Study Questions Value of Common Knee Surgery
Procedure to repair a torn meniscus worked no better than a fake one to ease lingering pain
"It's a wonderfully designed study, amazing," said Felson.
Both groups improved after surgery. Remarkably, those who'd had the sham procedure reported improvements in pain and function that were nearly identical to those who'd had actual meniscal repairs. Average improvement for both groups ranged from about 20 to 30 points on 100-point pain scales.
What's more, most patients in both groups were satisfied with their results. The study found 77 percent in the surgery group said they were happy with the outcome versus 70 percent who had nothing done, and 89 percent in the surgery group reported improvement in their knee pain compared to 83 percent in the placebo group. Nearly all said they'd be willing to repeat the procedure again -- 93 percent of the surgery group versus 96 percent of those who'd had the fake procedure.
"I'm expecting a roar from the orthopedic community. This is the most common orthopedic procedure," said study author Dr. Teppo Jarvinen, a resident in the department of orthopedics and traumatology at Helsinki University Central Hospital in Finland.
"I don't expect people to be happy about somebody showing that the stuff that they had been doing isn't any better than a sham procedure, but what can I do? That's the evidence," he said.
A study published in the same journal in March found that surgery was no better for knee pain than physical therapy for patients with more advanced disease -- those with meniscal tears who also had osteoarthritis.
Despite the latest round of discouraging results, several experts said it was important not to overgeneralize the latest findings.
"I think we should be careful making the blanket conclusion that there's no role for meniscus surgery," said Dr. Scott Rodeo, an attending orthopedic surgeon at the Hospital for Special Surgery in New York City.
Rodeo said he thought meniscal repair could still be helpful for patients who experience mechanical symptoms like clicking and catching when they move their knee.
And Felson said meniscal repairs might still be useful for people who suddenly injure their knees, like those who play sports.