Arthroscopy is still commonly being performed on people with osteoarthritis (OA) of the knee despite evidence against the effectiveness of the surgical procedure for this condition, according to research published in the October 1 issue of the Medical Journal of Australia.
Although the number of knee arthroscopies had declined overall, rates had remained steady in those with osteoarthritis in the 9 years to 30 June 2009, according to Dr Megan Bohensky from the Centre of Research Excellence in Patient Safety and coauthors, who studied usage patterns in Victorian hospitals.
According to the authors, research published 10 years ago and backed by subsequent studies questions the benefit of knee arthroscopy in patients with osteoarthritis.
“Because arthroscopic procedures can be associated with complications, it is important that they are used only when they are likely to have measurable positive outcomes”, the authors wrote.
“Given the uncertain evidence of effectiveness, general practitioners should encourage patients with OA of the knee who have no evidence of major mechanical derangement to try non-surgical treatments in the first instance”, they wrote.
In an accompanying editorial, Professor Rachelle Buchbinder, director of Monash Department of Clinical Epidemiology, Cabrini Health and Professor Ian Harris from the South Western Sydney Clinical School, University of New South Wales wrote that it was difficult to “shift the convictions of many surgeons”.
They wrote that in contrast to new drugs, promising new surgical interventions continued to be introduced into practice before their proper evaluation.
“The use of arthroscopy for knee osteoarthritis has been allowed to continue, exposing patients to an intervention that is at best ineffective, and at worst, harmful”, they wrote.
The Medical Journal of Australia is a publication of the Australian Medical Association.