The long-term benefits of knee surgery for middle aged or older patients are outweighed by the negative consequences, a study has found.
Although rare, patients can suffer from infections, deep vein thrombosis, cardiovascular problems, pulmonary embolism and even death.
The research, led by the University of Southern Denmark, involved the analysis of 18 different studies and concluded that the “small, inconsequential benefit” only lasted one to two years after surgery.
Patients experienced less pain for the first six months after surgery − but not for any longer, while there was no effect on their ability to physically function at any stage.
The study authors concluded: “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.
Small, inconsequential benefit only lasted one to two years after surgery
“Knee arthroscopy is associated with harms. 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.”
The study is published in the BMJ as part of its Too Much Medicine campaign, which aims to highlight the waste of resources caused by unnecessary care and the potential harm it can cause.
In an accompanying editorial, Andy Carr, director of the NIHR Musculoskeletal Biomedical Research Unit in Oxford, said the procedure remains common and could even be increasing, but instances of deep vein thrombosis could be reduced if it was discontinued.
He said the evidence supporting knee arthroscopy was known to be weak, but suggested surgeons do not accept this as they are “falling prey” to bias.
“It is difficult to support or justify a procedure with the potential for serious harm, even if it is rare, when that procedure offers patients no more benefit than placebo,” he wrote.
He said he believes “we may be close to a tipping point” where the weight of evidence against the procedure is enough to overcome concerns about the quality of studies, bias and vested interests, and when that point is reached, “we should expect a swift reversal of established practice”.