Arthroscopic knee surgery does little for osteoarthritis

Arthroscopic knee surgery does little for osteoarthritis

Posted By DR. DAVID LIPSCHITZ, CREATORS SYNDICATE
Posted 1 hour ago

Osteoarthritis of the knee is more frequent after the age of 50, but can occur at any age. On occasion, it is precipitated by an injury, but more commonly it occurs as a result of a lifetime of wear and tear. It can lead to a great deal of disability, interfering with mobility, increasing the risk of falls, contributing to deconditioning of the muscles, and markedly impairing quality of life.
For most adults, the presenting symptom is pain, which is made worse by movement. As the disease progresses, the knee can swell and become deformed. This condition can be very painful and difficult to manage, prompting many patients to look to arthroscopic surgery as a solution. However, new research indicates that the minimally invasive procedure may not be as beneficial as once thought.

In patients who continue to have pain despite treatment with analgesics, arthroscopic surgery may be recommended. The procedure involves inserting a flexible fiber-optic scope and other small instruments through a tiny incision in order to remove loose material in the knee, to smooth out irregular and damaged cartilage and to remove bone spurs. Often a torn meniscus is repaired.

Although arthroscopy's efficacy is controversial, there is a general feeling that arthroscopy greatly relieves symptoms and reduces the need for a total knee replacement.
In the past few years, this conventional wisdom has come into question. Two research studies recently published in the New England Journal of Medicine indicate that the value of arthroscopic surgery is questionable.

While there is little need for arthroscopic surgery, partial or total knee replacement remains a mainstay of therapy for those patients in whom pain is continually present and unrelieved by pain management, movement is very difficult and quality of life is poor. There is no question that this operation, done under the right circumstances, can be very successful. Remember, though, that appropriate medical care combined with exercise and weight loss may prevent the need for a major surgical procedure.