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Numerous knee surgery without benefit
Many people develop knee problems in old age, such as joint wear or damage to the meniscus, which increasingly affects them. Here, arthroscopy (minimally invasive knee surgery) promises relief against chronic knee pain, but warns the renowned journal "British Medical Journal" (BMJ) in the context of the campaign "Too much Medicine" against the dubious benefits of arthroscopy. Researchers in Denmark and Sweden had reviewed the results of 18 studies on the benefits and harms of arthroscopic surgery and found no significant benefits from the procedure, reports the BMJ. In addition, there is the risk of serious side effects.
Knee surgeries in the form of arthroscopy are among the most common surgical procedures in modern industrial nations. "Over 700,000 knee arthroscopies are performed in the US and 150,000 in the UK each year in middle-aged and elderly patients with persistent knee pain," reports the BMJ. But the evidence for the benefits of arthroscopic surgery has always been weak. The current study does not recognize any relevant additional benefit for surgery compared to non-invasive treatments, but many specialists are still convinced of their advantages.
Tens of thousands of arthroscopy are performed annually in Germany, but their benefits remain doubtful. (Picture: Picture-Factory / fotolia.com) Study results do not support the use of arthroscopy
According to the "BMJ", in the current evaluation, nine randomized trials with a total of 1,270 patients recognized slight benefits from surgery, with the patients ranging in age from 48 to 63 years and the study period between three and 24 months. Overall, arthroscopy was associated with a small but significant effect on pain after three and six months (but not more) compared to control treatments. There were no significant benefits in terms of physical function. A further nine studies reported "rare injuries" as a result of the procedure, with deep vein thrombosis (DVT) being the most common adverse event, followed by infection, pulmonary embolism, and even death, according to "BMJ." "Arthroscopic interventions are associated with little benefit and harm," the researchers report. In any case, the benefit is significantly lower than with exercise therapy. "These results do not support the common practice of arthroscopic surgery as a treatment for middle-aged or elderly patients," the researchers concluded.
Moving away from the usual practice required
"It's difficult to support or justify a procedure that has the potential for serious harm unless it's more useful to patients than a placebo," commented Professor Andy Carr of Oxford University in an accompanying editorial , Numerous lives could be saved and deep venous thrombosis prevented if the arthroscopies were deleted or reduced, Professor Carr continued. In his assessment, the medicine is nearing a turning point and when this is achieved, will be a quick departure from the usual practice. In any case, with movement therapy, manual therapies such as osteopathy or Rolfing and various alternative medical approaches, the chronic knee joint pain can be successfully contained in many cases. An operation is therefore not required here. (Fp)