Numerous knee operations without benefit

Numerous knee operations without benefit



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Arthroscopy, according to current studies, has no significant benefit
Many people develop knee problems in old age, such as joint wear or damage to the meniscus, which increasingly affect them. Here, arthroscopy (minimally invasive knee surgery) promises a remedy for chronic knee pain, but the renowned specialist magazine "British Medical Journal" (BMJ) warns of the dubious benefits of arthroscopy as part of the "Too much Medicine" campaign. Researchers in Denmark and Sweden have 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". There is also a risk of serious side effects.

Knee surgery in the form of arthroscopy is one of the most common surgical procedures in modern industrial nations. "Over 700,000 knee arthroscopies are performed in the United States and 150,000 in the United Kingdom each year on middle-aged and senior 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 benefits for surgery compared to non-invasive treatments, but many specialists are still convinced of their advantages.

Study results do not support the use of arthroscopy
According to the "BMJ", nine randomized studies with a total of 1,270 patients identified slight advantages in surgery in the current evaluation, with the age of the patients ranging 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 no longer) compared to the control treatments. There were no significant advantages in terms of physical function. In another nine studies, according to the "BMJ", rare damage as a result of the procedure was reported, with deep vein thrombosis (DVT) being the most common side effect - followed by infections, pulmonary embolism and also deaths. "Interventions in the form of arthroscopy are associated with a small assigned benefit and harm," the scientists report. In any case, the benefit is significantly less than with exercise therapy. "These results do not support the common practice of arthroscopic surgery as a treatment for middle or senior age patients," the researchers concluded.

A move away from the usual practice is required
"It is difficult to support or justify a procedure that has the potential for serious damage as long as this procedure does not benefit the patient more than a placebo," said Professor Andy Carr from Oxford University in an accompanying editorial commenting on the current results . Many lives could be saved and deep vein thrombosis prevented if the arthroscopy was removed or reduced, Professor Carr added. In his opinion, medicine is close to a turning point and when this has been reached, there will be a quick departure from the usual practice. In any case, movement therapy, manual therapies such as osteopathy or Rolfing and various alternative medical approaches can in many cases successfully curb chronic knee pain. An operation is therefore not necessary here. (fp)

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