Should you get arthroscopic knee surgery to fix arthritis?

More than 650,000 arthroscopic knee procedures are performed for knee pain each year in the United States.

These cost an average cost of $5,000 each.

But the greatest cost may be in recovery time, in pain and suffering, and in things being worse down the line.

If so many surgeries are being done, then there must be a good reason for that, right?

Not so fast.

Let’s take a closer look.

With drugs, the FDA requires that the drug company to show that the drug has some short-term effect.

A diabetes medication must be shown to lower blood sugar at least for six months or a year.

That’s really not a very high bar to jump over.

But it’s something.

With surgeries, there is no bar.

A surgeon can do anything he wants, and there really is no regulation of which surgeries are appropriate for what.

So now we have 650,000 new procedures being done per year, but they’re not a good idea.

These surgeries actually make the knee problems WORSE, not better.

2016-05-09_14-39-49The gold standard for any drug or surgery is to be tested in a randomized, controlled trial.

With drug trials, it’s a simple matter to set up and complete a valid study of this sort.

For surgery, this is a bit more difficult, but this study did it.

The only way that you can reliably know if surgery helps or harms is to assign knee patients randomly to one of two groups.

In this study, neither the patient or the doctor knew which group the patients were assigned.

Then they completed either real surgery done on the knee or sham surgery.

In sham surgery, they opened up the knee, they produced a scar and pretended that they did the actual surgery.

And almost nobody knows that they didn’t do the actual surgery.

2016-05-09_14-51-07Now they compared the function of people in the two groups.

They compared those who had sham surgery and compared them to the people that had the real surgery.

In this case, the sham surgery patients did better than the people that actual arthroscopic surgery.

The sham surgery people healed a bit quicker and felt less pain.

This is not the only study to show that arthroscopic surgery for most conditions actually hurts the knee, and doesn’t help it.

But I can’t but help notice that there are still 650,000 of these worse than useless surgeries done each year.

This is an astonishing and ridiculous outcome.

There is no question that the standard of care for treating arthritic knees not include new surgery.

And yet 650,000 people per year are putting themselves through this procedure that will make things worse.

I hope you are not one of those people.

 

Citations

Arthroscopic Knee Surgery Little Help for Arthritis
http://www.arthritis.org/living-with-arthritis/treatments/joint-surgery/types/knee/arthroscopic-knee-surgery.php

A randomized trial of arthroscopic surgery for osteoarthritis of the knee
http://www.nejm.org/doi/full/10.1056/NEJMoa0708333#t=article

See this for more on Knee Surgery, and see more on Living Healthy, and for more information see effects of Arthroscopic Knee Surgery.