Knee Surgery Useless?

Arthroscopic surgery will have only a placebo effect on those suffering from osteoarthritis of the knee, a new study shows.

Arthroscopic surgery, or surgery performed without the need for a big open incision, has been performed with great success on patients with knee injuries, reports health and medicine correspondent Emily Senay. Small incisions are made in the knee to insert a tube with a camera and a light so the surgeon repairing the damage can see. Other tubes that contain the surgical instruments also are used in this kind of surgery.

However, researchers have found there is little this kind of surgery can do for osteoarthritis of the knee, a progressive and painful degeneration of the knee.

Researchers compared two common types of arthroscopic surgery to a placebo surgery, where surface incisions were made but no surgery was performed. Doctors found that patients who received surgery felt no better than those in the placebo group, and none of the patients showed any improvement in walking or climbing stairs.

Placebo surgery is controversial because puts the patient at risk for infection and side effects of anesthesia. In this case, Dr. Senay says, the researchers argue it's warranted if it avoids surgery that's ineffective. In this country, that's a couple hundred thousand surgeries every year.

There are these other options for people with osteoarthritis of the knee, which should be considered before surgery:

• Painkillers and anti-inflammatories
• Physical therapy for stretching and strengthening
• Behavior modification - in other words "don't overdo it"
• Weight loss to avoid putting pressure on the joint
• Injections of cortisone or lubricant
• Heat or ice before activity.

The granddaddy of all treatments is a total knee replacement with an artificial knee. It's not an easy fix, but it's effective for at least 10 years.