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: Radiologist recommendations for chest CT have high clinical yield

add to favorites email to friend print save as pdf

Related Stories

Surfaces that communicate in bio-chemical Braille

Oct 01, 2014

A Braille-like method that enables medical implants to communicate with a patient's cells could help reduce biomedical and prosthetic device failure rates, according to University of Sydney researchers.

Depression can worsen knee arthritis symptoms in older adults

Mar 16, 2011

Clinical depression can exacerbate the symptoms of knee arthritis beyond what is evident on X-rays, according to a new study from the Journal of Bone and Joint Surgery (JBJS). Patients with mild to moderate knee arthritis are es ...

Knee-deep sensing

Aug 19, 2014

A new, non-invasive technique to track the motion of knee bones in 3D with a very high precision has been presented by researchers in Australia. By employing a single-element ultrasound sensor and a fast ...

The fix is in: Team studies self-healing polymers

Aug 07, 2014

(Phys.org) —A surfboard that seals its own cracks without having to cure in the sun for days. Underwater structures that can be fixed with less work and downtime. Joints that are almost instantly stronger ...

Materials scientists turn to collagen

Jun 05, 2014

(Phys.org) —Miniature scaffolds made from collagen – the 'glue' that holds our bodies together – are being used to heal damaged joints, and could be used to develop new cancer therapies or help repair ...

A smart prosthetic knee with in-vivo diagnoses

Apr 22, 2014

The task was to develop intelligent prosthetic joints that, via sensors, are capable of detecting early failure long before a patient suffers. EPFL researchers have taken up the challenge.

Recommended for you

New approach to particle therapy dosimetry

Dec 19, 2014

Researchers at the National Physical Laboratory (NPL), in collaboration with EMRP partners, are working towards a universal approach to particle beam therapy dosimetry.

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.