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Arthroscopy of the knee joint for arthrosis: No benefit detectable
Date:5/13/2014

ithout arthroscopy, such as glucocorticoid injections into the knee joint. The effect of these treatments on the daily activities and the quality of life of the people affected was of particular interest. Changes in the severity of symptoms and possible side effects of the treatments were also compared, for example infections after surgery.

Studies were subject to uncertainty

Eleven randomized controlled trials with a total of more than 1000 patients were identified for this research question, but a considerable number of them were subject to uncertainty. For example, in many cases the interventions were not blinded: The patients knew then whether or not they had arthroscopy. Sham arthroscopies can be done, however, in which patients receive a small skin incision on the knee, but no further surgery. This kind of "placebo surgery", albeit controversial, is particularly informative for the assessment.

No advantage over sham interventions

No benefit of therapeutic arthroscopy in comparison with sham surgery and no treatment could be derived from most study results, and no clear conclusion could be drawn on potential harm from adverse treatment effects. It was already known that invasive treatment methods often have a particularly strong placebo effect. However, the extent of improvement perceived by the patients after placebo arthroscopy in these studies was surprising.

The comparison with active interventions was also sobering. Arthroscopy had a slight advantage only in comparison with glucocorticoid injection into the knee joint: The symptoms were somewhat milder. The study did not provide any information about whether the quality of life of the people affected also improved in comparison with the injection.

Also no benefit in comparison with strengthening exercises

Data from patients who had gonarthrosis with damage of the medial meniscus were used for the comparison of arthroscopic
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Contact: Dr. Anna-Sabine Ernst
presse@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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