Knee Pain? This Common Surgery May Be No Help

Arthroscopic knee surgery may not benefit older adults

(RxWiki News) A common knee surgery to relieve pain may not be worth the risks for middle-aged and older patients.

A new study from Denmark found that arthroscopic surgery did not benefit, and may even harm, older and middle-aged patients with knee pain.

"The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time and absent at one to two years after surgery," wrote lead study author JB Thorlund, MD, a professor of sports medicine and orthopedic surgery at the University of Southern Denmark, and colleagues. "Knee arthroscopy is also associated with harms. Taken together, 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."

Arthroscopic surgery is a minimally invasive surgery on a joint. The surgery is performed using an arthroscope, a tiny camera that is inserted into the joint through a small incision.

According to these researchers, arthroscopic knee surgery with meniscus resection is commonly recommended for middle-aged or older patients with persistent knee pain.

The knees of these patients often show degenerative lesions of cartilage and other tissues, which suggests osteoarthritis.

Dr. Thorlund and team looked at nine past trials on arthroscopic knee surgeries with a combined total of 1,270 patients.

While a small benefit was found in pain improvement at the three to six-month mark after surgery for these patients, by the 24-month mark, this benefit had disappeared.

The surgery was also no better than other options, such as exercise, for improving physical function.

Some significant harms were also found, such as blood clots developing in the leg. Some patients also developed blood clots in the lungs or died from the procedure.

Dr. Thorlund and team concluded that the risks of arthroscopic surgery may outweigh the benefits for middle-aged and older patients with knee pain.

“Middle-aged patients with knee pain and meniscal tears should be considered as having early stage osteoarthritis and be treated according to clinical guidelines for knee osteoarthritis, starting with information, exercise, and often weight loss,” Dr. Thorlund and colleagues wrote.

This study was published in the July issue of The BMJ.

No funding sources were disclosed.

Study author Dr. Stefan Lohmander disclosed support from the Swedish Research Council. Dr. Lohmander also disclosed personal fees from Össur, Flexion Therapeutics, Medivir, Teijin, MerckSerono, Allergan and Galapagos. These companies make equipment or drugs used in treating arthritis.

Review Date: 
July 23, 2015