A popular surgical procedure worked no better than fake operations in helping people with one common knee problem, suggesting that thousands of people may be undergoing unnecessary surgery, a new has study found.
The study compared surgical treatment of degenerative meniscal tears to placebo surgery.
A year after the procedure the study participants, both those in the group who underwent surgery and the ones in the placebo group, had an equally low incidence of symptoms and were satisfied with the overall situation of their knee.
"These results show that surgery is not an effective form of treatment in such cases. It's difficult to imagine that such a clear result would result in no changes to treatment practices," said Teppo Jarvinen from the University of Helsinki and the Helsinki University Central Hospital.
Knee problems – ones associated both with trauma and with aging – are highly common and place a significant burden on the health care system, researchers said.
The most common diagnosis of the knee that requires treatment is a tear in the meniscus, for which the established form of treatment is the partial removal of the meniscus through keyhole surgery.
"This operation has become the most common orthopaedic surgical procedure, or in fact any surgical procedure next to cataract surgery, in nearly all Western countries," said Raine Sihvonen, a specialist in orthopaedics and traumatology from Hatanpaa Hospital in Tampere.
Most of the treated meniscal tears are degenerative. This means that the tear was not caused by a traumatic incident on a healthy knee, but normal ageing.
Previous randomised studies have shown that keyhole surgery on the knee does not alleviate the symptoms of patients who suffer from osteoarthritis - whether the surgery would be for a meniscal tear or another complaint – and as a result, keyhole surgeries on arthritis sufferers have become less common.
At the same time, however, the number of partial meniscectomies has increased significantly, even though proof of the impact of the surgery on the symptoms has lacking.
The goal of the trial was to determine whether keyhole surgery to partially remove the meniscus (arthroscopic meniscal resection) is an effective form of treatment when the tear is caused by degeneration.
The study included 146 participants, ranging between 35 and 65 years of age.