The Finnish Degenerative Meniscal Lesion Study (FIDELITY) compared surgical treatment of degenerative meniscal tears to placebo surgery. A year after the procedure the study participants, both those in the group who underwent surgery and the ones in the placebo group, had an equally low incidence of symptoms and were satisfied with the overall situation of their knee.
"These results show that surgery is not an effective form of treatment in such cases. It's difficult to imagine that such a clear result would result in no changes to treatment practices," state adjunct professor Teppo Jrvinen from the University of Helsinki and the Helsinki University Central Hospital, and Raine Sihvonen, a specialist in orthopaedics and traumatology from Hatanp Hospital in Tampere.
Knee problems ones associated both with trauma and with aging are highly common and place a significant burden on the health care system. The most common diagnosis of the knee that requires treatment is a tear in the meniscus, for which the established form of treatment is the partial removal of the meniscus through keyhole surgery (i.e., arthroscopy; a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision [Wikipedia]).
"This operation has become the most common orthopaedic surgical procedure, or in fact any surgical procedure next to cataract surgery, in nearly all Western countries. Nearly 12,000 partial meniscectomies are done in Finland every year. In the United States, the number is close to a million," explains Sihvonen.
Most of the treated meniscal tears are degenerative. This means that the tear was not caused by a traumatic incident on a healthy knee, but normal ageing.
Previous randomised studies have shown that keyhole surgery on the knee does not alleviate th
|Contact: Dr. Teppo Järvinen|
University of Helsinki