Have knee surgery or take a sugar pill? A new study based on a common knee surgery showed a placebo effect works the same as having the actual surgery. The study was published in the New England Journal of Medicine indicating that arthroscopic partial meniscectomy may actually be ineffective in reducing pain in patients. In most cases the surgery is done in order to reduce pain due to wear or from a previous injury.
The surgery is usually done on a torn meniscus using very small equipment, that includes a camera and miniscule surgical instruments that are threaded through small openings around the knee. The surgeon then removes floating debris and shaves away any damaged tissue that is found. It is thought that such pieces and shreds of tissue may be the cause of pain, indicating a potential need for knee surgery eventually. But it seems with more evidence over time, patients may not even be benefiting from having such a surgery performed in the first place.
This new randomized clinical study included patients that were ages 35 to 65 and had pain within their knee-joint for at least 3 months. 70 patients received the actual knee surgery and 76 patients received the fake surgery were the surgeon placed small incisions around the knee and just prodded around with no actual repair. No one but the surgeon actually knew that the surgery was faked or not. Everything was done using the same tools and by making sure the procedure was timed correctly. The patients never knew whether they had the surgery or not.
What really turned out interesting is that practically all the patients who went through the fake knee surgery reported improvements in pain and mechanical function nearly the same as those who had the procedure. On a 100 point pain scale, both groups reported improvements with pain around 20 to 30 points. The two groups also reported high satisfaction on their real or faked procedures, and most also said they would do the surgery again.
These findings more than likely will cause a lot of friction in the orthopedic field due to how common this knee surgery is. Many people may not be happy to hear that it’s no better than having a fake procedure done, but alas you cannot fake the results of such research studies. Another study published in the same journal also stated that there seemed to be no improvement with physical therapy and many patients also had osteoarthritis. As some doctors say not to jump to conclusions too quickly, the knee surgery may at least be helpful for those who have major clicking and catching when they move the joint.
About 700,000 people have this knee surgery a year. That is a lot of people going under the knife for a knee surgery that may not even be effective. The cost of this surgery also includes 4 billion U.S. dollars a year. Dr. David Jevseva, from American Academy of Orthopedic Surgeons, mentions that arthroscopy knee surgery is not always going to help problems many patients have. Although, this common knee surgery study shows how powerful the human brain can be when it comes down to the sugar pill/placebo effect.
By Tina Elliott