Knee surgery for arthritis is ineffective: study

By IANS,

Toronto : A new Canadian study shows that the popular knee surgery for arthritis is actually ineffective in reducing joint pain or improving joint function.


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Arthroscopic surgery, currently considered an effective treatment for osteoarthritis of the knee, is performed for inserting an arthroscope and other instruments into the joint to remove cartilage fragments and smoothen the joint surfaces.

But a landmark study by the University of Western Ontario at Waterloo near here, and the Lawson Health Research Institute, about 200 km from here, shows that arthroscopic surgery has no additional benefits for patients.

“This study provides definitive evidence that arthroscopic surgery provides no additional therapeutic value when added to physical therapy and medication for patients with moderate osteoarthritis of the knee,” said study co-author Brian Feagan of the University of Western Ontario.

As part of their eight-year-long study, which ran from 1999 to 2007, researchers – orthopaedic surgeons, rheumatologists, and physiotherapists – subjected 178 men and women – with an average age of 60 – to two different treatments.

While all participants received physical therapy as well as medications, including ibuprofen or acetaminophen, only 86 of the patients also received surgery consisting of lavage and arthroscopic debridement.

At intervals after the treatment, the researchers found that both groups experienced comparable improvements in joint pain, stiffness, and function, but surgery provided no additional benefit.

The research confirms the similar results of another study in 2002 which was dismissed by the medical community.

However, study co-author Bob Litchfield was quick to add, “Although this study did not show a significant therapeutic benefit of arthroscopic debridement in this patient population, knee arthroscopy is still beneficial in many other conditions affecting the knee, such as meniscal repair and resection, and ligament reconstruction.

“As surgeons, we need to know when things are working and when they’re not. If this particular technique is not working for this subgroup of patients, we better come up with something else that does.”

Osteoarthritis is the most common form of arthritis affecting 3.3 million Canadians and 27 million Americans.

The study appears in this week’s issue of New England Journal of Medicine.

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