Study Questions the Value of Knee Arthroscopy

Knee arthroscopy is a common procedure—more than 700,000 are performed each year in the U.S. But a new meta-analysis of studies involving knee arthroscopies reveals that they’re not very effective.

What is arthroscopy?

Knee arthroscopy is a minimally invasive procedure in which surgeons make small incisions to allow surgical tools and a small camera into the knee. The purpose is to trim away and remove loose or torn pieces of cartilage in the knee joint and sometimes also bumpy osteophytes.

In theory, arthroscopy should help relieve knee pain and improve function by clearing away loose or disconnected tissue that is interfering with the movement of the knee. It’s been used to treat problems like osteoarthritis, tendinosis, and/or meniscus tears.

However, evidence of its effectiveness has been mixed—and now a new review of studies adds even more doubt on its claims.

Arthroscopy’s benefits are small and temporary

The review looked at 9 studies that included 1,270 middle-aged or older patients who had both knee pain and evidence of cartilage or joint degeneration through an MRI scan. In the studies, some received an arthroscopy and others received no treatment or alternate, nonsurgical treatments.1

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The review revealed that those who had an arthroscopy had a little more pain relief than the nonsurgical groups, but only for 3 to 6 months. After 6 months, their results were no better than the others. When it came to knee function, the surgical groups had no significant improvements compared with the control groups.

Knee Injection
Knee injections can be an effective treatment option if more conservative measures are not offering symptom relief. Learn more: Steroid Injections

Even if arthroscopy produces few or no benefits, it might be worth trying if there were no dangers involved. But it’s a surgical procedure, so it has some risks just like any surgical option does. The review revealed that deep vein thrombosis was the most common adverse effect of arthroplasty, occurring in 4 of 1,000 cases. It can even cause death, although this is very rare.

A better alternative to arthroscopy

If you have knee pain and limited function, you may be wondering what your other treatment options are instead of arthroplasty. This same review found that one other intervention had a substantial impact for improving pain: exercise therapy. Studies in which participants exercised 3 times a week showed a large pain-relieving effect as a result.

Other treatment options for knee osteoarthritis that have proven benefits and few or no side effects include weight loss, heat or ice therapy, and use of braces or orthotics. Your doctor can also recommend medication options to treat pain and/or inflammation.

If nonsurgical treatments are not providing relief, there are also injections and multiple procedures that can be used to treat knee osteoarthritis, such as knee osteotomy, cartilage repair, and partial or total knee replacement.

Learn more

Reference:
  1. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ. 2015; 350 :h2747
Post written by Carrie DeVries