Arthroscopic surgery may have no benefit for osteoarthritis of the knees5 years ago | Doctors
By pH health care professionals
If you have osteoarthritis, you know the pain that accompanies simple tasks like standing up or walking. So naturally, you want to do whatever you can to get some relief and get back to enjoying your life, pain-free. You talk to your doctor about treatment options, and perhaps you’ve been offered the option of arthroscopic knee surgery. Let’s review what this procedure is, its effectiveness, and what other options you can consider.
What is arthroscopic knee surgery?
Arthroscopy is a minimally invasive procedure that allows direct visualization of the interior of a joint through incisions as small as one centimeter in length, compared to the large incisions required with open surgery.
During the procedure, the orthopedic surgeon inserts the arthroscope (a small camera instrument about the size of a pencil) into the knee joint to visualize the structures of the knee. The arthroscope sends images to a monitor so the surgeon can see the knee structures in great detail. If surgical treatment is needed, the orthopedic surgeon will insert tiny instruments through another small incision. These instruments might be scissors, motorized shavers, or lasers.
Sometimes the surgeon flushes the joint with a saline solution (arthroscopic lavage) or smoothes rough cartilage and removes loose parts of the meniscus (arthroscopic debridement).
Is arthroscopic knee surgery effective for osteoarthritis?
Research seems to point toward non-surgical options for better outcomes. A 2002 clinical trial showed that outcomes from arthroscopic lavage and debridement were no better than the placebo. And more recently, a 2008 study also found no benefit with arthroscopic knee surgery for osteoarthritis compared with the non-surgical treatment options including physical and medical therapy. However, you should talk to your doctor and make a decision based on your specific, individual situation.
What are some non-surgical options?
If you discuss arthroscopic surgery with your doctor and determine it is not the best route for you, your doctor may recommend some of the following research-based approaches from the Osteoarthritis Research Society International:
- Education. Your doctor should educate you about what you can do to care for your knees so that you are empowered to take a more proactive role in the management and treatment of your osteoarthritis.
- Physical therapy. You may work with a physical therapist to reduce pain and improve knee function.
- Exercise. The right kind of exercise, such as water-based, can help you strengthen the muscles that support your knees and improve your range of motion.
- Maintaining a healthy weight. Carrying excess weight puts added stress and pressure on your knees.
- Walking assistance. Some people may need to use a cane or crutches to reduce the pain they experience while walking.
- Supportive footwear, insoles, knee braces. They can reduce pain and improve your ability to walk.
- Alternative medicine. Acupuncture, a form of Chinese medicine, has been shown to help with pain intensity in a trial of over 350 patients with knee osteoarthritis. You also may consider transcutaneous electrical nerve stimulation (TENS), which administers an electric current, which is believed to stop pain messages from reaching the brain.
- Drugs. Your doctor may recommend acetaminophen, non-steroidal anti-inflammatory drugs, corticosteroid injections or hyaluronic acid injections to give you some pain relief.
There are also other types of surgeries, including joint replacement, partial knee replacement, osteotomy (bones are cut and realigned) and joint fusion.
Talk to your doctor about how you can be proactive at home, and make sure you understand your treatment options so you can make an educated decision. If you need help, get an advocate on your side.
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