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A panel of international health experts and patients on Wednesday challenged the effectiveness of one of the most common orthopedic procedures and recommended strongly against the use of arthroscopic surgery for patients with degenerative knee problems.
The guidelines, published in the journal BMJ, relied on 13 studies involving nearly 1,700 patients that found the surgery did not provide lasting pain relief or improve function. Those studies compared the surgery with physical therapy, exercise and even placebo surgery. It did not address the efficacy of total knee replacement surgery.
The experts said that fewer than 15 percent of patients who had arthroscopic knee surgery felt an improvement in pain and function three months later and that those effects disappeared after one year. In addition, the surgery exposed patients to “rare but important harms,” such as infection.
In an arthroscopic knee surgery, physicians make several small incisions around the joint and insert a tiny camera that allows them to see inside the knee as well as insert small instruments to correct problems they identify. Often the surgery is performed to remove damaged cartilage.
The panel said meniscal tears “are common, usually incidental findings, and unlikely to be the cause of knee pain, aching or stiffness.”
The panel said the surgery is performed more than 2 million times a year across the globe, and in the United States alone costs more than $3 billion annually.
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