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.
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
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
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.
For extremity-pain studies, click here.