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Arthroscopic Knee Surgery Not Effective For Older Patients

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A new study has questioned the benefits of arthroscopic knee surgery — a type of keyhole surgery — for middle-aged or older patients with knee pain and degenerative knee disease.

The research suggests that far fewer knee surgeries should be carried out because the procedure offers “no real benefit” to middle-aged or older patients with persistent knee pain, according to a linked British Medical Journal editorial written by Professor Andrew Carr, head of Oxford University´s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences.

Led by the University of Southern Denmark, the study reviewed data from nine previous trials assessing the benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement or both for middle-aged or older patients with knee pain and degenerative knee disease.

A small difference was seen in favour of interventions including arthroscopic surgery compared with control treatments for pain.

However, the benefits were described as being small and inconsequential, with any improvement in pain levels recorded after six months disappearing within one to two years. What´s more, the potential harms caused by this type of surgery were found to be potentially serious, including an elevated risk of symptomatic deep venous thrombosis, pulmonary embolism, infection and death.

“These findings do not support the practice of arthroscopic surgery for middle-aged or older patients with knee pain with or without signs of osteoarthritis,” the researchers concluded.

Commenting on the study, Professor Carr said: “It is difficult to support or justify a procedure with the potential for serious harm, even if it is rare, when that procedure offers patients no more benefit than placebo. With rates of surgery at their current level, a substantial number of lives could be saved and deep vein thrombosis prevented each year if this treatment were to be discontinued or diminished.”