Study: Skip Surgery for Knee OA

A new meta analysis from McMaster University in Canada has found that knee surgery isn’t necessary for mild osteoarthritis (OA). The study, just published in the Canadian Medical Association Journal (CMAJ), says middle-aged or older patients with mild or no knee OA may not benefit from the procedure of arthroscopic knee surgery.

Doctors need to be carefully weighing the costs and benefits when deciding who should undergo such surgery, says Dr. Moin Khan, principal investigator for the study and research fellow in orthopedic surgery in the Michael G. DeGroote School of Medicine.

“This study shows that surgery should not be the initial option for middle-aged or older patients, as there is limited evidence supporting partial meniscectomy surgery for meniscus tears, ” he said in the August 25, 2014 news release. “Other treatments should be used first.”

As indicated in the news release, the investigators evaluated seven published randomized control trials between 1946 and 2014 on the success of arthroscopic partial meniscectomy in patients with no to mild osteoarthritis compared to non-operative treatments. The sample total was 811 knees in 805 patients with a mean age of 56 years. In four trials, there was no short-term pain relief in the first six months after surgery for patients with some osteoarthritis; nor was their improvement in long-term function up to two years later in five trials.

Mohit Bhandari, M.D., professor and associate chair of research for McMaster’s surgery department, and study co-investigator confirmed the study’s conclusions. He noted, “Arthroscopic debridement or washout of knee osteoarthritis has come under lots of scrutiny based upon trials that suggest patients get no benefit from the procedure. We’re concerned that many surgeons worldwide may still be doing this procedure.”