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Do You Really Kneed Surgery?

Osteoarthritis is a painful condition caused by inflammation and cartilage breakdown in the joints. Over 600,000 knee-osteoarthritis patients undergo arthroscopic surgery each year because they are unable to find relief through other therapy. These $5,000 procedures - the most common orthopedic surgeries - have been shown to relieve pain in approximately half of patients, yet the basis for pain relief is unclear. In effect, this type of knee surgery may offer no real benefits.

In a recent study in The New England Journal of Medicine, 180 knee-osteoarthritis patients received one of two types of arthroscopic surgery (joint flushing or flushing plus surgical tissue removal) or placebo surgery, consisting of only skin incisions and simulated surgery, with no irrigation or insertion of instruments.

Neither surgery group reported less pain or greater function than the placebo group at any time over the two years after the procedure. Average scores on pain scales for each group were virtually the same at one year, and were in fact better for the placebo group. At two years, scores remained almost identical. Also, surgery groups did not experience greater improvements in function at any point, compared to the placebo group.

Billions of dollars are spent on arthroscopic knee surgeries every year, though they appear to provide no measurable benefits. The gains made by recipients may simply be due to a placebo effect; that is, surgery only helps them because they think it will. Factors known to contribute to knee osteoarthritis include obesity, injury, and overuse of the knees. Talk to your doctor of chiropractic about prevention and alternative treatment of this condition.


Moseley JB, O'Malley K, Petersen NJ, et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. The New England Journal of Medicine 2002:347(2), pp. 81-88.

For extremity-pain studies, click here.


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