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A recent systematic review concluded that arthroscopic surgery for degenerative knee disease (including arthritis and meniscal tears) did not result in lasting pain relief or improved function. As a result, panelists strongly recommend against arthroscopy for patients with degenerative knee disease.
The review (Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline- May 2017) was published in BMJ.
According to the review, about 25 percent of people older than 50 years of age experience pain from degenerative knee disease (the percentage rises with age), and costs for arthroscopies for this condition are in excess of $3 billion per year in the United States. Furthermore, only 15 percent of arthroscopy patients reported a small or very small improvement in pain or function at three months post surgery, and those benefits were not sustained at one year post surgery.
In place of arthroscopy, panelists recommend effective alternatives including an individualized regimen combining rest, weight loss as needed, a variety of treatments provided by a physical therapist, exercise and nonsteroidal anti-inflammatory drugs.
In an interview with the New York Times, Dr. Reed A.C. Siemieniuk, a methodologist at McMaster University in Hamilton, Ontario, Canada, and chairman of the panel, said, “Arthroscopic surgery has a role, but not for arthritis and meniscal tears.” The procedure, he elaborated, “became popular before there were studies to show that it works, and we now have high-quality evidence showing that it doesn’t work.”
— American Physical Therapy Association
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