Why Knee Surgery is Often Unnecessary
There are two obvious reasons why knee operations are avoided: cost and safety. Regardless of those issues, the assumption has always been that if a doctor recommends surgery, you should get it.
However, a recent study reveals that arthroscopic knee surgery is unnecessary and ineffective as a strategy to heal a torn meniscus, as discussed by Peter Sergo in Medical Daily.
Sham achieves same results
The study, carried out in Finland and appearing in the New England Journal of Medicine in 2013, studied outcomes of the surgery in individuals with damaged menisci. Ranging from 35 to 65 years, the patients selected for participation were randomly placed in one of two groups to compare the degree of knee pain relief offered by arthroscopic surgery: one group received the procedure, while the other was given a mock operation (so that neither group knew whether they should expect improvement). The researchers revealed that the two populations both communicated a similar, higher degree of comfort 12 months afterward.
This isn’t the first time research has suggested that surgical approaches have nonexistent or negligible impact as knee pain solutions, noted Dr. David Jevsevar, evidence-based committee chair of the American Academy of Orthopaedic Surgeons. Speaking with the New York Times, Jevsevar commented that it’s now that some operations are unnecessary. However, what is not yet obvious is the percentage of arthroscopy that is pointless.
“We still think there’s benefit in arthroscopic meniscectomy in appropriate patients,” Jevsevar said. “What we need to define in the future is what’s the definition of ‘appropriate patient.’”
Knee surgery research background
If arthroscopic techniques are indeed ineffective as knee pain solutions, that is terrible news for the 700,000 patients who may have needlessly undergone the surgery in 2013 at a total expense of approximately $4 billion.
As indicated above, concern surrounding the true potential of arthroscopic surgery to deliver knee pain relief is bolstered by previous studies. Research released in 2002 essentially matched the results of the 2013 Finnish one: the real surgery group did not fare any better than the control. A subsequent clinical trial in Canada determined that outcomes following treatment with physical therapy vs. arthroscopy differed only insignificantly.
Turning away from surgery
Many physicians are now being very cautious about recommending surgery for meniscal tears and other knee pain conditions. Orthopedist Kenneth Fine explained to the Times how he now advises his patients: “I tell them, ‘No. 1, I’m not so sure the meniscal tear is causing your pain, and No. 2, even if it is, I’m not sure the surgery’s going to take care of it.’”
People have tended to want surgery because it is (quite literally) a clear-cut option, but studies have repeatedly demonstrated that nonsurgical solutions are preferable. The latter is our specialty at Diagnostic Health & Injury, where we offer knee pain relief through non-surgical, safe solutions.