment outcomes. The nomogram demonstrated good predictive performance (concordance index = 0.82, area under the curve = 0.83). CONCLUSION: BMI, K-L grade, and Outerbridge grade are key determinants of clinical outcomes following arthroscopic treatment for KOA. The proposed nomogram offers a practical tool for preoperative prediction of surgical efficacy.