Popular surgery provides no relief for osteoarthritis of the knee

Sep 10, 2008

A landmark study conducted in London, Canada at The University of Western Ontario and Lawson Health Research Institute shows that a routinely practiced knee surgery is ineffective at reducing joint pain or improving joint function for sufferers of osteoarthritis. The study appears in the September 11th New England Journal of Medicine.

"This study provides definitive evidence that arthroscopic surgery provides no additional therapeutic value when added to physical therapy and medication for patients with moderate osteoarthritis of the knee," says study co-author Dr. Brian Feagan, Clinical Trials Director at the Robarts Research Institute at Western. Feagan is also a professor of Medicine, and Epidemiology and Biostatistics at Western's Schulich School of Medicine & Dentistry.

Arthroscopic surgery is widely accepted as an effective treatment for osteoarthritis of the knee. It's a minimally invasive surgical procedure involving insertion of an arthroscope and other instruments into the joint through small incisions in order to remove cartilage fragments and smooth the joint surfaces. Osteoarthritis is the most common form of arthritis affecting one in ten Canadians and 27 million Americans.

The study was designed by the late Sandy Kirkley, an orthopedic surgeon specializing in arthroscopic surgery. It was coordinated by the Clinical Trials Group at Robarts Research Institute and conducted by orthopedic surgeons at the Fowler Kennedy Sport Medicine Clinic at London Health Sciences Centre (LHSC). The research team also included rheumatologists and physiotherapists.

Running from 1999 to 2007, the study treated 178 London-area men and women with an average age of 60. All study participants received physical therapy as well as medications such as ibuprofen or acetaminophen, but 86 of the patients also received surgery consisting of lavage and arthroscopic debridement at LHSC. At several time intervals post-treatment, the researchers found both patient groups experienced comparable improvements in joint pain, stiffness, and function, but surgery provided no additional benefit.

Orthopedic surgeon and study co-author Dr. Bob Litchfield emphasizes this study addresses only arthritis-related knee problems. "Although this study did not show a significant therapeutic benefit of arthroscopic debridement in this patient population, knee arthroscopy is still beneficial in many other conditions affecting the knee, such as meniscal repair and resection, and ligament reconstruction." Litchfield is the Medical Director of the Fowler Kennedy Sport Medicine Clinic. He's also a professor In the Department of Surgery at Western's Schulich School of Medicine & Dentistry and a scientist with the Lawson Health Research Institute. "As surgeons, we need to know when things are working and when they're not. If this particular technique is not working for this subgroup of patients, we better come up with something else that does."

A 2002 study demonstrating similar results to this study was broadly dismissed by the medical community, and arthroscopic surgery of the knee remains a common treatment for joint pain and stiffness. But in this latest study the researchers conclude "based on the available evidence, we believe that the resources currently allocated towards arthroscopic surgery for osteoarthritis would be better directed elsewhere."

Source: University of Western Ontario

Explore further: Ebola scare boosts business for US company

add to favorites email to friend print save as pdf

Related Stories

Form Devices team designs Point as a house sitter

4 hours ago

A Scandinavian team "with an international outlook" and good eye for electronics, software and design aims to reach success with what they characterize as "a softer take" on home security. Their device is ...

Man pleads guilty in New York cybercrime case

7 hours ago

A California man has pleaded guilty in New York City for his role marketing malware that federal authorities say infected more than a half-million computers worldwide.

NASA issues 'remastered' view of Jupiter's moon Europa

16 hours ago

(Phys.org) —Scientists have produced a new version of what is perhaps NASA's best view of Jupiter's ice-covered moon, Europa. The mosaic of color images was obtained in the late 1990s by NASA's Galileo ...

Dish restores Turner channels to lineup

16 hours ago

Turner Broadcasting channels such as Cartoon Network and CNN are back on the Dish network after being dropped from the satellite TV provider's lineup during contract talks.

Recommended for you

Ebola scare boosts business for US company

2 hours ago

The Ebola scare has subsided in the United States, at least temporarily, but an Alabama manufacturer is still trying to catch up with a glut of orders for gear to protect against the disease.

Thai parliament votes to ban commercial surrogacy (Update)

10 hours ago

Thailand's parliament has voted to ban commercial surrogacy after outrage erupted over the unregulated industry following a series scandals including the case of an Australian couple accused of abandoning a baby with Down's ...

Doctor behind 'free radical' aging theory dies

Nov 25, 2014

Dr. Denham Harman, a renowned scientist who developed the most widely accepted theory on aging that's now used to study cancer, Alzheimer's disease and other illnesses, has died in Nebraska at age 98.

Mexican boy who had massive tumor recovering

Nov 25, 2014

An 11-year-old Mexican boy who had pieces of a massive tumor removed and who drew international attention after U.S. officials helped him get treatment in the southwestern U.S. state of New Mexico is still recovering after ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.