According to a research by Brian Feagan of the University of Western Ontario, published Thursday in the New England Journal of Medicine, a comparison of 178 patients showed that those who underwent arthroscopy had no advantage over those who took medication and went through physical therapy.
"We have definitive evidence that the procedure is ineffective... If it isn't effective, patients should not be undergoing it," Feagan wrote.
It is the second study with the same conclusion. A 2002 study made by Houston surgeon J. Bruce Moseley led to a halt on arthroscopy payments by Medicare, which resulted to a drop in number of claims for that type of surgery. Arthroscopy costs about $5,000 and is done on 950,000 American arthritis patients annually out of 27 million afflicted with the ailment.
The 2002 study was questioned by some medical experts because its subjects were all treated by one doctor and were all older males. After the 2002 study, about 300,000 knee surgeries were still being performed each year, Feagan said.
His study had male and female subjects averaging 60 years old. All underwent standard nonsurgical treatment such as physical therapy, painkillers including acetaminophen and ibuprofen, glucosamine supplements and injections to lubricate their joints. Eight-six of the group also had arthroscopy in which an instrument is inserted through tiny cuts to clean loose debris and smooth out the joints.
Feagan tested all patients every half year for the next two years and his findings showed both groups showed improvements. But Feagan admitted knee surgeries may still be needed by other patients with other problems such as a badly torn ligament or cartilage. Dr. Robert Marx, associate attending orthopedic surgeon at the Hospital for Special Surgery in New York agreed that knee operation could benefit arthritis patients who have co-existing knee problems like meniscal tear or a loose piece of cartilage.
