News Article - Study: Common Knee Surgery Doesn't Work

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Study: Common Knee Surgery Doesn't Work

Arthroscopic Surgery Not Recommended For Some Patients

UPDATED: 9:42 a.m. EDT July 11, 2002

BOSTON -- Walking, climbing, biking -- if these activities make your knees

ache, you might suffer from osteoarthritis of the knee -- and you wouldn't

be alone.

Millions of people have the condition, and hundreds of thousands of them

turn to arthroscopic surgery for relief, but a new study is casting

tremendous doubt on whether it's effective at all.

Benotti just had knee surgery. He's an equipment operator suffering

from osteoarthritis, and he needed relief.

" You've always got this leg down to the floor pressing on the throttle, and

it gets sore, " Benotti said.

Arthroscopic surgery is what his doctor ordered. The procedure clears out

debris and repairs damaged cartilage in the hopes of decreasing pain and

increasing mobility.

That may be the hope, but according to a new study published in Thursday's

issue of the New England Journal of Medicine, that's not always the result.

" For most patients with osteoarthritis, based on this study, I wouldn't

recommend it, " Boston University School of Medicine's Dr. Felson said.

Neither does the study, which found that arthroscopic surgery is no more

effective than a placebo procedure.

Researchers from the Department of Veterans Affairs and Baylor College of

Medicine performed the operation to clear out debris or repair damaged

cartilage on some subjects. But on others, they just made incisions. The

study found those who had the fake surgery reported the best results.

New England Baptist Hospital's Dr. McKeon would agree, but believes

the surgery is useful in certain cases -- like Benotti's.

" Somebody who has baseline arthritis and they have a sudden change in their

pain -- or something got tore off -- a piece of cartilage, " McKeon said.

In those cases, McKeon said that arthroscopy can be helpful, but in the

majority of cases, people would be better off looking elsewhere.

" Anti-inflammatories are quite effective. Muscle conditioning is quite

effective. Losing weight is probably very effective, " Felson said about ways

to decrease pain.

Still, the idea that a procedure performed on 650,000 patients annually at a

cost of about $5,000 each is sometimes worthless is more than a little

shocking.

" The evidence is persuasive. This study strongly suggests that this

treatment is overdone, " Felson said.

The American Academy of Orthopaedic Surgeons wants to see more data before

it makes any hard and fast recommendations.

Meanwhile, there is speculation that a treatment that costs about $5,000 may

not be covered by some insurers.