Arthroscopic surgery is generally accepted as a treatment option for osteoarthritis of the knee. It is minimally invasive and allows for removal of cartilage fragments and smoothing the surfaces of the joint.
In what is being called a “landmark” study recently conducted in Canada at the University of Western Ontario and Lawson Health Research Institute, arthroscopic knee surgery has been shown to be ineffective at reducing joint pain or improving joint function beyond physical therapy and medication for patients with moderate knee osteoarthritis.
The study was conducted from 1999 to 2007 and included 178 people from the London, Canada area. The group’s average age was 60 years. All of the patients were provided physical therapy and pain relievers, such as acetaminophen or ibuprofen. 86 of the patients also received arthroscopic surgery. Follow up exams during the next 2 years found that all of the patients had similar improvements in joint pain and function and those who had surgery received no additional benefit.
Study co-author and orthopedic surgeon Dr. Bob Litchfield, Medical Director of the Fowler Kennedy Sport Medicine Clinic, points out that this study addresses only arthritis-related knee problems. “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.”
A study conducted in 2002 compared arthroscopic knee surgery to placebo knee surgery and found that there was no difference in the amount of pain relief experienced by the patients. The findings were published in the July 11, 2002 issue of the New England Journal of Medicine and challenged the usefulness of knee surgery as a treatment for knee osteoarthritis. However, the conclusions were broadly dismissed by the medical community and arthroscopic knee surgery continued to be a common treatment.
The current study concludes that “based on the available evidence, we believe that the resources currently allocated towards arthroscopic surgery for osteoarthritis would be better directed elsewhere.” This study has been published in today’s issue of the New England Journal of Medicine.
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