News

Doubtful surgeries: Arthroscopic surgery doesn't help with knee arthritis


Experts study effectiveness of arthroscopic surgery
An international panel of surgeons and patients has examined the effectiveness of one of the most common orthopedic procedures. The experts found that the use of arthroscopic surgery in patients with degenerative knee problems does not bring about permanent pain relief or improvement.

An international team of scientists found in their investigation that the use of arthroscopic surgery in patients with degenerative knee problems does not really improve. The doctors published the results of their analysis of various studies in the British Medical Journal (BMJ).

Surgery does not lead to permanent pain relief
For their investigation, the experts analyzed the results of 13 studies with a total of almost 1,700 patients. They found that the operation did not permanently relieve pain or improve function for most of those affected. The studies examined compared the effects of surgery to a variety of options, including physiotherapy, exercise, and also placebo surgery, the scientists explain.

Pain relief was no longer available after one year
Less than 15 percent of patients felt an improvement in pain and knee function three months after the procedure, the doctors say. However, this effect was no longer present after about a year, the researchers further explain. In addition, the use of surgery can lead to rare but dangerous damage such as infections, the experts add.

What happens in arthroscopic knee surgery?
With arthroscopic knee surgery, doctors make several small incisions around the joint. Then they use a tiny camera to look into the knee and fix identified problems with the help of small instruments. The surgery is often performed to remove part of a damaged meniscus, the scientists say. This form of surgery is performed more than two million times a year around the world. In the United States alone, these operations cost more than $ 3 billion annually.

Many organizations make recommendations against arthroscopy in patients with arthritis
The panel's recommendations are consistent with guidelines from a number of medical groups. Most of these organizations have made recommendations against arthroscopy for patients with arthritis if the arthritis can be detected by an x-ray, the authors explain.

exceptions prove the rule
The guidelines of the American Academy of Orthopedic Surgeons recommend that patients with arthritis not perform this type of treatment. This recommendation is also confirmed by the new study. However, the generalization of a large number of randomized studies does not necessarily take individual patient circumstances into account, the experts warn. The guidelines do not apply to every patient. There will always be exceptions.

Pain relief from surgery is just too little
Some people's frustration with the results of the investigation is understandable, especially when those affected saw the surgery as a way to improve their health problems, explains lead author Reed Siemieniuk. Despite positive personal experiences, the evidence suggests that the results may not be as good for the patient, the expert adds. Reading the studies examined showed that the pain relief received was too low to be classified as relevant.

Surgery is no more effective than pain relief exercises
The evaluation of the studies in the BMJ is the latest in a series of studies that raised concerns about this form of surgery. The magazine published a study by researchers from Denmark back in 2015. At the time, this showed that arthroscopic repair of the meniscus was not much more effective for middle-aged people than various exercises to relieve pain. In addition, there is a risk of debilitating side effects from the operation. (as)

Author and source information



Video: Arthroscopic Surgery for Joint Pain: Ross Wodicka, MD, Orthopedic Surgeon (December 2021).