Wednesday, January 16, 2008

A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee

Moseley, J.B. et al. (July 2002). A Controlled Trial of Arthoscopic Surgery for Osteoarthritis of the Knee, The New England Journal of Medicine, Volume 347, Number 2, 81-88.

Over 650,000 knee surgeries are performed each year to relieve the pain of osteoarthritis. However, there is no evidence to support that arthroscopy cures or arrests osteoarthritis. Amazingly though, about half of the patients report relief from pain. This paper set out to see if the surgeries were being successful due to some direct medical benefit being received or whether they were equivalent to placebo, and thus successful for other, psychological reasons. The outcomes showed that arthroscopic lavage and arthroscopic debridement were in fact no better than a placebo procedure. Therefore, the successes being witnessed were likely related to placebo effect. (Ergo, researchers should not underestimate the power of placebo.)