Surgery for Knee Arthritis Doesn't Beat Placebo
A new study reported in the New England Journal of Medicine casts serious doubt over whether arthroscopic surgery for knee arthritis is worthwhile.

The study found that one-hundred-and-twenty men who received either of two common types of arthroscopic surgery fared no better than a comparison group of sixty who received sham surgery in which surgeons made incisions but left the knee's interior untouched.

Two years later, those who received the real surgery showed no improvements on tests of knee function and experienced slight reductions in pain�?nearly the same results as for those who had sham surgery.

Arthritis occurs when the cartilage that cushions joints breaks down, leading to pain, swelling, and loss of mobility. With one type of arthroscopic knee surgery, lavage, a large needle flushes out tiny cartilage fragments with fluid. A second type, debridement plus lavage, trims damaged tissue fragments and smooths interior sur-faces before flushing the debris. More than 650,000 such procedures, costing about five-thousand dollars each, are performed in the US each year.

An accompanying editorial says a small subset of people with knee arthritis, such as those with loose flaps of cartilage, might still benefit from arthroscopic surgery, but concludes that such surgery is probably not effective in most cases. The editorial's authors speculate that surgery often fails because it doesn't address root causes of arthritis, such as muscle weakness and obesity.

from Earth Star Magazine, March 03