Exercise could be just as effective as surgery for managing knee arthritis, claims study
A study claims arthroscopies should not be performed on those suffering painful degenerative knee disease because it rarely works.
In fact, a collaboration of international experts said the keyhole procedure to relieve pain and improve movement should be avoided in almost all patients.
Their recommendation is based on evidence that it does not result in lasting improvement in pain or function.
The panel said: “Knee arthroscopy has been oversold as a cure-all for knee pain.
“We make a strong recommendation against the use of arthroscopy in nearly all patients with degenerative knee disease.
“Further research is unlikely to alter this recommendation.”
Degenerative knee disease is a chronic condition in which symptoms fluctuate.
Each year around two million people go under the knife but the procedure is no better than traditional exercise or physiotherapy.
Knee arthroscopy has been oversold as a cure-all for knee pain
Around a quarter of those aged over 50 years experience pain from degenerative knee disease with weight loss, exercise and anti-infammatory drugs and surgery options to combat the debilitating pain.
Knee replacement is the only definitive therapy, but it is usually reserved for patients with the severest form of the disease.
The review by bone surgeons, physiotherapists, clinicians and patients with experience of degenerative knee disease suggests arthroscopic surgery offers little benefit and is not cost effective.
The research claimed arthroscopies rarely works for patients with degenerative knee disease
The assessment comes after the panel carried out a detailed analysis of the available evidence.
A linked review of 13 random control trials and 12 observational studies concluded the treatment did not reap “important benefits” in pain or function.
Researchers found that when compared with “conservative management” surgery resulted in a very small reduction in pain up to three months following the procedure and very small or no pain reduction up to two years later.
They also found knee arthroscopy results in a very small improvement in the short term and very small or no improved function up to two years after the operation.
Patient Casey Quinlan said: “Knee arthroscopy has been oversold as a cure-all for knee pain.
“Mine was nowhere near what I had been told it would be, function and pain level were only marginally improved.”
Degenerative arthritis is a group of conditions where the main problem is damage to the cartilage which covers the ends of the bones.
Painful and debilitating degenerative knee arthritis affects around 4 million people in the UK.
Mark Wilkinson, Professor of Orthopaedics at the University of Sheffield and Arthritis Research UK spokesman, said: “Previous studies have shown knee arthroscopy is not recommended for the symptoms of pain and loss of function for people with degenerative knee arthritis.
“People with mechanical symptoms, such as locked knee, are more likely to benefit for this type of surgery. Current guidelines support this.
Each year around two million people receive the keyhole surgery but experts say it has been oversold
“Anyone with pain and loss of function in their knee joints will find benefit from lifestyle modification, exercise, physiotherapy, suitable pain medication, or joint replacement when non-surgical treatment becomes no longer effective.”
Publishing their findings in the BMJ the experts said: “We make a strong recommendation against the use of arthroscopy in nearly all patients with degenerative knee disease, based on linked systematic reviews.
“Further research is unlikely to alter this recommendation.”
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