Arthroscopy useless in osteoarthritis of the knee | medicine transparent

Arthroscopy useless in osteoarthritis of the knee |  medicine transparent

Unfortunately, there are few effective treatments for osteoarthritis. Arthroscopy is not one of them.

Arthroscopy (reflection of the joints) may not relieve knee pain or improve mobility. It does not bring any benefit in knee arthrosis.

Stiff, painful joints are a widespread problem in old age. Cause: A breakdown of the normally protective layer of cartilage in the joint. Excessive or incorrect tension causes friction and swelling in the joint, making it painful and stiff. Osteoarthritis is most common in the knee and hip joints.

What does arthroscopy do for arthrosis?

People with osteoarthritis of the knee joint are often advised to have arthroscopy (joint reflex). Doctors use tiny cameras to look directly into the joint through small incisions. They usually assess not only the condition of the affected cartilage and meniscus: small interventions such as lavage of the joint or smoothing the surface of the cartilage are usually performed during arthroscopy. Goal: To “clean” the knee joint, that is, to remove loose cartilage particles and tissue fibers and thus reduce friction in the joint. This should reduce the pain.

However, there is a catch to what may seem logical: arthroscopy is of no use to those treating arthrosis. To this unequivocal conclusion comes a current review [1],


Studies clearly speak against benefits

A research team presented the most meaningful summary of all previously published studies on arthroscopy in osteoarthritis of the knee. In these studies, people treated for arthroscopy had significantly less pain or restricted mobility than those who received only sham treatment or no treatment at all. It was examined 3 months after the operation. There seemed to be no difference in quality of life either.

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Arthroscopy for osteoarthritis: not effective, but not too risky

Nonetheless, adverse events were not observed with a particularly high frequency in the arthroscopy groups. The procedure does not appear to be very risky, but the available data are not reliable enough to be ruled out entirely.

Austria Pays, Germany Doesn’t

In Germany, arthroscopy as a treatment for knee arthrosis has not been paid for by health insurance since 2016. Reason: Lack of effectiveness. In Austria, however, this does not bother health insurance companies. In this country, the cost of arthroscopy is always covered – there is no single reason why.


Osteoarthritis: What Helps?

Severe obesity and poor posture put pressure on the knee joint. This may promote the development of osteoarthritis at an early age. Losing weight can reduce pain and improve mobility in affected joints. Although rest isn’t a good idea with osteoarthritis, on the contrary: Proper exercise helps keep the joint stable, supplies the cartilage with nutrients and “lubricates” the joint. Aerobics, walking, yoga, swimming and cycling are good examples. [2,3], Pain-relieving medications may also provide short-term relief. However, osteoarthritis cannot be cured.

In many cases, an operation is necessary at some point, in which the affected joint is partially or completely replaced with an artificial joint prosthesis.

Suspicious remedy for osteoarthritis

The level of pain associated with arthrosis is usually very good and those affected seek effective treatment for it. It is also known by providers of various treatments and supplements whose benefits are questionable.

For example, we have already learned in other articles that dietary supplements chondroitin and with ointment DMSO are probably ineffective in osteoarthritis. It seems like magnetic resonance therapy bring no profit.

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Not proven because with very little research there is a benefit to the preparation hyaluronic acid, Pine Bark Extract, Devil’s claw, cat’s paw, Turmeric either rose powder,

Just as there has been little research on the effectiveness of some interventions, such as stem cell therapy And this pulsating magnetic field treatment, effectiveness of ultrasound therapy,

However, they can help vocal therapy such as Avocado and Soybean Oil either sunshine,

learn more

You can find more reliable information about osteoarthritis here www.gesundheitsinformation.de, Read more about when arthroscopy makes sense and when it doesn’t. Here,
Also provides a clear overview of the benefits of arthroscopy in German arthrosis Harding Center for Risk Literacy,

history:

  • June 23, 2022: During a renewed search, we found a current observation article. Their results reinforce the confidence in our original assessment.
  • 8/22/2014: First publication of the article.

Is it easy to understand? Did he answer your question?

study in detail

What studies were we looking for?

Anyone who swallows a medicine and is convinced of its effect will feel an effect – even if there is no active ingredient. This is called the placebo effect. Surgical intervention may have a greater placebo effect than medication – it is known from studies [4],

Therefore, to study whether people with osteoarthritis do better after arthroscopy, the best way to compare their symptoms is with a group of people who think they have had arthroscopy. In reality, however, there is only a so-called sham operation behind them. In a simulated operation, the patient is given anesthesia and an incision is made in the skin – nothing more. Of course, this only happens in the context of a clinical study and everyone involved gives their prior consent to participate.

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Such studies are the most reliable way to assess the effectiveness of arthroscopy. The review we found summarizes the results of four such studies involving 309 people. [1], Half of these people underwent arthroscopy to either flatten the meniscus or saline the joint. The other half had no or sham arthroscopy. After 3 months to 2 years, the participants had almost the same number of complaints, regardless of whether they were actually treated or not.

So we come to our assessment

We have great confidence in the result because

  • The reviews and studies summarized in it are both of high quality
  • And all studies come to very similar conclusions.

We think it is unlikely that future studies will reach very different conclusions.

scientific sources

[1] O’Connor, D., et al. (2022). “Arthroscopic surgery for degenerative knee disease (osteoarthritis including degenerative meniscal tears).” Cochrane Database Syst Rev 3(3):Cd014328. ,link to review paper,

[2] IQWiG (2021)
retrieved on 6/21/2022 www.gesundheitsinformation.de

[3] IQWiG (2021)
retrieved on 6/21/2022 www.gesundheitsinformation.de

[4] Kaptchuk, TJ, Goldman, P, Stone, DA, & Stasson, WB (2000). Have medical devices amplified the placebo effect? Journal of Clinical Epidemiology, 53(8), 786-792. ,link to study,

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