Some Mostly Useless Procedures “Enrich the Pockets of Medical Practitioners”

(p. D5) Many of the procedures people undergo to counter chronic knee pain in the hopes of avoiding a knee replacement have limited or no evidence to support them. Some enrich the pockets of medical practitioners while rarely benefiting patients for more than a few months.

I wish I had known that before I had succumbed to wishful thinking and tried them all.

. . .

Serious questions are now being raised about the benefits of the arthroscopic procedures that millions of people endure in hopes of delaying, if not avoiding, total knee replacements.

The latest challenge, published in May [2017] in BMJ by an expert panel that systematically reviewed 12 well-designed trials and 13 observational studies, concluded that arthroscopic surgery for degenerative knee arthritis and meniscal tears resulted in no lasting pain relief or improved function.

Three months after the procedure, fewer than 15 percent of patients experienced at best “a small or very small improvement in pain and function,” effects that disappeared completely within a year.

As with all invasive procedures, the surgery is not without risks, infection being the most common, though not the only, complication.

Furthermore, the panel added, “Most patients will experience an important improvement in pain and function without arthroscopy.”

For the full commentary see:

Jane E. Brody. “Personal Health; What I Wish I’d Known About My Knees.” The New York Times (Tuesday, July 4, 2017 [sic]): D5.

(Note: ellipsis, and bracketed year, added.)

(Note: the online version of the commentary has the date July 3, 2017 [sic], and has the same title as the print version.)

The May 2017 BMJ academic review article mentioned above, is:

Siemieniuk, Reed A. C., Ian A. Harris, Thomas Agoritsas, Rudolf W. Poolman, Romina Brignardello-Petersen, Stijn Van de Velde, Rachelle Buchbinder, Martin Englund, Lyubov Lytvyn, Casey Quinlan, Lise Helsingen, Gunnar Knutsen, Nina Rydland Olsen, Helen Macdonald, Louise Hailey, Hazel M. Wilson, Anne Lydiatt, and Annette Kristiansen. “Arthroscopic Surgery for Degenerative Knee Arthritis and Meniscal Tears: A Clinical Practice Guideline.” BMJ 357 (May 10, 2017).

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