Risks of Arthroscopic Knee Surgery Outweigh Benefits

The benefits of arthroscopic surgery for middle-aged and older patients with degenerative knees do not outweigh the harms, according to the results of a recent study.

In order to better understand and evaluate the risks and benefits of arthroscopic knee surgery involving partial meniscectomy, debridement, or both, researchers conducted a systematic review and meta-analysis of data from 9 studies involving 1270 participants randomized to either surgical treatment or a number of control therapies including placebo and exercise.
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Overall, researchers identified a small but statistically significant improvement in pain in those participants who underwent surgery, but the improvement was only present during the 6 months post-surgery, and not beyond.

No benefits to physical function were found in those who underwent surgery over controls, and potential harms with surgery included deep vein thrombosis (4 per 1000 surgeries), infection (2 per 1000), pulmonary embolism (1 per 1000), and death (1 per 1000).

“The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time and absent at one to two years after surgery. Knee arthroscopy is associated with harms,” the researchers concluded.

“Taken together, these findings do not support the practice of arthroscopic surgery for middle aged or older patients with knee pain with or without signs of osteoarthritis.”

—Michael Potts

Reference:
Thorlund JB, Juhl CB, Roos EM, et al. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ. 2015;350:h274